Amantadine

Indications
 Oral
Influenza A
Adult: 100 mg daily for 5 days.
Elderly: >65 yr: Daily dose of <100 mg or 100 mg given at intervals >1 day.
CrCl (ml/min)Dosage Recommendation
>35100 mg daily.
15-35100 mg every 2-3 days.
<15Not recommended.

Oral
Prophylaxis of influenza A
Adult: 100 mg daily for up to 6 wk; when used with influenza vaccination: only up to 3 wk after vaccination.
Child: 10-15 yr: 100 mg daily.
CrCl (ml/min)Dosage Recommendation
>35100 mg daily.
15-35100 mg every 2-3 days.
<15Not recommended.

Oral
Herpes zoster in immunocompromised patients
Adult: 100 mg bid for 14 days, continued for another 14 days if pain persists.
CrCl (ml/min)Dosage Recommendation
>35100 mg daily.
15-35100 mg every 2-3 days.
<15Not recommended.

Oral
Parkinson's disease
Adult: Initially, 100 mg/day, increased to 100 mg bid after a wk or more. Max dose: 400 mg daily.
Elderly: >65 yr: Lowest effective dose.

Special Populations: Reduce dose in patients with renal impairment.
Contraindications
 Hypersensitivity. Pregnancy and lactation. Epilepsy or other seizure disorders, severe renal impairment and gastric ulceration.
Warnings / Precautions
 Patients with CV or liver disease, impaired renal function, recurrent eczema. Elderly. Withdrawal of the drug should be gradual.
Adverse Reactions
 Seizures, psychosis, hallucinations, confusion, ataxia, heart failure, depression, orthostatic hypotension, blood dyscrasias, urinary retention, irritability, GI disturbances, anorexia, livedo reticularis, ankle oedema.
Potentially Fatal: Congestive heart failure, convulsions.
Overdose Reactions
 Cardiac arrest may occur.
Drug Interactions
 Enhances the adverse effects of antimuscarinics and levodopa. CNS stimulants, drugs that raise urinary pH.
See Below for More amantadine Drug Interactions
Mechanism of Actions
 Amantadine is a weak dopamine agonist possessing antimuscarinic properties. It alters dopamine release and re-uptake. It also noncompetitively antagonises N-methyl-D-aspartate. As an antiviral drug, it inhibits replication of influenza type A virus.
Absorption: Readily absorbed from the GIT (oral); peak concentrations after 4 hrs.
Distribution: Crosses the placenta and the blood-brain barrier; enters breast milk. Protein binding: 67%.
Excretion: Mainly via urine by glomerular filtration and tubular secretion (as unchanged and small amounts of an acetylated metabolite); 11-15 hrs (elimination half-life), significantly prolonged in the elderly and renal impairment; may be increased by acidification of the urine.
Administration
 Should be taken with food.
Storage Conditions
 Oral: Store at 20-25°C.
ATC Classification
 N04BB01 - amantadine ; Belongs to the class of adamantine derivative dopaminergic agents. Used in the management of Parkinson's disease.
Storage
 Oral: Store at 20-25°C.
Available As
  • Amantadine 100 mg

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