How To Use Amantadine Hcl Capsule Extended Release 24 Hr
Take this medication by mouth with or without food as directed by your doctor, usually once daily. Ask your doctor or pharmacist when to take your medication since different brands are taken at different times . Swallow this medication whole. Do not crush, chew, or split the capsules/tablets. Doing so can release all of the drug at once, increasing the risk of side effects.
If you using the capsules and have trouble swallowing them whole, you may open the capsule and sprinkle the contents on a small amount of soft food just before taking. Swallow the mixture right away without chewing. Do not save it to take later.
The dosage is based on your medical condition and response to treatment.
Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.
Do not stop taking this medication without consulting your doctor. Your condition may get worse if this drug is suddenly stopped or if your dose is quickly decreased. Your doctor may gradually reduce your dose to lessen the chance of symptoms such as agitation, anxiety, hallucinations, depression, or trouble speaking. Tell your doctor right away of any new or worsening symptoms.
Amantadine may take several weeks to have an effect. Tell your doctor if your condition does not get better or if it gets worse.
Influenza A Prophylaxis Or Treatment
Immediate-release tablet/capsule or syrup only
NOTE: Because of resistance, amantadine is no longer recommended for prophylaxis or treatment of influenza A refer to current CDC recommendations
200 mg PO as a single daily dose may split daily dosage to one 100 mg q12hr if central nervous system effects develop in once-a-day dosage, a split dosage schedule may reduce such complaints
Can Amantadine Cause Problems
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the common ones associated with amantadine. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
| Very common amantadine side-effects | What can I do if I experience this? |
| Swollen ankles, red skin blotches | If troublesome, speak with your doctor |
| Common amantadine side-effects | What can I do if I experience this? |
| Loss of appetite, feeling sick , constipation | Eat a well-balanced diet and drink plenty of water |
| Blurred vision feeling dizzy, light-headed or tired | Do not drive and do not use tools or machines while affected. Do not drink alcohol |
| Dry mouth | Try chewing sugar-free gum or sucking sugar-free sweets |
| Headache, muscle pain | Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If the headaches continue, let your doctor know |
| Feeling anxious or confused, changes in your mood, difficulties sleeping, lack of concentration, slurred speech, a fast heartbeat, increased sweating, hearing or seeing things that are not real | If any of these become troublesome, speak with your doctor |
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Drug Interactions And Contraindications
Other drugs that have anticholinergic effects can worsen the anticholinergic adverse effects of amantadine. Doses may need to be reduced if anticholinergic AEs occur .4
Amantadine has an excretion rate related to the acidity of the urine. Any drug, change in diet, or patient state that influences urine pH may alter the elimination or accumulation of amantadine and will need to be monitored.
Alcohol increases sedation and orthostatic hypotension and should not be taken with amantadine. Live influenza vaccines are also not recommended as amantadine may interfere with the efficacy of the vaccine.
Amantadine is contraindicated in patients with end-stage renal disease .
Dosage For Parkinsons Disease
Generic: Amantadine
- Strength: 68.5 mg, 137 mg
Immediate-release capsule
Adult dosage
- Typical starting dosage: 100 mg, taken twice per day, when not used with other drugs for Parkinsons disease.
- In some cases: Some people may need to start with 100 mg, taken once per day, if they have certain serious medical illnesses or are taking high doses of other drugs to treat Parkinsons disease.
- Maximum dosage: 200 mg, taken twice per day.
Child dosage
It has not been confirmed that amantadine is safe and effective for use in people younger than 18 years.
Senior dosage
The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This increases your risk of side effects.
Extended-release capsule
Adult dosage
- Typical starting dosage: 137 mg, taken once a day at bedtime.
- Dosage increases: After one week, your doctor will likely increase your dosage to 274 mg one a day at bedtime.
Child dosage
It has not been confirmed that amantadine is safe and effective for use in people younger than 18 years.
Senior dosage
The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This increases your risk of side effects, such as falls and hallucinations.
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What Happens If I Overdose
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of amantadine can be fatal.
Overdose symptoms may include confusion, agitation, behavior changes, hallucinations, severe headache or pounding in your ears, muscle stiffness, problems with balance or walking, trouble breathing, fast heartbeats, or seizure.
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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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
How To Take Amantadine
- Before you start the treatment, read the manufacturer’s printed information leaflet from inside the pack and any additional information your doctor has given to you. These will give you more information about amantadine and will provide you with a full list of the side-effects which you may experience from taking it.
- Take amantadine exactly as your doctor tells you to.
- If you have been prescribed amantadine for Parkinson’s disease symptoms it is usual to take 100 mg daily for the first week, and then for the dose to increase to twice a day. Some people may require doses of up to 400 mg daily.
- If you have been prescribed amantadine to prevent a shingles rash and nerve pain the dose is 100 mg twice a day for 14 days. If you are still in pain after 14 days a further course of treatment may be prescribed.
- Your doctor or pharmacist will tell you what dose to take each day, and the directions will also be printed on the label of the pack to remind you about what the doctor said to you.
- Try to take your doses of amantadine at the same time each day, as this will help you remember to take it regularly.
