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Symmetrel (amantadine) Disease Interactions

There are 7 disease interactions with Symmetrel (amantadine):

Major

Amantadine (applies to Symmetrel) psychoses/depression

Major Potential Hazard, Moderate plausibility. Applicable conditions: Psychosis, History - Psychiatric Disorder, Alcoholism, Drug Abuse/Dependence

Amantadine may precipitate or exacerbate psychotic symptoms. Rarely, suicide attempts and suicidal ideation have also been reported, some of which occurred in patients with no prior history of psychiatric illness who were taking short courses of amantadine for influenza. Therapy with amantadine should be administered cautiously in patients with a history of psychiatric disorders, emotional instability, or substance abuse, and particularly if they are elderly. It may be prudent to refrain from dispensing large quantities of amantadine to these patients to prevent intentional overdose, which is potentially fatal.

References

  1. Millet VM, Dreisbach M, Bryson YJ "Double-blind controlled study of central nervous system side effects of amantadine, rimantadine, and chlorpheniramine." Antimicrob Agents Chemother 21 (1982): 1-4
  2. Millet VM, Dreisbach M, Bryson YJ "Double-blind controlled study of central nervous system side effects of amantadine, rimantadine, and chlorpheniramine." Antimicrob Agents Chemother 21 (1982): 1-4
  3. Armbruster KF, Rahn AC, Ing TS, Halper IS, Oyama JH, Klawans HL "Amantadine toxicity in a patient with renal insufficiency." Nephron 13 (1974): 183-6
  4. Hayden FG, Hoffman HE, Spyker DA "Differences in side effects of amantadine hydrochloride and rimantadine hydrochloride relate to differences in pharmacokinetics." Antimicrob Agents Chemother 23 (1983): 458-64
  5. Noveske FG "Breakthrough panic after amantadine treatment in a parkinson's disease patient." J Clin Psychiatry 57 (1996): 374
  6. Borison RL "Amantadine-induced psychosis in a geriatric patient with renal disease." Am J Psychiatry 136 (1979): 111-2
  7. Nestelbaum Z, Siris SG, Rifkin A, Klar H, Reardon GT "Exacerbation of schizophrenia associated with amantadine." Am J Psychiatry 143 (1986): 1170-1
  8. Stroe AE, Hall J, Amin F "Psychotic episode related to phenylpropanolamine and amantadine in a healthy female." Gen Hosp Psychiatry 17 (1995): 457-8
  9. Degelau J, Somani S, Cooper SL, Irvine PW "Occurrence of adverse effects and high amantadine concentrations with influenza prophylaxis in the nursing home." J Am Geriatr Soc 38 (1990): 428-32
  10. Postma JU, van Tilburg W "Visual hallucinations and delirium during treatment with amantadine (Symmetrel)." J Am Geriatr Soc 23 (1975): 212-5
  11. Strange KC, Little DW, Blatnik B "Adverse reactions to amantadine prophylaxis of influenza in a retirement home." J Am Geriatr Soc 33 (1991): 700-5
  12. Rizzo M, Biandrate P, Tognoni, Morselli PL "Amantadine in depression: relationship between behavioural effects and plasma levels." Eur J Clin Pharmacol 5 (1973): 226-8
  13. Somani SK, Degelau J, Cooper SL, Guay DR, Ehresman D, Zaske D "Comparison of pharmacokinetic and safety profiles of amantadine 50- and 100-mg daily doses in elderly nursing home residents." Pharmacotherapy 11 (1991): 460-6
  14. Ing TS, Daugirdas JT, Soung LS, et al "Toxic effects of amantadine in patients with renal failure." Can Med Assoc J 120 (1979): 695-8
  15. "Product Information. Symmetrel (amantadine)." DuPont Pharmaceuticals, Wilmington, DE.
View all 15 references
Major

Amantadine (applies to Symmetrel) renal dysfunction

Major Potential Hazard, High plausibility.

Amantadine is primarily eliminated by the kidney. Patients with renal impairment may be at greater risk for adverse effects from amantadine due to decreased drug clearance. Therapy with amantadine should be administered cautiously in patients with renal impairment. Dosage adjustments are recommended for patients with moderate to severe renal dysfunction.

