What is Rimantadine
Rimantadine is an oral antiviral agent indicated for the prophylaxis and treatment of seasonal influenza A virus infections in adults and for prophylaxis only in children.
Rimantadine is chemically and structurally related to amantadine, but rimantadine lacks the central nervous system effects seen with amantadine.
These 2 drugs differ significantly in their pharmacokinetics, with rimantadine achieving higher concentrations in respiratory secretions.
The pharmacokinetic properties of rimantadine may account for its more favorable side effect profile. The prophylactic efficacy of rimantadine is comparable to that of amantadine when these agents are administered in equivalent dosages of 200 mg/day.
Both drugs provide therapeutic benefit if administered early in cases of uncomplicated influenza. However, antivirals should not be used as substitutes for influenza virus vaccination, which remains the main option for reducing the impact of seasonal influenza.
The Centers for Disease Control and Prevention (CDC) and the Infectious Diseases Society of America (IDSA) recommend that adamantanes not be used for the treatment or prophylaxis of currently circulating influenza A viruses due to high resistance among H3N2 and H1N1 strains.
The neuraminidase inhibitors oseltamivir or zanamivir are preferred.
Brand Name
Flumadine
Indications
- influenza A virus
- influenza A virus infection
- seasonal influenza prophylaxis
Side Effects
- abdominal pain
- agitation
- anorexia
- antimicrobial resistance
- anxiety
- asthenia
- ataxia
- AV block
- bronchospasm
- confusion
- constipation
- cough
- depression
- diaphoresis
- diarrhea
- dizziness
- drowsiness
- dysgeusia
- dyspepsia
- dysphagia
- dyspnea
- edema
- euphoria
- fatigue
- fever
- galactorrhea
- hallucinations
- headache
- heart failure
- hyperkinesis
- hypertension
- hypoesthesia
- increased urinary frequency
- insomnia
- lacrimation
- nausea
- ocular pain
- pallor
- palpitations
- parosmia
- rash
- seizures
- sinus tachycardia
- stomatitis
- syncope
- tinnitus
- tremor
- vomiting
- xerostomia
Monitoring Parameters
- LFTs
- serum creatinine/BUN
Contraindications
- amantadine hypersensitivity
- breast-feeding
- children
- geriatric
- hepatic disease
- infants
- neonates
- pregnancy
- renal failure
- renal impairment
- rimantadine hypersensitivity
- seizure disorder
- seizures
Interactions
- Talimogene Laherparepvec