Trade Names:Flumadine- Tablets 100 mg
Inhibits viral replication cycle in various strains of influenza A virus.
Well absorbed. C max is 74 ng/mL (single dose). T max is 6 h (single dose).
Protein binding is 40%, mainly albumin.
Extensively metabolized in the liver to 3 hydroxylated metabolites.
Eliminated in the urine (less than 25% as unchanged drug). Half-life is 25.4 h (single dose) and 32 h (older than 70 yr of age).
Apparent Cl for CrCl 31 to 50 mL/min was 37% lower; apparent Cl for CrCl 11 to 30 mL/min was 16% lower and plasma metabolite concentrations were higher; apparent Cl for CrCl 0 to 10 mL/min was 40% lower with a 1.6-fold increase in elimination half-life.Elderly
In patients older than 70 years of age, the average AUC, peak concentrations, and elimination half-life at steady state were 20% to 30% higher.Severe hepatic insufficiency
AUC was about 3-fold larger, elimination half-life was about 2-fold longer, and the apparent Cl was 50% lower.
Prophylaxis and treatment of infection caused by various strains of influenza A virus.Children
Prophylaxis against influenza A virus.H1N1 recommendations
Per the CDC recommendations for treatment and chemoprophylaxis of H1N1 influenza A (swine flu) virus infection, refer to the oseltamivir and zanamivir A-Z monographs. The H1N1 virus is resistant to the antiviral medication rimantadine. For more information, refer to the CDC guidelines at http://www.cdc.gov/h1n1flu/recommendations.htm .
Hypersensitivity to drugs of adamantine class, including rimantadine and amantadine.
PO 100 mg twice daily.Elderly Nursing Home Patients, Hepatic and Renal Impairment (CrCl less than 10 mL/min)
Reduce to 100 mg/day.ProphylaxisChildren 10 yr of age or older
PO 100 mg twice daily.
Store at controlled room temperature (59° to 86°F).
Decreased C max and AUC of rimantadine.Cimetidine
Increased rimantadine serum concentration caused by decreased Cl.Live attenuated influenza vaccine (LAIV)
Because of potential interference between these products, do not give LAIV until 48 h after cessation of rimantadine, and do not administer rimantadine until 14 days after cessation of LAIV.
None well documented.
Cardiac failure, heart block.
Insomnia (3%); dizziness, impaired concentration, nervousness (2%); asthenia, fatigue, headache (1%).
Nausea (3%); anorexia, dry mouth, vomiting (2%); abdominal pain (1%).
Monitor patients with any degree of renal insufficiency for adverse reactions and adjust the dose as needed.
Category C .
Undetermined. Do not administer to breast-feeding mothers.
Do not administer to children younger than 10 yr of age.
CNS symptoms may occur more frequently.
Use with caution. Monitor patients for adverse reactions and adjust the dose as needed.
Use with caution.
Serious bacterial infections may begin with influenza-like symptoms or may coexist with or occur as complications during influenza; rimantadine has not been shown to prevent such complications.
Increased incidence of seizures in patients with seizure history and who receive amantadine.
Transmission of resistant virus should be considered when treating patients whose contacts are at high risk of influenza A illness.
Agitation, cardiac arrhythmias, death, hallucinations.
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