rimantadine hydrochloride


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rimantadine hydrochloride

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.

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.

rimantadine hydrochloride

(rĕ-măn-tĕ-dēn)
An antiviral drug given orally to treat influenza A.
References in periodicals archive ?
The 4 approved therapeutic medications (amantadine hydrochloride, rimantadine hydrochloride, zanamivir, and oseltamivir) must be started within 30 to 48 hours of initial symptoms for any appreciable benefit to the patient, yet only a small fraction of patients present to their primary care providers within this time frame.
Nursing homes and other facilities providing care for persons at risk for influenza-associated complications should consider using the antiviral agents amantadine hydrochloride or rimantadine hydrochloride for prophylaxis and/or treatment during institutional outbreaks of influenza type A (3).
The significant year-over-year increase came on additional sales of Fludrocortisone Acetate Tablets, introduced at the end of the first quarter of 2002, Minocycline Hydrochloride Capsules launched in the third quarter of 2002, Rimantadine Hydrochloride Tablets launched in the fourth quarter of 2002, higher Lipram sales, and lower product returns.