Rimantadine

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

  1. abdominal pain
  2. agitation
  3. anorexia
  4. antimicrobial resistance
  5. anxiety
  6. asthenia
  7. ataxia
  8. AV block
  9. bronchospasm
  10. confusion
  11. constipation
  12. cough
  13. depression
  14. diaphoresis
  15. diarrhea
  16. dizziness
  17. drowsiness
  18. dysgeusia
  19. dyspepsia
  20. dysphagia
  21. dyspnea
  22. edema
  23. euphoria
  24. fatigue
  25. fever
  26. galactorrhea
  27. hallucinations
  28. headache
  29. heart failure
  30. hyperkinesis
  31. hypertension
  32. hypoesthesia
  33. increased urinary frequency
  34. insomnia
  35. lacrimation
  36. nausea
  37. ocular pain
  38. pallor
  39. palpitations
  40. parosmia
  41. rash
  42. seizures
  43. sinus tachycardia
  44. stomatitis
  45. syncope
  46. tinnitus
  47. tremor
  48. vomiting
  49. 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
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