Amantadine hydrochloride
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 :
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 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
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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