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amantadine (Oral route)

Pronunciation

a-MAN-ta-deen

Commonly used brand name(s)

In the U.S.

  • Symmetrel

Available Dosage Forms:

  • Capsule, Liquid Filled
  • Solution
  • Tablet
  • Capsule
  • Syrup

Therapeutic Class: Antiparkinsonian

Pharmacologic Class: Anticholinergic

Chemical Class: Adamantane

Uses For amantadine

Amantadine is an antiviral medicine. It is used to prevent or treat certain influenza (flu) infections (type A). It may be given alone or along with flu shots. Amantadine will not work for colds, other types of flu, or other virus infections.

Amantadine is also an antidyskinetic medicine. It is used to treat Parkinson's disease, which is sometimes called paralysis agitans or shaking palsy. It may be given alone or with other medicines for Parkinson's disease. By improving muscle control and reducing stiffness, amantadine allows more normal movements of the body as the disease symptoms are reduced. Amantadine is also used to treat stiffness and shaking caused by certain medicines that are used to treat nervous, mental, and emotional conditions.

Slideshow: Top 11 Reasons Why You Should Get Your Flu Vaccine Now

Amantadine is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, amantadine is used in certain patients with the following medical condition:

  • Unusual tiredness or weakness associated with multiple sclerosis

Before Using amantadine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For amantadine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to amantadine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of amantadine in children. Safety and efficacy have not been established in children younger than 1 year of age.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of amantadine in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart disease which may require an adjustment in the dose for patients receiving amantadine.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking amantadine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using amantadine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Potassium Chloride

Using amantadine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Bupropion

Using amantadine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Betel Nut
  • Bromperidol
  • Triamterene
  • Trimethoprim

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of amantadine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Congestive heart failure or
  • Eczema, recurrent, history of or
  • Epilepsy or seizures, history of or
  • Liver disease or
  • Low blood pressure (hypotension) or
  • Neuroleptic malignant syndrome (NMS), history of or
  • Peripheral edema (swelling of the hands, ankles, or feet) or
  • Psychosis (a mental disease), history of—Use with caution. May make these conditions worse.
  • Glaucoma, angle-closure, untreated (narrow-angle glaucoma)—Should not be used in patients with this condition.
  • Kidney disease—Use with caution. The effects of amantadine may be increased because of slower removal from the body.

Proper Use of amantadine

For patients taking amantadine to prevent or treat flu infections:

  • Talk to your doctor about the possibility of getting a flu shot if you have not had one yet.
  • amantadine is best taken before exposure, or as soon as possible after exposure, to people who have the flu.
  • To help keep yourself from getting the flu, keep taking amantadine for the full time of treatment. Or if you already have the flu, continue taking amantadine for the full time of treatment even if you begin to feel better after a few days. This will help to clear up your infection completely. If you stop taking amantadine too soon, your symptoms may return. amantadine should be taken for at least 2 days after all your flu symptoms have disappeared.
  • amantadine works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses. Also, it is best to take the doses at evenly spaced times day and night. For example, if you are to take two doses a day, the doses should be spaced about 12 hours apart. If this interferes with your sleep or other daily activities, or if you need help in planning the best times to take your medicine, check with your doctor.
  • If you are using the oral liquid form of amantadine, use a specially marked measuring spoon or other device to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid.

For patients taking amantadine for Parkinson's disease or movement problems caused by certain medicines used to treat nervous, mental, and emotional conditions:

  • Take amantadine exactly as directed by your doctor. Do not miss any doses and do not take more medicine than your doctor ordered.
  • Improvement in the symptoms of Parkinson's disease usually occurs in about 2 days. However, in some patients amantadine must be taken for up to 2 weeks before full benefit is seen.

The nasal flu vaccine (e.g., live attenuated influenza vaccine, Flumist®) should not be given in the 2 weeks before or 48 hours after taking amantadine.

