How Does Amantadine Work For Parkinson’s

Some Side Effects Can Be Serious If You Experience Any Of These Symptoms Call Your Doctor Immediately:

• hallucinations
• believing things that are not true
• not trusting others or feeling that others want to hurt you
• depression
• suicidal
• lack of interest, enthusiasm, or concern
• dizziness, lightheadedness, fainting, or blurred vision
• swelling of the hands, feet, ankles, or lower legs
• difficulty urinating
• shortness of breath

Amantadine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .

Amantadine May Interact With Other Medications

Amantadine oral capsule can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs youre taking. To find out how this drug might interact with something else youre taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with amantadine are listed below.

What Is Amantadine Used For

Amantadine is used to treat involuntary body movements associated with

• Parkinsons disease – involuntary tremors and dyskinesia while on levodopa based medicines
• extrapyramidal symptoms which are side effects from medication that block dopamine receptors including muscle spasm, tremor and irregular, jerky movements
• Chorea due to Huntington disease

Amantadine brand names available in the US are Gocovri and Osmolex. They do not have the same labeled indications and are not interchangeable.

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What Is Parkinsons Disease

Parkinsons disease is a brain and nervous system disease that gradually gets worse over time.

There is a gradual loss of nerve cells in a part of the brain called the substantia nigra, these cells usually make dopamine which controls and coordinates body movements. As there are less cells that make dopamine, the dopamine levels become low and this results in body movements becoming slow and awkward. Other symptoms can be tremor , dyskinesia, rigid limbs and gait and balance problems.

Treatment of Parkinsons disease symptoms is often started with levodopa, which helps replace the lost dopamine. Levodopa works well to reduce movement disorders and dyskinesia, although long term use can result in levodopa-induced dyskinesia.

Gocovri is used in Parkinsons disease patients who are on levodopa-based medication and/or dopaminergic medications but are still struggling with dyskinesia. The addition of Gocovri can reduce dyskinesia and uncontrolled movements and therefore reduce disability and increase quality of life.

How Does This Medication Work What Will It Do For Me

antiviralsprevent and treat influenza A infections,

Amantadine also belongs to the family of medications called antiparkinsonians. It is also used to treat of Parkinson’s disease and for the short-term management of Parkinson-like symptoms caused by certain medications. The way it works is not clear, but it appears to help Parkinson’s disease by increasing the levels of a chemical called dopamine in the brain. Not having enough dopamine in the brain is believed to be a cause of the symptoms of Parkinson’s disease. Amantadine generally begins to work within 2 days.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

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What Side Effects Are Possible With This Medication

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• agitation
• purplish-red blotchy spots on skin
• trouble sleeping

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• confusion
• hallucinations
• poor muscle coordination
• signs of heart problems

Stop taking the medication and seek immediate medical attention if any of the following occur:

• seizures
• symptoms of a severe allergic reaction
• thoughts of suicide or attempts at suicide

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

What Is The Most Important Information I Should Know About Amantadine

You should not use amantadine if you are allergic to it, or if:

• you have severe kidney disease or
• you received a “live” nasal flu vaccine within the past 14 days.

Tell your doctor if you have ever had:

• kidney disease
• daytime drowsiness
• congestive heart failure
• low blood pressure, fainting spells
• alcoholism or drug addiction or
• mental illness, psychosis, or suicidal thoughts or actions.

People with Parkinson’s disease may have a higher risk of skin cancer . Talk to your doctor about this risk and what skin symptoms to watch for.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

You should not breast-feed while using this medicine.

Amantadine is not approved for influenza in a child younger than 1 year old. Gocovri is not approved for use by anyone younger than 18 years old.

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Symmetrel For Parkinson’s Disease

OverviewSymmetrel is a prescription medication approved by the Food and Drug Administration in 1976 for treating motor symptoms associated with all forms of Parkinsonism. Symmetrel is sometimes prescribed to treat dyskinesia in people who are taking Levodopa/Carbidopa. Symmetrel is also known by its drug name, amantadine.

Symmetrel is not suitable for use by people who are allergic to amantadine. Symmetrel should be used with caution in people with glaucoma, mental illness, depression, a history of seizures, low blood pressure, frequent rashes, or problems with the liver, kidney, or heart. Symmetrel may not be appropriate for women who are pregnant or breastfeeding.

Symmetrel is classified as an antiviral and anti-Parkinsonian drug. It is believed that Symmetrel works by increasing the amount of dopamine available in the brain.

How do I take it?Symmetrel is taken orally as a capsule or liquid once or twice a day. Take Symmetrel with food or milk. The best times to take Symmetrel are usually in the morning and at mid-day in order to avoid disrupting sleep.

Avoid alcohol while taking Symmetrel.

Always follow your doctors instructions exactly when taking Symmetrel.

ResultsA 2003 article reviewed the evidence from six clinical trials of amantadine as treatment for Parkinsonism. The trials involved a total of 215 participants. Researchers concluded that there is insufficient data supporting the efficacy and safety of amantadine as a Parkinsons medication.

What Is The Dosage For Amantadine

Amantadine is taken once or twice daily with or without food. If it causes an upset stomach, it can be taken with food. The dosage for prevention and treatment of influenza A infections in adults is 200 mg daily. For treatment of influenza, amantadine should be started within 24 to 48 hours after the onset of signs or symptoms and should be continued for 24 to 48 hours after the disappearance of signs or symptoms. To prevent influenza, amantadine should be started as soon as possible after exposure to the influenza virus and continued for at least 10 days. Persons with reduced kidney function and elderly persons may need lower doses .

