rimantadine (Flumadine)
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Introduction
Tradename: Flumadine.
Indications
- prophylaxis & treatment of influenza A virus
- NOT effectvie against influenza B
- NOT recommended 2005-2006 flu season[4]
- FDA-approved for adults only
Contraindications
- severe liver dysfunction
Dosage
Tabs: 100 mg.
Syrup: 50 mg/5 mL.
Dosage adjustment in renal failure
Table
| creatinine clearance | dosage |
|---|---|
| > 50-90 mL/min | 100 mg BID |
| 10-50 mL/min | 100 mg QD-BID |
| < 10 mL/min | 100 mg QD |
Pharmacokinetics
- metabolized in liver[4]
- eliminated primarily in urine
- elimination 1/2life 13-65 hours, prolonged with ESRD
elimination via liver
elimination via kidney
Adverse effects
- fewer CNS effects than amantadine (6% vs 13%)
- GI effects (3%)
Drug interactions
- none noted[5]
Mechanism of action
- influenza virus M2 inhibitor
More general terms
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Prescriber's Letter 7(8):43 2000
- ↑ 3.0 3.1 Prescriber's Letter 11(1):1 2004
- ↑ 4.0 4.1 4.2 Bright RA, Medina MJ, Xu X, Perez-Oronoz G, Wallis TR, Davis XM, Povinelli L, Cox NJ, Klimov AI. Incidence of adamantane resistance among influenza A (H3N2) viruses isolated worldwide from 1994 to 2005: a cause for concern. Lancet. 2005 Oct 1;366(9492):1175-81. Epub 2005 Sep 22. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16198766
Centers for Disease Control and Prevention (CDC). High levels of adamantane resistance among influenza A (H3N2) viruses and interim guidelines for use of antiviral agents: United States, 2005-06 influenza season. MMWR Morb Mortal Wkly Rep. 2006 Jan 20;55(2):44-6. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16424859
Prescriber's Letter 13(2): 2006 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220202&pb=PRL (subscription needed) http://www.prescribersletter.com
Bright RA et al, Adamantane resistance among influenza A viruses isolated early during the 2005-2006 influenza season in the United States. JAMA 2006 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16456807
Centers for Disease Control and Prevention (CDC). CDC recommends against use of amantadine and rimantadine for the treatment of prophylaxis of influenza during the 2005- 2006 flu season. CDC Health Alert Network 2006, Jan 14 http://www.cdc.gov/flu/han011406.htm - ↑ 5.0 5.1 Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
- ↑ Department of Veterans Affairs, VA National Formulary