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Amantadine is a dopaminergic drug, meaning it increases extracellular dopamine levels. It is used to treat the symptoms of Parkinson's disease and movement disorders. What is the effect of amantadine? What are the side effects of its use?

Action of amantadine

Amantadine is a dopaminergic drug, meaning it increases extracellular dopamine levels. This happens by increasing its release in the striatum and by blocking the reuptake of this neurotransmitter.

Amantadine is also a low affinity N-methyl-D-aspartate (NMDA) glutamate receptor antagonist and has antiviral activity (at low concentrations it specifically inhibits replication of influenza A viruses).

Indications for the use of amantadine

Amantadine is used to treat the symptoms of Parkinson's disease, a Parkinson's-like movement disorder caused by certain medications (neuroleptics and drugs with a similar mechanism of action). There was a heated debate about its use in treating COVID-19 at one time.

It should be noted, however, that amantadine, at the moment, is still not approved for the treatment of COVID-19 and is not recommended by the Polish Society of Epidemiologists and Doctors of Infectious Diseases. Research is ongoing to provide definitive answers on this issue.

Contraindications to the use of amantadine

Drugs of this composition are contraindicated if the patient is allergic to amantadine, suffers from heart diseases (decompensated heart failure NYHA IV, cardiomyopathy, myocarditis, heart conduction disturbances, slowed heart rate, changes in electrocardiogram such as prolonged QT interval, severe abnormal heart rhythm), low levels of potassium or magnesium in the blood.

Particular care should be taken in the case of an enlarged prostate gland, increased pressure inside the eye (narrow-angle glaucoma), renal failure of various severity (risk of drug accumulation due to deterioration of renal filtration), states of agitation or entanglement.

Available preparations

The drug is dispensed only with a doctor's prescription and is available in two pharmaceutical forms - coated tablets, solution forinfusion.

Amantadine dosage

Tablets should be taken orally with a small amount of liquid, preferably in the morning and afternoon. The last daily dose should not be taken later than 4 pm. Do not stop taking the tablets without consulting your doctor. The doctor determines the duration of treatment depending on the patient's disease state and individual response to treatment.

Initial and intensive treatment of severe and life-threatening symptoms of Parkinson's disease. Treatment of disturbances of consciousness and wakefulness of various etiologies (as part of comprehensive therapy in a hospital setting).

The solution for infusion is administered intravenously, usually in a hospital setting. It is used for the intensive treatment of severe and life-threatening symptoms of Parkinson's disease.

Side effects of amantadine

They often appear:

  • sleep disorders,
  • anxiety and agitation,
  • urinary retention in patients with an enlarged prostate gland,
  • delusions with accompanying visual hallucinations (mainly in elderly patients),
  • marbled cyanosis (red-blue spots on the skin that form a mesh),
  • sometimes with accompanying swelling of the lower legs and ankles,
  • dry mouth,
  • sudden drop in blood pressure when getting up from a lying or sitting position sharply.

Interaction with other drugs and substances

The drug must not be used simultaneously with other drugs that prolong the QT interval, such as :

  • certain drugs used to treat irregular heartbeat (e.g. amiodarone, sotalol),
  • certain drugs used in the treatment of mental illnesses (e.g. thioridazine, chlorpromazine, haloperidol, pimozide),
  • certain medications used to treat depression (e.g. amitriptyline)
  • certain medications used to treat allergies,
  • certain drugs used to treat bacterial infections (e.g. erythromycin, clarithromycin and gyrase inhibitors, e.g. sparfloxacin),
  • certain medications used to treat fungal infections (azole antifungal drugs),
  • other drugs, such as co-trimoxazole, cisapride.

You should avoid consuming alcoholic beverages while taking the drug as this drug reduces alcohol tolerance.

Pregnancy and breastfeeding

The drug is contraindicated during pregnancy and breastfeeding women.

Impact on the operation of machinery and driving of motor vehicles

The effects of amantadine on concentration and wakefulness as well as accommodation cannot be excludedthe eye (the adaptation of the eye to seeing at different distances), especially when combined with the effects of other medications used to treat Parkinson's disease.

The patient may not be able to react quickly and decisively in unexpected situations.

Amantadine storage

The drug should be kept out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the blister and carton. The expiry date refers to the last day of that month.

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