rimantadine hydrochloride

rimantadine hydrochloride

Flumadine

Pharmacologic class: Miscellaneous and anticholinergic-like agent

Therapeutic class: Antiviral

Pregnancy risk category C

Action

Prevents nucleic acid uncoating during viral cell replication, preventing penetration in host. Also causes dopamine release from neurons.

Availability

Syrup: 50 mg/5 ml

Tablets: 100 mg

⊘Indications and dosages

➣ Treatment of influenza type A

Adults: 100 mg P.O. b.i.d.

➣ Prophylaxis of influenza type A

Adults and children older than age 10: 100 mg P.O. b.i.d.

Children younger than age 10: 5 mg/kg P.O. daily. Maximum dosage is 150 mg daily.

Dosage adjustment

• Renal or hepatic disease
• Seizure disorders
• Elderly patients

Off-label uses

• Parkinson's disease

Contraindications

• Hypersensitivity to drug or amantadine

Precautions

Use cautiously in:
• history of seizures or renal or hepatic disease
• pregnant or breastfeeding patients
• children younger than age 1.

Administration

• Give several hours before bedtime.
• Start therapy within 48 hours of symptom onset and continue for at least 1 week.

Route	Onset	Peak	Duration
P.O.	Slow	6 hr	Unknown

Adverse reactions

CNS: headache, dizziness, fatigue, depression, insomnia, poor concentration, asthenia, nervousness

CV: hypotension

EENT: tinnitus

GI: nausea, vomiting, diarrhea, abdominal pain, dyspepsia, dry mouth, anorexia

Respiratory: dyspnea

Skin: rash

Interactions

Drug-drug. Acetaminophen, aspirin: decreased rimantadine peak blood level

Cimetidine: increased rimantadine blood level

Patient monitoring

• Assess patient's flu symptoms. Notify prescriber if symptoms don't improve within 2 to 3 days.
• Monitor vital signs; watch for hypotension.
• Closely monitor nutritional status and hydration.

Patient teaching

• Advise patient to take several hours before bedtime.
• If patient's taking syrup, tell him to use specially marked oral syringe or measuring device to ensure accurate dose.
• Instruct patient to contact prescriber if symptoms don't improve within 2 to 3 days.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration, motor function, and alertness.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.