Dosing

The dose of amantadine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of amantadine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (capsules, syrup, and tablets):
    • For the treatment or prevention of flu:
      • Adults and teenagers—200 milligrams (mg) or four teaspoonfuls once a day as a single dose.
      • Older adults—100 milligrams (mg) once a day as a single dose.
      • Children 9 to 12 years of age—100 milligrams (mg) or two teaspoonfuls two times a day.
      • Children 1 to 9 years of age—Dose is based on body weight and must be determined by the doctor. The usual dose is 4.4 to 8.8 milligrams (mg) per kilogram (kg) of body weight per day. The dose is divided evenly and given two times a day. However, the dose is usually not more than 150 mg per day.
      • Children up to 1 year of age—Use and dose must be determined by your doctor.
    • For the treatment of Parkinson's disease or movement problems:
      • Adults—100 milligrams (mg) two times a day. Your doctor may adjust your dose if needed.
      • Older adults—At first, 100 milligrams (mg) once a day as a single dose. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of amantadine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using amantadine

It is important that your doctor check your progress at regular visits to allow changes in your dose and to check for any unwanted effects.

Amantadine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you, your child, or your caregiver notice any of these adverse effects, tell your doctor or your child's doctor right away.

Some people who have used amantadine had unusual changes in their behavior. Talk with your doctor right away if you start having problems with gambling or an increased interest in sex while using amantadine.

Drinking alcoholic beverages while taking amantadine may cause increased side effects, such as circulation problems, dizziness, lightheadedness, fainting, or confusion. Do not drink alcoholic beverages while you are taking amantadine.

amantadine may cause some people to become dizzy, confused, or lightheaded, or to have blurred vision or trouble concentrating. Make sure you know how you react to amantadine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert or able to see well. If these reactions are especially bothersome, check with your doctor.

Dizziness, lightheadedness, or fainting may occur with amantadine, especially when you get up from a lying or sitting position suddenly. These symptoms are more likely to occur when you begin taking amantadine, or when the dose is increased. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

Patients with Parkinson's disease must be careful not to overdo physical activities when their condition improves and body movements become easier since injuries resulting from falls may occur. Such activities must be gradually increased to give your body time to adjust to a change in balance, circulation, and coordination.

Amantadine may cause dryness of the mouth, nose, and throat. For temporary relief of mouth dryness, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

amantadine may cause purplish red, net-like, blotchy spots on the skin. This problem occurs more often in females and usually occurs on the legs and/or feet after amantadine has been taken regularly for a month or more. Although the blotchy spots may remain as long as you are taking amantadine, they usually go away gradually within 2 to 12 weeks after you stop taking the medicine. If you have any questions about this, check with your doctor.

Check with your doctor right away if you are having convulsions (seizures); difficulty with breathing; a fast heartbeat; a high fever; high or low blood pressure; increased sweating; loss of bladder control; severe muscle stiffness; unusually pale skin; or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

If you are using amantadine for Parkinson's disease, do not stop taking amantadine suddenly without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely.

If you are using amantadine for Parkinson's disease, it is important that your doctor check your skin regularly for signs of a skin cancer called melanoma. If you notice any unusual red, brown, or black spots on your skin, talk to your doctor right away.

If your Parkinson's symptoms do not improve within a few days, if they become worse, or if amantadine appears less effective after a few weeks, check with your doctor.

amantadine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common
  • Blurred vision
  • confusion
  • difficult urination
  • dizziness or lightheadedness
  • fainting
  • seeing, hearing, or feeling things that are not there
  • swelling of the hands, feet, or lower legs
Rare
  • Convulsions (seizures)
  • decreased vision or any change in vision
  • difficulty in coordination
  • fever, chills, or sore throat
  • increased blood pressure
  • increase in body movements
  • irritation and swelling of the eye
  • loss of memory
  • mental depression
  • severe mood or mental changes
  • skin rash
  • slurred speech
  • thoughts of suicide or attempts at suicide
  • unexplained shortness of breath

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Agitation, anxiety, or nervousness
  • difficulty concentrating
  • headache
  • irritability
  • loss of appetite
  • nausea
  • purplish red, net-like, or blotchy spots on the skin
  • trouble in sleeping or nightmares
Less common or rare
  • Constipation
  • decrease in sexual desire
  • diarrhea
  • drowsiness
  • dryness of the mouth, nose, and throat
  • false sense of well-being
  • vomiting
  • unusual tiredness or weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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