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Wednesday, November 23, 2022
HomeRisksWhy Is Amantadine Used In Parkinson Disease

Why Is Amantadine Used In Parkinson Disease

Can Amantadine Cause Problems

Amantadine Mnemonic for USMLE

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

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 รข 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.

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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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 .

Getting The Most From Your Treatment

Parkinson Disease Drugs
  • Sometimes people taking medicines like amantadine can fall asleep suddenly with little or no warning of being tired beforehand. Until you know how you react, take extra care if you operate machinery or drive. If you do find yourself falling asleep suddenly, you should see your doctor as soon as possible for advice, and avoid driving or using tools and machines in the meantime.

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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.

Topiramate As An Adjunct To Amantadine In The Treatment Of Dyskinesia In Parkinson’s Disease

Objective/Rationale: Dyskinesia is a term used to describe involuntary movements that develop as side effects of dopamine drugs used to treat Parkinson’s disease. Dyskinesias are frequent and disabling to many patients. They can interrupt smooth coordinated movements, affect communication and disrupt activities of daily living. Currently, among medications to treat dyskinesia, only amantadine is effective and readily available. A recent laboratory study documented that a readily available drug, topiramate, provided additional improvement with amantadine in parkinsonian pre-clinical models with dyskinesia. In fact, the benefit of the combination of topiramate and amantadine proved to be better than the benefits from either one alone even if the individual effects were added. This study will build on the laboratory information to test topiramate in Parkinsons disease patients with dyskinesia who are already taking daily amantadine.

Anticipated Outcome:The anticipated outcomes are that i) topiramate treatment will be safe and well-tolerated in patients and ii) those patients receiving both topiramate and amantadine will have reduced dyskinesia in comparison to those patients receiving only amantadine and placebo tablets.

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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.

What You Need To Know About Amantadine For Parkinson Disease

Amantadine blocks COVID-19? [research in multiple sclerosis, parkinsonism, dementia]

This guide includes everything you need to know about amantadine for the treatment of Parkinson disease and drug-induced extrapyramidal reactions in adults.

In February 2018, the FDA approved amantadine for the treatment of Parkinson disease and drug-induced extrapyramidal reactions in adults.1

Parkinson disease is a neurological disorder where patients have a lack of dopaminergic neurons in the substantia nigra. The affected population is estimated to extend toward 10 million worldwide.2 Drug-induced extrapyramidal reactions, mainly caused by antipsychotics, has led to many problematic symptoms such as dystonia, pseudo-parkinsonism, akathisia, and tardive dyskinesia. Anticholinergics, such as amantadine have been used to treat extrapyramidal symptoms caused by antipsychotics for many years now.3

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Warnings For Other Groups

For pregnant women: Amantadine is a category C pregnancy drug. That means two things:

  • Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  • There havent been enough studies done in humans to be certain how the drug might affect the fetus.
  • Talk to your doctor if youre pregnant or planning to become pregnant. This drug should be used only if the potential benefit justifies the potential risk to your pregnancy.

    If you become pregnant while taking this drug, call your doctor right away.

    For women who are breastfeeding: Amantadine passes into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this drug.

    All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

    • your age
    • how severe your condition is
    • other medical conditions you have
    • how you react to the first dose

    Why Amantadine For Restoring Good Movement

    • Amantadine is used for symptomatic treatment for PD and can reduce levodopa-induced dyskinesia and OFF9-11
    • The mechanism by which amantadine exerts efficacy in the treatment of dyskinesia and OFF in patients with PD is unknown9
    • May work by reducing excessive glutamatergic activity, which contributes to dyskinesia and OFF3,7
    • Amantadine may have direct and indirect effects on dopamine neurons it exerts dopaminergic-like side effects such as hallucinations and dizziness in humans9
  • Common daily dosing of amantadine HCl IR in PD is 100 mg BID9
  • * Amantadine is a low-affinity, noncompetitive NMDA antagonist, which means inhibition of the NMDA channel occurs at a different binding site than the active site where the substrate binds.1

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    Role In Therapy And Clinical Updates

    Clinical studies that evaluated the role of entacapone as adjunctive therapy in PD patients experiencing motor fluctuations while receiving carbidopa/levodopa have reported improvements in end-of-dose wearing off of approximately 1.5 hours daily, as well as approximately one hour of additional daily on time. Other benefits included improvements in motor function and reductions of approximately 15% to 30% in levodopa total daily doses, especially in patients receiving daily doses of less than 600 mg.

