Symetrel

Amantadine 100mg

Warnings
Contraindications
capsule, tablet, syrup

  • Hypersensitivity to amantadine, rimantadine
  • Untreated narrow-angle glaucoma
  • Breastfeeding
capsule, extended-release
  • End-stage renal disease (CrCl <15 mL/min)
Cautions
Reports of falling asleep while engaged in activities of daily living (eg, operation of motor vehicles); patients may not perceive warning signs, such as excessive drowsiness, or they may report feeling alert immediately prior to the event; advise patients of the potential to develop drowsiness
Avoid abrupt withdrawal; abrupt discontinuation of amantadine may cause an increase in symptoms of Parkinson disease or cause delirium, agitation, delusions, hallucinations, paranoid reaction, stupor, anxiety, depression, or slurred speech
In clinical trials, suicidal ideation, depression, and/or depressed mood were reported; monitor for depression, including suicidal ideation or behavior

capsule, tablet, syrup

  • Since 2008-09 influenza season, Centers for Disease Control and Prevention (CDC) advises against use for treatment or prophylaxis of influenza in US
  • Reports of congestive heart failure (CHF), peripheral edema, and hypotension with amantadine; monitor patients with history of CHF, peripheral edema, and/or orthostatic hypotension
  • Amantadine may accumulate in the plasma and body when renal function declines; see Dosing Considerations
  • Rare instances of reversible elevation of liver enzymes have been reported in patients receiving amantadine, though the mechanism is unknown
  • History of seizures, eczematoid rash, severe psychosis or psychoneurosis
  • Consider reducing anticholinergic dosages before initiating amantadine therapy
  • Risk of neuroleptic malignant syndrome (NMS) with dosage reduction or withdrawal; management of NMS should include intensive symptomatic treatment, medical monitoring, and treatment of any concomitant serious medical problems for which specific treatments are available
  • Possibility of reduced effectiveness after several months; may regain efficacy if dosage is increased
capsule, extended-release

  • Patients with a major psychotic disorder should ordinarily not be treated with amantadine because of the risk of exacerbating psychosis; observe patients for the occurrence of hallucinations throughout treatment, especially at initiation and after dose increases
  • In controlled clinical trials, patients experienced dizziness, syncope, orthostatic hypotension, presyncope, postural dizziness or hypotension; monitor patients for dizziness and orthostatic hypotension, especially after starting amantadine extended-release or increasing the dose
Parkinson patients

  • Patients can experience intense urges to gamble, increased sexual urges, intense urges to spend money, binge eating, and/or other intense urges, and inability to control these urges while taking one or more of the medications, including amantadine, that increase central dopaminergic tone
  • May be linked to higher melanoma risk; ; monitor for melanomas frequently and on a regular basis when using amantadine for any indication; periodic skin examinations should be performed by appropriately qualified individuals

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Symetrel only for the indication prescribed.