Drug Action
Amantadine is a weak dopamine agonist with modest antiparkinsonian effects.
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Drug reference
Amantadine is a weak dopamine agonist with modest antiparkinsonian effects.
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Parkinson’s disease ▶BY MOUTH ▶Adult: 100 mg daily for 1 week, then increased to 100 mg twice daily, usually administered in conjunction with other treatment. Some patients may require higher doses; maximum 400 mg per day ▶Elderly: 100 mg daily, adjusted according to response Post-herpetic neuralgia ▶BY MOUTH ▶Adult: 100 mg twice daily for 14 days (continued for another 14 days if necessary) Treatment of influenza A (but not recommended) ▶BY MOUTH ▶Adult: 100 mg daily 4–5 days Prophylaxis of influenza A (but not recommended) ▶BY MOUTH ▶Adult: 100 mg daily usually for 6 weeks or with influenza vaccination for 2–3 weeks after vaccination Fatigue in multiple sclerosis (initiated by a specialist) ▶BY MOUTH ▶Adult: 100 mg daily for 1 week, dose to be taken in the morning, then increased to 100 mg twice daily; maximum 400 mg per day l UNLICENSED USE g Amantadine is used for fatigue in Nervous system multiple sclerosis, l but is not licensed for this indication.
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Epilepsy. history of gastric ulceration
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Confused or hallucinatory states. congestive heart disease (may exacerbate oedema). elderly. tolerance to the effects of amantadine may develop in Parkinson’s disease
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NICE decisions ▶Oseltamivir, amantadine (review) and zanamivir for the prophylaxis of influenza (September 2008) NICE TA158 Amantadine is not recommended for prophylaxis of influenza. www.nice.org.uk/guidance/ta158 ▶Amantadine, oseltamivir and zanamivir for the treatment of influenza (February 2009) NICE TA168 Amantadine is not recommended for treatment of influenza. www.nice.org.uk/guidance/ta168
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→Appendix 1: dopamine receptor agonists
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▶Common or very common Anxiety. appetite decreased. concentration impaired. confusion. constipation. depression. dizziness. dry mouth. hallucination. headache. hyperhidrosis. lethargy. mood altered. movement disorders. myalgia. nausea. palpitations. peripheral oedema. postural hypotension. skin reactions. sleep disorders. speech slurred. vision disorders. vomiting ▶Uncommon Neuroleptic malignant-like syndrome. psychosis. seizure. tremor ▶Rare or very rare Cardiovascular insufficiency. diarrhoea. eye disorders. eye inflammation. heart failure. leucopenia . photosensitivity reaction. urinary disorders ▶Frequency not known Delirium
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Avoid; toxicity in animal studies.
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Avoid; present in milk; toxicity in infant reported.
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Manufacturer advises use with caution in liver disorders.
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Avoid if eGFR less than 15 mL/minute/1.73 m2. Dose adjustments Reduce dose.
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There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: tablet Oral solution ▶Amantadine hydrochloride (Non-proprietary) Amantadine hydrochloride 10 mg per 1 ml Amantadine 50mg/5ml oral solution sugar-free | 150 ml P £140.00 DT = £129.27 Capsule ▶Amantadine hydrochloride (Non-proprietary) Amantadine hydrochloride 100 mg Amantadine 100mg capsules | 14 capsule P £8.72–£10.25 | 56 capsule P £41.00 DT = £33.61
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Avoid abrupt withdrawal in Parkinson’s disease.
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Driving and skilled tasks May affect performance of skilled tasks (e.g. driving).
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100 mg daily, adjusted according to response
First-line fragment. Read the complete Indications and Dose section above.
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