The dosage for treating Parkinson’s or extrapyramidal symptoms is 100 mg twice daily.

Such combinations can cause dizziness, confusion, lightheadedness, fainting, or dizziness upon standing .

Since amantadine amplifies the actions of dopamine in the brain, drugs which block the effects of dopamine should be avoided in persons taking amantadine when amantadine is used for the treatment of Parkinson’s disease. Such drugs include haloperidol , metoclopramide , and phenothiazines, for example, thioridazine or triflupromazine .

The use of the diuretics hydrochlorothiazide or triamterene with amantadine can reduce the kidney’s ability to eliminate amantadine. This can lead to high levels of amantadine in the blood and amantadine-associated toxicity.

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How Should I Use This Medication

The recommended adult dose of amantadine varies according to the condition being treated.

For treatment of Parkinson’s disease, the recommended adult dose is 100 mg once daily to start. After 1 to 2 weeks, your doctor may recommend increasing the dose to 100 mg twice daily. The maximum daily dose is 400 mg in divided doses.

To treat symptoms similar to Parkinson’s disease that are caused by medications, the recommended dose is the same as the dose used to treat Parkinson’s disease. When used for this purpose, the maximum daily dose is 300 mg daily in divided doses.

For treatment and prevention of influenza A infections, the recommended dose for adults and children 10 years of age and older, weighing more than 40 kg, is 200 mg daily .

For children weighing less than 40 kg or those who are under 10 years old, the dosage is based on body weight. The recommended dose of amantadine is 5 mg per kilogram of body weight. The maximum dose for children 10 years and over is 200 mg daily. Children under 10 years of age should not be given more than 140 mg daily.

The appropriate dose is taken 2 or 3 times a day, as determined by your doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Important Information About All Medicines

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Chemistry Mechanism Of Action Spectrum And Resistance

Amantadine and rimantadine are symmetric tricyclic amines with cagelike structures that are closely related structurally to one another. Amantadine was the first antiviral agent to be licensed for systemic use in the U.S. The activity of amantadine and rimantadine is limited to influenza A viruses. Rimantadine is 4- to 10-fold more active than amantadine.268 The target of the inhibitory action for both amantadine and rimantadine is the influenza A virus M2 protein. Resistance to amantadine and rimantadine results from a point mutation in the RNA sequence encoding for the M2 protein transmembrane domain.269 Resistance typically appears in the treated subject and his or her close contacts within 2 to 3 days of the initiation of therapy as many as one-third of treated adults and children shed resistant strains of influenza by the fifth day of treatment.270

Howard S. Smith, … Christine N. Sang, in, 2009

Enhancing Healthcare Team Outcomes

Amantadine was once widely prescribed for Parkinson disease and even influenza. However, there are many more effective drugs on the market, and the use of amantadine has declined. Nevertheless, nurse practitioners or primary care providers who prescribe this agent should closely monitor the patient for adverse effects. Also, the patient’s renal function and mental status require monitoring. Amantadine can increase the risk of depression and lower the threshold for seizures, so nurses should explicitly query and search for this information on patient intake. Irreversible changes in the liver can occur, and hence liver enzymes require monitoring at the same time. Pharmacists should examine the patient’s medical record, and look for drug interactions, verify dosing, and express any concerns to the prescriber. With an interprofessional team approach to healthcare, amantadine therapy can be most effective in those cases where it is still useful, and other agents can substitute for it with a collaborative assessment of the patient’s needs and regimen.

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Kidney Or Liver Disease

The kidneys primarily excrete amantadine via the urine. In people with impaired kidney function, the drug can build up in the body. The doctor will lower the dose of amantadine, as a result.

Amantadine can also increase liver enzyme numbers. Anyone with a history of liver disease should take amantadine with caution.

How Should This Medicine Be Used

Amantadine comes as a capsule, extended-release capsule , tablet, extended-release tablet , and liquid to take by mouth. The capsules, tablets, and liquid medications are usually taken once or twice a day. The extended-release capsules are usually taken once a day at bedtime. The extended-release tablets are usually taken once a day in the morning. Take amantadine at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take amantadine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the extended-release capsules and extended-release tablets whole do not split, chew, or crush them. If you have difficulty swallowing the extended-release capsule, you may open the capsule and sprinkle the entire contents on a teaspoonful of soft food, like applesauce. Eat the mixture right away and swallow without chewing.

If you are taking amantadine for Parkinson’s disease, your doctor may start you on a low dose of amantadine and gradually increase your dose.

Do not stop taking amantadine without talking to your doctor. If you suddenly stop taking amantadine, you may experience fever, confusion, changes in mental state, or severe muscle stiffness. Your doctor will probably decrease your dose gradually.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

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How Should I Take Amantadine

Take amantadine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

If you take amantadine to treat influenza A, start taking the medicine within 24 to 48 hours after flu symptoms begin. Keep taking this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared.

You may take amantadine with or without food. You may need to take this medicine only at bedtime. Follow your doctor’s instructions.

Measure liquid oral solution carefully. Use the dosing syringe provided, or use a medicine dose-measuring device .

Swallow the capsule or tablet whole and do not crush, chew, or break it.

If you cannot swallow a capsule whole, open it and sprinkle the medicine into a spoonful of applesauce. Swallow the mixture right away without chewing. Do not save it for later use.

Call your doctor if your symptoms do not improve, or if you have a fever with a headache, cough, skin rash, or other new symptoms.

If you take amantadine for Parkinson symptoms: You should not stop using amantadine suddenly or your condition may become worse. Stopping suddenly may also cause unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

What Should I Know About Storage And Disposal Of This Medication

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture .

It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.

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