Contents

Search

rimantadine (Flumadine)

Tradename: Flumadine. Indications: -> prophylaxis & treatment of influenza A virus a) NOT effectvie against influenza B b) NOT recommended 2005-2006 flu season [4] c) FDA-approved for adults only Contraindications: - severe liver dysfunction Dosage: 1) 100 mg PO BID 2) 100 mg PO QD in elderly [3] Tabs: 100 mg. Syrup: 50 mg/5 mL. Dosage adjustment in renal failure: 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: 1) metabolized in liver [4] 2) eliminated primarily in urine 3) elimination 1/2life 13-65 hours, prolonged with ESRD Adverse effects: 1) fewer CNS effects than amantadine (6% vs 13%) 2) GI effects (3%) Drug interactions: - none noted [5] Mechanism of action: - influenza virus M2 inhibitor

Interactions

drug interactions

General

antiviral agent

Properties

MISC-INFO: elimination route LIVER KIDNEY pregnancy-category C safety in lactation -

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Prescriber's Letter 7(8):43 2000
  3. Prescriber's Letter 11(1):1 2004
  4. 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: 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: 16424859 - Prescriber's Letter 13(2): 2006 Detail-Document#: 220202 (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: 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. Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
  6. Department of Veterans Affairs, VA National Formulary