Amantadine hydrochloride

CLINICAL USE

  • Parkinson’s disease (but not drug inducedextrapyramidal symptoms)
  • Post-herpetic neuralgia
  • Prophylaxis and treatment of influenza A

    DOSE IN NORMAL RENAL FUNCTION

  • Parkinson’s disease: 100 mg once a day,increased after one week to 100–200 mg
    twice a day
  • Post-herpetic neuralgia: 100 mg twice aday for 14 days
  • Influenza A: treatment – 100 mg once aday for 4–5 days; prophylaxis – 100 mg
    once a day

    PHARMACOKINETICS

  • Molecular weight                           :
    187.7
  • %Protein binding                           :
    67
  • %Excreted unchanged in urine     :
    90
  • Volume of distribution (L/kg)       :
    5–10
  • half-life – normal/ESRD (hrs)      :
    15/500

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

    35–50 100 mg every 24 hours
    15–35 100 mg every 48–72 hours
    <15
    100 mg every 7 days

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :
    Not dialysed. Dose as in
    GFR <10 mL/min
  • HD                     :
    Not dialysed. Dose as in
    GFR <10 mL/min
  • HDF/high flux   :
    Unknown dialysability. Dose as in
    GFR<15 mL/min
  • CAV/VVHD      :
    Unknown dialysability. Dose as in
    GFR=15–35 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • Memantine: increased risk of CNStoxicity – avoid concomitant use; effects of
    amantadine possibly enhanced

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

  • Peripheral oedema may occur in somepatients; should be considered when
    the drug is prescribed for those with
    congestive heart failure
  • Side effects are often mild and transient;usually appear within 2–4 days of
    treatment and disappear 24–48 hours after
    discontinuation of the drug
  • Due to extensive tissue binding, <5% of a

    dose is removed by a 4 hour haemodialysis
    session

  • A reduction in creatinine clearance to40 mL/min may result in a 5-fold increase
    in elimination half-life
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