Details About Generic Salt ::  Amantadi

Main Medicine Class:: Antiparkinson, Antiviral   

(uh-MAN-tuh-deen HIGH-droe-KLOR-ide)
Symmetrel
Tablets: 100 mg
Syrup: 50 mg/5 mL
Amantadine HCl
Capsules: 100 mg
Endantadine
PMS-Amantadine
Symmetrel
Class: Antiparkinson, Antiviral

 

Drugs Class ::

 Action Exact mechanism is unknown; thought to facilitate dopamine release from intact dopaminergic terminals, increasing dopamine concentration at dopaminergic terminals. Exhibits antiviral activity against influenza A virus by inhibiting entry of virus into host cell.

Indications for Drugs ::

 Indications Symptomatic treatment of several forms of Parkinson disease or syndrome and drug-induced extrapyramidal reactions; prevention and treatment of influenza A viral respiratory illness, especially in high-risk patients.

Drug Dose ::

 Route/Dosage

Parkinson Disease

ADULTS: PO 100 mg bid when used as single agent. Initial dose: PO 100 mg/day if patient is debilitated or receiving high doses of other antiparkinson drugs. If necessary, dose may be titrated to max of 400 mg/day.

Drug-Induced Extrapyramidal Reactions

ADULTS: PO 100 mg bid; up to 300 mg/day may be given in divided doses.

Influenza A Viral Infection (Symptomatic Treatment)

ADULTS: PO 200 mg/day as single dose or 100 mg bid. If CNS effects develop on a once-daily dosage, split dosage schedule may reduce complaints.

ELDERLY ³ 65 Yr: PO 100 mg qd.

CHILDREN 9 to 12 yr: PO 100 mg bid.

CHILDREN 1 to 9 yr: PO 4.4 to 8.8 mg/kg/day; not to exceed 150 mg/day.

Renal Impairment

ADULTS: PO Ccr 30 to 50 mL/min: Administer 200 mg first day followed by 100 mg daily thereafter; Ccr 15 to 29 mL/min: Administer 200 mg first day followed by 100 mg on alternate days; Ccr < 15 mL/min and hemodialysis patients: Administer 200 mg every 7 days.

Influenza A Viral Infection (Prophylaxis)

Same dosages as for symptomatic treatment. However, start in anticipation of contact or as soon as possible after exposure. Continue drug administration for ³ 10 days after known exposure. When influenza A virus vaccine is unavailable or contraindicated, administer amantadine for up to 90 days. In conjunction with the vaccine, administer amantadine for 2 to 3 wk after vaccination.

Contraindication ::

 Contraindications Standard considerations.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Excreted in breast milk. Newborns and Infants (< 1 yr): Safety and efficacy not established. Elderly: Decreased dosage is necessary. CHF: CHF has developed in patients taking amantadine. Renal Impairment: Reduced dose is required in renal impairment. Seizures: Reduced dose is necessary in patients with prior seizure disorders, including epilepsy. Suicide: Successful suicide and suicide attempts have been reported in patients with and without a history of psychiatric illness. Glaucoma: Because amantadine has anticholinergic effects and may cause mydriasis, do not give to patients with untreated angle-closure glaucoma. Hepatic Impairment: Use with caution. Neuroleptic Malignant Syndrome: Neuroleptic malignant syndrome may occur in association with dose reduction or withdrawal of amantadine therapy. Special Risk Patients: Use with caution in patients with a history of recurrent eczematoid rash, psychosis, or severe psychoneurosis not controlled by chemotherapeutic agents.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CNS: Lightheadedness; dizziness; insomnia; depression; anxiety; irritability; hallucinations; confusion; ataxia; headache. EENT: Visual disturbances. GI: Nausea; anorexia; constipation; dry mouth. OTHER: Livedo reticularis; peripheral edema; orthostatic hypotension.

Drug Mode of Action ::  

 Action Exact mechanism is unknown; thought to facilitate dopamine release from intact dopaminergic terminals, increasing dopamine concentration at dopaminergic terminals. Exhibits antiviral activity against influenza A virus by inhibiting entry of virus into host cell.

Drug Interactions ::

 Interactions

Anticholinergic Agents, Quinidine, Quinine, Triamterene, Thiazide Diuretics, Trimethoprim-Sulfamethoxazole

May increase the effects of amantadine.

CNS Stimulants

The effects of the CNS stimulant may be increased by amantadine.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note cardiac or renal disease.
  • Assess for psychotic or abnormal behavior during therapy.
  • Assess for suppression of parkinsonian symptoms during therapy.
  • Monitor cardiac, GI, and GU functioning throughout therapy.
  • In patients with prior seizure disorders, observe patient carefully. Notify health care provider immediately if seizures occur.
  • Notify health care provider if orthostatic hypertension develops.

Drug Storage/Management ::

 Administration/Storage

  • Administer after meals or with food.
  • Do not administer at bedtime because drug may cause insomnia.
  • Store in tightly closed container in cool location.

Drug Notes ::

 Patient/Family Education

  • Explain that full effectiveness of medication may not occur for several days after initiation of drug therapy.
  • When medication is used for Parkinson disease, explain that doses will be tapered gradually before stopping.
  • Advise patient that during first week of therapy, blurred vision, redness, and mottling of skin are common, but these signs and symptoms will subside later.
  • Instruct patient to take sips of water frequently, suck on ice chips or sugarless hard candy, or chew sugarless gum if dry mouth occurs.
  • Instruct patient to avoid sudden position changes to prevent orthostatic hypotension.
  • Advise patient that drug may cause drowsiness, and to use caution while driving or performing other tasks requiring mental alertness.
  • Warn patient to avoid alcoholic beverages.
  • Instruct patient not to take otc medications without consulting health care provider.
  • Instruct patient to notify health care provider if dizziness or lightheadedness, mood or mental changes, swelling of extremities, difficulty urinating, or shortness of breath occur.

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