Amantadine

Administration

  • Type: Antiviral, anticholinergics
  • Dosage Forms: capsule or tablet, syrup
  • Routes of Administration: Oral
  • Common Trade Names: Gocovri

Adult Dosing

Influenza A

  • 100 mg BID or 200 mg daily PO

Parkinsonism, extrapyramidal disease

  • 100-200 mg BID

Neuroleptic malignant syndrome

  • 100mg PO initially
  • Titrate up as needed to max dose 200mg q12hr

Pediatric Dosing

Influenza, 1-9 years old

  • 2.2-4.4 mg/kg PO BID

Influenza, >9 years old

  • 100 mg PO BID

Special Populations

  • Pregnancy Rating: C
  • Lactation risk: Infant risk cannot be ruled out
  • Renal dosing:
    • CrCl 30-50 mL/min: 200 mg PO on first day, then 100 mg/day
    • CrCl 15-29 mL/min: 200 mg PO on first day, then 100 mg every other day
    • CrCl <15 mL/min or on HD: 200mg weekly
  • Hepatic dosing: not defined

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

  • CHF, hypotension, dysrhythmia, tachycardia, cardiac arrest
  • Pulmonary edema, acute respiratory failure
  • Malignant melanoma
  • Leukopenia, agranulocytosis, neutropenia
  • Neuroleptic malignant syndrome
  • Suicidal ideation

Common

  • Nausea, diarrhea, constipation, lack of appetite
  • Headache
  • Fatigue, dizziness, confusion, ataxia
  • Anxiety, insomnia, depression, irritability, hallucinations, dream disorder
  • Orthostatic hypotension
  • Peripheral edema

Pharmacology

  • Half-life: 10-25h
  • Metabolism: Not appreciably metabolized; small amounts of acetyl metabolite identified
  • Excretion: Renal

Mechanism of Action

  • Interferes with the function of viral M2 protein, preventing release of viral nucleic acids into host cell

Comments

See Also

References