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AMANTADINE

(Also Known As: SYMMETREL, ENDANTADINE)

For patients taking amantadine to prevent or treat flu infections :

• Talk to your doctor about the possibility of getting a flu shot if you have not had one yet.
• This medicine is best taken before exposure, or as soon as possible after exposure, to people who have the flu.
• To help keep yourself from getting the flu, keep taking this medicine for the full time of treatment. Or if you already have the flu, continue taking this medicine for the full time of treatment even if you begin to feel better after a few days. This will help to clear up your infection completely. If you stop taking this medicine too soon, your symptoms may return. This medicine should be taken for at least 2 days after all your flu symptoms have disappeared.
• This medicine works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses. Also, it is best to take the doses at evenly spaced times day and night. For example, if you are to take two doses a day, the doses should be spaced about 12 hours apart. If this interferes with your sleep or other daily activities, or if you need help in planning the best times to take your medicine, check with your health care professional.
• If you are using the oral liquid form of amantadine, use a specially marked measuring spoon or other device to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid.

For patients taking amantadine for Parkinson's disease or movement problems caused by certain medicines used to treat nervous, mental, and emotional conditions:

• Take this medicine exactly as directed by your doctor. Do not miss any doses and do not take more medicine than your doctor ordered.
• Improvement in the symptoms of Parkinson's disease usually occurs in about 2 days. However, in some patients this medicine must be taken for up to 2 weeks before full benefit is seen.

Dosing

The dose of amantadine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of amantadine. Your dose may be different if you have kidney disease. If your dose is different, do not change it unless your doctor tells you to do so. The number of capsules, tablets, or teaspoonfuls of suspension that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking amantadine.

• For oral dosage forms (capsules, syrup, and tablets):
  • For the treatment or prevention of flu:
    • Older adults 100 milligrams once a day.
    • Adults and children 12 years of age and older 200 milligrams once a day, or 100 milligrams two times a day.
    • Children 9 to 12 years of age 100 milligrams two times a day.
    • Children 1 to 9 years of age Dose is based on body weight and must be determined by the doctor.
    • Children up to 1 year of age Use and dose must be determined by your doctor
  • For the treatment of Parkinson's disease or movement problems:
    • Older adults 100 milligrams once a day to start. The dose may be increased slowly over time, if needed.
    • Adults 100 milligrams one or two times a day. Your doctor may increase this dose, if needed.
    • Children Dose has not been determined.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. This will help to keep a constant amount of medicine in the blood. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the capsule form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the oral liquid form of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For amantadine, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to amantadine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy Studies have not been done in humans. However, there have been reports of birth defects, including birth defects of the heart, when women took amantadine during the first trimester of pregnancy. Also, a malformation involving the lower leg occurred in one infant. In addition, studies in some animals have shown that amantadine is harmful to the fetus and causes birth defects. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding Amantadine passes into breast milk. However, the effects of amantadine in newborn babies and infants are not known. It may be necessary for you to take another medicine or to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Children This medicine has been tested in children over 1 year of age and has not been shown to cause different side effects or problems in these children than it does in adults. There is no specific information comparing the use of amantadine in children under 1 year of age with use in other age groups.

Older adults Elderly people are especially sensitive to the effects of amantadine. Confusion, difficult urination, blurred vision, constipation, and dry mouth, nose, and throat may be especially likely to occur.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking amantadine, it is especially important that your health care professional know if you are taking any of the following:

• Amphetamines or
• Appetite suppressants (diet pills), except fenfluramine (e.g., Pondimin), or
• Caffeine (e.g., NoDoz) or
• Chlophedianol (e.g., Ulone) or
• Cocaine or
• Medicine for asthma or other breathing problems or
• Medicine for colds, sinus problems, or hay fever or other allergies (including nose drops or sprays) or
• Methylphenidate (e.g., Ritalin) or
• Nabilone (e.g., Cesamet) or
• Pemoline (e.g., Cylert) The use of amantadine with these medicines may increase the chance of unwanted effects such as nervousness, irritability, trouble in sleeping, and possibly seizures or irregular heartbeat

• Anticholinergics (medicine for abdominal or stomach spasms or cramps) The use of amantadine with these medicines may increase the chance of unwanted effects such as blurred vision, dryness of the mouth, confusion, hallucinations, and nightmares

• Quinidine (e.g., Quinaglute Dura-tabs, Quinidex Extentabs) or
• Quinine or
• Trimethoprim and sulfamethoxazole (e.g., Bactrim, Septra) These medicines may increase the amount of amantadine in the blood and increase the chance for side effects

• Eczema (recurring) Amantadine may cause or worsen eczema

• Epilepsy or other seizure disorder (history of) Amantadine may increase the frequency of convulsions (seizures) in patients with a seizure disorder

• Heart disease or other circulation problems or
• Swelling of feet and ankles Amantadine may increase the chance of swelling of the feet and ankles, and may worsen heart disease or circulation problems

• Kidney disease Amantadine is removed from the body by the kidneys; patients with kidney disease will need to receive a lower dose of amantadine

• Mental or emotional illness Higher doses of amantadine may cause confusion, hallucinations, and nightmares

• Substance abuse (drug or alcohol abuse), history of The chance of side effects from this medicine may be increased