Amantadine

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  • Class of drug: Treatment for Parkinson’s disease, antiviral agent.
  • Mechanism of action: Anti-Parkinson action: promotes release of dopamine in substantia nigra. Antiviral action: prevents viral penetration of influenza A virus into target host cells.
  • Indications/dosage/route: Oral only.
    Parkinson’s disease
    Ð Adults: 100 mg b.i.d., may be titrated up. Maximum: 400 mg/d.
    Influenza A: Ð Adults: 200 mg/d, single or divided dose.
  • Adjustment of dosage:
    Kidney disease: reduce dose as follows. Creatinine clearance 30–50 mL/min: initial 200 mg, then 100 mg/d; creatinine clearance 15–29 mL/min: initial 200 mg, then 100 mg q.i.d.; creatinine clearance <15 mL/min: 200 mg q7d.
    • Liver disease: None
    • Elderly: Dosage should be divided as twice daily administration.
    Contraindications: Hypersensitivity to amantadine, untreated angle-closure glaucoma.
  • Warnings/precautions: Use with caution in patients with the following conditions:
    Psychiatric disorders, liver or kidney disease, history of epilepsy, peripheral edema, orthostatic hypotension, severe psychosis, eczematoid dermatitis, exposure to rubella.
    • There is a possibility of seizures if given with CNS stimulants or in patients with history of epilepsy.
    • Do not stop abruptly when treating Parkinson’s disease.
    • Deaths from amantadine overdose have been reported.
    Adverse reactions: Common: dizziness, insomnia.
    • Serious: CHF, seizures, hallucinations, depression, psychosis, bone marrow depression, livedo reticularis, renal toxicity.

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