    Although tolcapone and entacapone are similarly effective in patients with PD, the association of tolcapone with hepatic toxicity limits its clinical utility. Tolcapone may be considered in PD patients who have failed other therapies, with appropriate monitoring for liver toxicity.

    Clinical trials do not support the use of COMT inhibitors as adjuncts to carbidopa/levodopa in patients who are not experiencing motor complications, nor are these drugs used to prevent or delay motor fluctuations or dyskinesias.,,

    What Is The Most Important Information I Should Know About Amantadine

    Amantadine and antiglutamatergic drugs in the management ...

    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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    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.

    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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    Amantadine And The Risk Of Dyskinesia In Patients With Early Parkinsons Disease: An Open

    1Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

    2Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea

    3Department of Neurology, Ewha Womans University School of Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea

    4Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea

    5Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea

    6Department of Neurology, Kyung Hee University Medical Center, Seoul, Korea

    7Department of Neurology, Seoul Central Clinic, Seoul, Korea

    8Department of Neurology, Daejeon St. Marys Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea

    9Department of Neurology, Seoul St. Marys Hospital, Catholic University of Korea, Seoul, Korea

    10Department of Neurology, Presbyterian Medical Center, Jeonju, Korea

    Transplantation Stem Cell Research And Gene Therapy

    I am on Amantadine now for my young and early onset Parkinson’s disease

    The transplantation of dopaminergic neurons has been studied for more than 20 years. The results have been variable, with some patients developing graft-induced dykinesias., Stem-cell transplantation in PD patients appears to be more promising, but it, too, has caused some concern regarding cell survival, tumor formation, tissue rejection, and purification.

    Other areas of research include the use of neurorestorative proteins, physiologic delivery of deficient neurotransmitters, and gene-replacement procedures. A dose-escalation study of ProSavin, an experimental gene-based therapy, reported positive changes in motor outcomes, but these effects were inferior to the preoperative response to levodopa.

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    Amantadine Might Be Used As A Drug For Sars

    , Medical Pharmacology Department, Faculty of Medicine, Maltepe University, Istanbul, TurkeyNeurology Department, Faculty of Medicine, Maltepe University, Istanbul, Turkey

    Affiliation:

    The World’s First International Journal Dedicated to Coronaviruses

    Volume 2 , Issue 1 , 2021

    Abstract:

    Coronavirus Disease 2019 infection, the pandemics, caused by severe acute respiratorysyndrome coronavirus 2 has no known effective radical pharmacotherapy andjust supportive approach at present. Amantadine is a drug used in Parkinsons disease and other parkinsonisms and is known to increase indirectly dopamine by antagonistic effects at the N-methyl-Daspartate receptor by increasing the release and blocking the reuptake of dopamine. Initially,amantadine was approved as an antiviral drug. We hypothesize that if amantadine is considered its antiviral,immunological and neurostimulant effects might be useful in the supportive treatment of SARSCoV-2 cases, especially those who developed acute respiratory failure with decreased vigilance and arebeing monitored in the intensive care unit. Further phase III clinical trials are needed.

    Title:Amantadine Might be Used as a Drug for SARS-Cov-2 Treatment?

    VOLUME: 2ISSUE: 1

    Zeynep Gunes Ozunal and Sevki Sahin*

    Affiliation:Medical Pharmacology Department, Faculty of Medicine, Maltepe University, Istanbul, Neurology Department, Faculty of Medicine, Maltepe University, Istanbul

    Amantadine For Traumatic Brain Injury

    According to Medlineplus.org, Amantadine is used to treat the symptoms of Parkinsons disease and other similar conditions. Currently, amantadine is used to treat brain severe traumatic brain injury cases, most notably in early recovery stages of recovery. However, lately, clinical trials have been conducted, charting the link of traumatic brain injury recovery and Amantadine, two years post the date of trauma.

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    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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