- If you forget to take a dose, take it as soon as you remember. Try to take the correct number of doses each day but do not take two doses together to make up for a missed dose.
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Why Is This Medication Prescribed
Amantadine is used to treat the symptoms of Parkinson’s disease and other similar conditions. It is also used to control movement problems that are a side effect of certain medications used to treat Parkinson’s disease. Amantadine extended-release capsules are used along with the combination of levodopa and carbidopa to treat ”off” episodes in people with Parkinson’s disease. It also is used to prevent symptoms of influenza A virus infection and for treatment of respiratory infections caused by influenza A virus. Amantadine is in a class of medications called adamantanes. It is thought to work to control movement problems by increasing the amount of dopamine in certain parts of the body. It works against influenza A virus by stopping the spread of the virus in the body.
What Drugs And Food Should I Avoid While Taking Amantadine
Do not receive a nasal flu vaccine while using amantadine, and for at least 48 hours after your last dose. The vaccine may not work as well during this time, and may not protect you from influenza.
Do not drink alcohol. Dangerous side effects could occur.
Avoid driving or operating machinery until you know how this medicine will affect you. Amantadine may impair your thinking or reactions. Some people taking amantadine have fallen asleep during normal daytime activities such as working, talking, eating, or driving. You may fall asleep suddenly, even after feeling alert. Be careful if you drive or do anything that requires you to be alert.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.
Avoid taking diet pills, caffeine pills, or other stimulants without your doctor’s advice. Taking a stimulant together with amantadine can increase your risk of unpleasant side effects.
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Suicidal Thoughts Or Actions
Suicidal thoughts or actions are a rare side effect of amantadine, occurring in fewer than 0.1% of people.
Many people affected in this way have taken amantadine for influenza prevention or treatment. This side effect can develop in people with no history of psychiatric illness.
People taking amantadine, and those close to them, should look carefully for any behavioral changes, including agitation, personality changes, paranoia, depression, and anxiety.
What Should I Do If I Forget A Dose
If you are taking the capsules, tablets, or liquid, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
If you are taking the extended-release capsules or the extended-release tablets, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. If you have forgotten to take the extended-release capsules or extended-release tablets for several days, call your doctor.
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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.
Before Taking This Medicine
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.
To make sure amantadine is safe for you, tell your doctor if you have ever had:
-
kidney disease
-
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 amantadine 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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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 .
What Is Amantadine And How Does It Work
Amantadine is used to prevent or treat a certain type of flu . If you have been infected with the flu, this medication may help make your symptoms less severe and shorten the time it will take you to get better. Taking amantadine if you have been or will be exposed to the flu may help to prevent you from getting the flu. This medication is an antiviral that is believed to work by stopping growth of the flu virus. This medication is not a vaccine. To increase the chance that you will not get the flu, it is important to get a flu shot once a year at the beginning of every flu season, if possible.
Based on the recommendation from the Centers for DiseaseControl in the U.S., amantadine should not be used to treat or prevent influenza A because the current influenza A virus in the United States and Canada is resistant to this medication. For more details, talk to your doctor or pharmacist.
Amantadine is also used to treat Parkinson’s disease, as well as side effects caused by drugs , chemicals, and other medical conditions. In these cases, this medication may help to improve your range of motion and ability to exercise. For the treatment of these conditions, amantadine is believed to work by restoring the balance of natural chemicals in the brain.
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What Is Parkinsons Disease
Parkinsons disease is a progressive brain disorder that affects mobility and mental ability. If you or a loved one has been diagnosed with Parkinsons, you may be wondering about life expectancy.
According to some research, on average, people with Parkinsons can expect to live almost as long as those who dont have the condition.
Rules To Intake Levodopa
Take Exact Dosage: You have to intake Levodopa for parkinsons disease exactly in the same way, as your doctor recommends doing it. If you face difficulty in understanding the mentioned directions, you should make sure to ask your nurse, pharmacist or doctor to explain you in detail.
Water: You should intake each dosage with one glass of water.
Take It with Food: You may intake Levodopa for many times in a day with your food. However, it is essential for you to follow the instructions given by your doctor strictly.
Take it On Time: You should make sure to intake Levodopa on a regular basis to get maximum possible benefit from it.
The Effect Takes Time: Depending on individual conditions, parkinsons disease patients may experience the benefits of Levodopa in a few months or in several weeks. In this situation, you should never stop intake the medicine without discussing about it with your doctor.
Take Tests Recommended by Doctor: Your doctor may recommend you to undergo medical evaluations, including blood examination while your treatment with Levodopa for parkinsons disease. This helps in monitoring your progress in a far better way and identifying side effects.
You should store the drug at room temperature and away from heat and moisture both i.e. at any dry place.
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Basic Rules Before Levodopa Intake
Before you should start with the intake of Levodopa regularly, you should intimate your doctor about-
- Any cardiac problem you have, which include arteriosclerosis, high blood pressure, heart attacks and strokes, arteries hardening problems or irregular heartbeat patternsRespiratory problems of any type
- Liver and/or kidney problems
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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