Amantadine hydrochloride

CLINICAL USE

  • Parkinson’s disease (but not drug induced

    extrapyramidal 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 a

    day for 14 days

  • Influenza A: treatment – 100 mg once a

    day for 4–5 days; prophylaxis – 100 mg
    once a day

    PHARMACOKINETICS


  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    187.7
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    67
  • %Excreted unchanged in urine &nbsp &nbsp :
    90

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :
    5–10

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :
    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 &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:
    Not dialysed. Dose as in
    GFR <10 mL/min

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

    IMPORTANT DRUG INTERACTIONS


    Potentially hazardous interactions with other drugs

  • Memantine: increased risk of CNS

    toxicity – avoid concomitant use; effects of
    amantadine possibly enhanced

    ADMINISTRATION


    Reconstition


    –

    Route


    Oral

    Rate of Administration


    –

    Comments


    –

    OTHER INFORMATION

  • Peripheral oedema may occur in some

    patients; 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 to

    40 mL/min may result in a 5-fold increase
    in elimination half-life

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