References

  1. Wu MJ, Ing TS, Soung LS, Daugirdas JT, Hano JE, Gandhi VC "Amantadine hydrochloride pharmacokinetics in patients with impaired renal function." Clin Nephrol 17 (1982): 19-23
  2. Horadam VW, Sharp JG, Smilack JD, et al "Pharmacokinetics of amantadine hydrochloride in subjects with normal and impaired renal function." Ann Intern Med 94 (1981): 454-8
  3. Borison RL "Amantadine-induced psychosis in a geriatric patient with renal disease." Am J Psychiatry 136 (1979): 111-2
  4. Ing TS, Daugirdas JT, Soung LS, et al "Toxic effects of amantadine in patients with renal failure." Can Med Assoc J 120 (1979): 695-8
  5. "Product Information. Symmetrel (amantadine)." DuPont Pharmaceuticals, Wilmington, DE.
  6. Armbruster KF, Rahn AC, Ing TS, Halper IS, Oyama JH, Klawans HL "Amantadine toxicity in a patient with renal insufficiency." Nephron 13 (1974): 183-6
View all 6 references
Major

Amantadine (applies to Symmetrel) seizure disorders

Major Potential Hazard, Moderate plausibility. Applicable conditions: Seizures

Amantadine may rarely precipitate or exacerbate seizure activity. Patients with epilepsy or predisposed to seizures should be monitored closely for increased seizure activity during therapy with amantadine.

References

  1. "Product Information. Symmetrel (amantadine)." DuPont Pharmaceuticals, Wilmington, DE.
  2. Ing TS, Daugirdas JT, Soung LS, et al "Toxic effects of amantadine in patients with renal failure." Can Med Assoc J 120 (1979): 695-8
  3. Millet VM, Dreisbach M, Bryson YJ "Double-blind controlled study of central nervous system side effects of amantadine, rimantadine, and chlorpheniramine." Antimicrob Agents Chemother 21 (1982): 1-4
  4. Millet VM, Dreisbach M, Bryson YJ "Double-blind controlled study of central nervous system side effects of amantadine, rimantadine, and chlorpheniramine." Antimicrob Agents Chemother 21 (1982): 1-4
View all 4 references
Major

Dopamine agonists (applies to Symmetrel) hypotension

Major Potential Hazard, Moderate plausibility.

Dopamine agonists may impair the systemic regulation of blood pressure, with resultant orthostatic hypotension, especially during dose escalation. Therapy with dopamine agonists should be monitored carefully in patients with Parkinson's disease since they may have an impaired ability to respond to an orthostatic challenge, and also in patients receiving antihypertensive drugs.

References

  1. Iwasaki S, Hamaguchi K, Iwasaki A, Takakusagi M, Narabayashi Y "Hypotensive effect of long-term levodopa in patients with Parkinson's disease." Eur Neurol 30 (1990): 194-9
  2. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
  3. Hoehn MM "Levodopa-induced postural hypotension. Treatment with fludrocortisone." Arch Neurol 32 (1975): 50-1
  4. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim, Ridgefield, CT.
  5. "Product Information. Dostinex (cabergoline)." Pharmacia and Upjohn, Kalamazoo, MI.
  6. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
View all 6 references
Major

Dopaminergic antiparkinson agents (applies to Symmetrel) psychosis

Major Potential Hazard, Moderate plausibility.

Ordinarily, patients with major psychotic disorder should not be treated with dopaminergic antiparkinson agents, because of the risk of exacerbating psychosis. Hallucinations and psychotic-like behavior have been reported with dopaminergic medications. In addition, certain medications used to treat psychosis may exacerbate the symptoms of Parkinson's disease and may decrease the effectiveness of these drugs.

Moderate

Amantadine (applies to Symmetrel) CHF/edema

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Congestive Heart Failure, Fluid Retention

Amantadine may occasionally cause peripheral edema and, rarely, congestive heart failure. Patients with edema or congestive heart failure should be monitored closely for exacerbation of their condition. Dosage adjustments may be necessary.

References

  1. "Product Information. Symmetrel (amantadine)." DuPont Pharmaceuticals, Wilmington, DE.
  2. Vale JA, Maclfan KS "Amantadine-induced heart-failure." Lancet 1 (1977): 548
Moderate

Amantadine (applies to Symmetrel) hypotension

Moderate Potential Hazard, Moderate plausibility.

Amantadine may occasionally cause orthostatic hypotension. Patients with hypotension should be monitored for exacerbation of their condition during therapy with amantadine. Dosage adjustments may be necessary, and patients should be advised not to rise abruptly from a sitting or recumbent position.

References

  1. "Product Information. Symmetrel (amantadine)." DuPont Pharmaceuticals, Wilmington, DE.

Symmetrel (amantadine) drug interactions

There are 125 drug interactions with Symmetrel (amantadine)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.