$16.22
Manufacturer: Ukraine
Antiparkinsonian drugs. Dopaminergic agents. ATX code N04B B01.
Parkinson’s Syndrome: Treatment of symptoms of Parkinson’s disease such as rigidity, tremors, hypokinesia and akinesia.
Extrapyramidal side effects of neuroleptics and other drugs: early dyskinesia, akathisia and parkinsonism.
Description
Ingredients
active ingredient: amantadine sulfate;
1 tablet contains amantadine sulfate 100 mg;
excipients: lactose, microcrystalline cellulose, potato starch, gelatin, povidone, croscarmellose sodium, talc, colloidal silicon dioxide, magnesium stearate, Opadry II White (polyethylene glycol, polyvinyl alcohol, talc, titanium dioxide (E 171)).
Pharmacotherapeutic group
Antiparkinsonian drugs. Dopaminergic agents. ATX code N04B B01.
Pharmacodynamics
Amantadine has various pharmacological properties. It reveals the indirect property of a striatal dopamine receptor agonist. Animal studies have shown that amantadine increases extracellular concentrations of dopamine both by increasing dopamine release and by blocking reuptake in presynaptic nerve cells. At therapeutic concentrations, amantadine inhibits the release of acetylcholine mediated by NMDA receptors and thus may have an anticholinergic effect. Amantadine has a synergistic effect with L-dopa.
Indications
Parkinson’s Syndrome: Treatment of symptoms of Parkinson’s disease such as rigidity, tremors, hypokinesia and akinesia.
Extrapyramidal side effects of neuroleptics and other drugs: early dyskinesia, akathisia and parkinsonism.
Contraindications
- hypersensitivity to amantadine or to any component of the drug;
- epilepsy and other convulsive seizures;
- severe renal failure;
- peptic ulcer;
- decompensated heart failure (stage IV according to the classification developed by the New York Heart Association – NYHA);
- cardiomyopathy and myocarditis;
- blockade II and III degree;
- bradycardia (less than 55 beats / min);
- prolonged QT interval (Bazett QTc > 420 ms) with either prominent U-waves or a family history of congenital QT syndrome;
- severe ventricular arrhythmia, including chaotic polymorphic ventricular tachycardia;
- simultaneous treatment with budipine or other drugs that prolong the QT interval;
- low levels of potassium or magnesium in the blood.
Special security measures.
Patients who take antipsychotics and amantadine concomitantly are at risk of developing neuroleptic malignant syndrome if amantadine is suddenly discontinued.
In patients with kidney damage, intoxication may occur.
It is necessary to be especially careful when prescribing the drug to patients with an organic brain syndrome or patients prone to convulsions, since convulsions and an increase in existing symptoms may occur.
Patients with cardiovascular disorders need medical supervision during treatment with amantadine.
Patients with Parkinson’s disease often present with symptoms such as hypotension, increased salivation, increased sweating, increased body temperature, heat buildup, edema, and depression. During the treatment of such patients, special attention should be paid to adverse reactions and interactions of amantadine with other drugs.
An examination by an ophthalmologist is necessary if there are symptoms of loss of visual acuity or blurred vision in order to exclude possible corneal edema. If corneal edema is diagnosed, amantadine should be discontinued. Corneal edema caused by taking amantadine usually disappears after stopping treatment for a month.
Patients should inform the doctor in case of difficulty with urination.
Directions
Tablets should be taken by adults inside, with a small amount of liquid, after meals, preferably in the morning and / or afternoon. Due to the possible activating effect on the central nervous system (CNS), the last dose is recommended to be taken no later than the sixteenth hour.
Single and daily dose.
By following the above measures and taking into account contraindications, it is possible to prevent a life-threatening adverse reaction – chaotic polymorphic ventricular tachycardia.
Treatment of patients with Parkinson’s syndrome and motor activity disorders caused by the use of drugs should be carried out gradually, observing the dosage in accordance with the therapeutic effect.
Treatment should begin with taking 1 tablet (100 mg of amantadine sulfate) of Amantine per day for the first 4 to 7 days, followed by an increase in the daily dose by 1 tablet once a week until an effective therapeutic dose is reached.
The usual effective dose is 1 to 3 tablets twice daily (200 to 600 mg of amantadine sulfate).
For elderly patients, in particular in conditions of agitation, confusion or delirium syndromes, a daily dose of 100 mg (1 tablet) is recommended. If this dose is not effective, it can be carefully increased to 200 mg per day under the supervision of a physician.
When combined treatment with other antiparkinsonian drugs, the dose should be selected individually.
For patients previously treated with amantadine, injection, the starting dose should be higher.
With a sharp deterioration in parkinsonian symptoms during an akinetic crisis, it is necessary to prescribe the introduction of a solution of amantadine sulfate.
Patients with renal insufficiency.
Doses for patients with renal insufficiency should be adapted according to the glomerular filtration rate (GFR), as shown in the table:
| GFR (ml/min) | Dose of amantadine sulfate (mg) | Interval between doses of amantadine sulfate |
| 80 – 60 | 100 | Every 12 hours |
| 60 – 50 | 200 and 100* | Every next day * |
| 50 – 30 | 100 | 1 time per day |
| 30 – 20 | 200 | 2 times per week |
| 20 – 10 | 100 | 3 times a week |
| < 10 and patients on hemodialysis | 200 and 100 | once a week or
1 time every 2 weeks |
* Achieved by taking alternately 1 time for 1 tablet and 1 time for 2 tablets of 100 mg of amantadine sulfate.
Amantadine is dialyzed poorly (about 5%).
The duration of treatment depends on the nature and severity of the disease and is determined by the doctor. Patients should not interrupt treatment on their own.
Abrupt discontinuation of treatment should be avoided, since in this case, in patients with Parkinson’s disease, extrapyramidal symptoms may increase, sometimes include akinetic crises, and the effect of discontinuation of the drug can sometimes manifest itself in the form of delirium.
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