Amantadine

Amantadine Brand Names

GOCOVRI | OSMOLEX ER | Symmetrel

What is Amantadine

Amantadine is a synthetic antiviral agent with dopamine agonist properties.

It was introduced as an agent for prophylaxis of seasonal influenza A and was later found to cause symptomatic improvement in parkinsonism.

While approved for the prophylaxis and treatment of influenza A, the Centers for Disease Control and Prevention (CDC) recommends against using amantadine due to the development of resistant strains.

Amantadine is indicated for motor symptoms associated with Parkinson’s disease or drug-induced extrapyramidal reactions.

An extended-release capsule is used for the treatment of dyskinesia in patients with Parkinson’s disease receiving levodopa-based therapy.

Amantadine may be used off-label for multiple sclerosis-associated fatigue, neuroleptic malignant syndrome, and chorea associated with Huntington’s Disease.

During treatment of chronic conditions, practitioners should monitor for anticholinergic effects, new or worsening impulse control symptoms, or patient reports of falling asleep during activities of daily living.

Indications

  1. drug-induced extrapyramidal symptoms
  2. dyskinesia
  3. fatigue
  4. Huntington’s Disease (Huntington’s Chorea)
  5. influenza A virus
  6. influenza A virus infection
  7. neuroleptic malignant syndrome
  8. Parkinson’s disease
  9. parkinsonism
  10. seasonal influenza prophylaxis

Side Effects

  1. abnormal dreams
  2. agitation
  3. agranulocytosis
  4. amnesia
  5. anaphylactoid reactions
  6. anorexia
  7. antimicrobial resistance
  8. anxiety
  9. arrhythmia exacerbation
  10. arthralgia
  11. ataxia
  12. blurred vision
  13. cardiac arrest
  14. cataracts
  15. coma
  16. confusion
  17. constipation
  18. corneal edema
  19. corneal opacification
  20. cough
  21. delirium
  22. depression
  23. diarrhea
  24. dizziness
  25. drowsiness
  26. dysarthria
  27. dysphagia
  28. dyspnea
  29. dystonic reaction
  30. edema
  31. elevated hepatic enzymes
  32. euphoria
  33. fatigue
  34. fever
  35. hallucinations
  36. headache
  37. heart failure
  38. hyperbilirubinemia
  39. hyperhidrosis
  40. hyperkinesis
  41. hypertension
  42. hypertonia
  43. impulse control symptoms
  44. infection
  45. insomnia
  46. irritability
  47. keratitis
  48. leukocytosis
  49. leukopenia
  50. libido decrease
  51. libido increase
  52. livedo reticularis
  53. mania
  54. muscle cramps
  55. mydriasis
  56. nausea
  57. neuroleptic malignant syndrome
  58. neutropenia
  59. orthostatic hypotension
  60. paranoia
  61. paresthesias
  62. peripheral edema
  63. photosensitivity
  64. pruritus
  65. psychosis
  66. pulmonary edema
  67. rash
  68. seizures
  69. sinus tachycardia
  70. sudden sleep onset
  71. suicidal ideation
  72. tachypnea
  73. tremor
  74. urinary retention
  75. visual impairment
  76. vomiting
  77. weakness
  78. withdrawal
  79. xerophthalmia
  80. xerostomia

Monitoring Parameters

  • neurologic function
  • serum creatinine/BUN

Contraindications

  • abrupt discontinuation
  • amantadine hypersensitivity
  • anticholinergic medications
  • breast-feeding
  • children
  • closed-angle glaucoma
  • coadministration with other CNS depressants
  • depression
  • dialysis
  • driving or operating machinery
  • eczema
  • ethanol ingestion
  • geriatric
  • heart failure
  • hepatic disease
  • impulse control symptoms
  • infants
  • infertility
  • melanoma
  • narcolepsy
  • neonates
  • orthostatic hypotension
  • peripheral edema
  • pregnancy
  • psychosis
  • renal failure
  • renal impairment
  • rimantadine hypersensitivity
  • schizophrenia
  • seizure disorder
  • sleep apnea
  • substance abuse
  • suicidal ideation
  • syncope

Interactions

  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Pentazocine
  • Alosetron
  • Ambenonium Chloride
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amoxapine
  • Amphetamine; Dextroamphetamine Salts
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Atropine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benzphetamine
  • Benztropine
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bupropion
  • Bupropion; Naltrexone
  • Caffeine
  • Caffeine; Ergotamine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Chlordiazepoxide; Clidinium
  • Chlorpromazine
  • Clomipramine
  • Clozapine
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Cyclobenzaprine
  • Darifenacin
  • Desipramine
  • Dexmethylphenidate
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Dicyclomine
  • Diethylpropion
  • Disopyramide
  • Donepezil
  • Donepezil; Memantine
  • Doxepin
  • Ethanol
  • Ezogabine
  • Fesoterodine
  • Flavoxate
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Galantamine
  • Glycopyrrolate
  • Glycopyrrolate; Formoterol
  • Homatropine; Hydrocodone
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hyoscyamine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Imipramine
  • Indacaterol; Glycopyrrolate
  • Intranasal Influenza Vaccine
  • Levodopa
  • Loperamide
  • Loperamide; Simethicone
  • Maprotiline
  • Memantine
  • Mepenzolate
  • Meperidine; Promethazine
  • Mesoridazine
  • Methamphetamine
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methscopolamine
  • Methylphenidate
  • Metoclopramide
  • Modafinil
  • Molindone
  • Nortriptyline
  • Olanzapine
  • Orphenadrine
  • Oxybutynin
  • Pemoline
  • Pentazocine
  • Pentazocine; Naloxone
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenothiazines
  • Phenylephrine; Promethazine
  • Prochlorperazine
  • Promethazine
  • Propantheline
  • Protriptyline
  • Quinidine
  • Rivastigmine
  • Scopolamine
  • Sedating H1-blockers
  • Solriamfetol
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Tacrine
  • Talimogene Laherparepvec
  • Thiethylperazine
  • Thioridazine
  • Thiothixene
  • Tolterodine
  • Triamterene
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trihexyphenidyl
  • Trimethoprim
  • Trimipramine
  • Trospium
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