Version May 2024
Influenza A, prophylaxis or treatment: The CDC and the Infectious Diseases Society of America do not recommend rimantadine for the treatment or prophylaxis of influenza A infection due to high resistance rates (CDC 2021; IDSA [Uyeki 2019]).
(For additional information see "Rimantadine: Pediatric drug information")
Influenza A, prophylaxis: Note: Rimantadine should NOT be used for prophylaxis of influenza A infection due to high resistance rates (AAP 2020; CDC 2021; IDSA [Uyeki 2019]).
Children ≤9 years: Oral: 5 mg/kg/dose once daily; maximum dose: 150 mg/dose (IDSA/PIDS [Bradley 2011]; manufacturer's labeling).
Children ≥10 years and Adolescents: Oral: 100 mg twice daily or 200 mg once daily (IDSA/PIDS [Bradley 2011]; manufacturer's labeling).
Influenza A infection, treatment: Note: Rimantadine should NOT be used for treatment of influenza A infection due to high resistance rates (AAP 2020; CDC 2021; IDSA [Uyeki 2019]).
Children ≤9 years: Limited data available: Oral: 3.3 mg/kg/dose twice daily for 7 days or until 24 to 48 hours after symptoms resolution; maximum dose: 75 mg/dose (IDSA/PIDS [Bradley 2011]).
Children ≥10 years and Adolescents: Limited data available: Oral: 100 mg twice daily or 200 mg once daily for 7 days, or until 24 to 48 hours after symptom resolution (IDSA/PIDS [Bradley 2011]).
There are no pediatric-specific recommendations; based on experience in adult patients, dosing adjustment suggested.
Hemodialysis: Nondialyzable.
There are no pediatric-specific recommendations; based on experience in adult patients, dosing adjustment suggested.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
1% to 10%:
Central nervous system: Insomnia (2% to 3%), lack of concentration (≤2%), dizziness (1% to 2%), nervousness (1% to 2%), fatigue (1%), headache (1%)
Gastrointestinal: Nausea (3%), anorexia (2%), vomiting (2%), xerostomia (2%), abdominal pain (1%)
Neuromuscular & skeletal: Weakness (1%)
<1%, postmarketing, and/or case reports: Abnormal gait, agitation, altered sense of smell, ataxia, bronchospasm, cardiac failure, confusion, cough, depression, diarrhea, drowsiness, dysgeusia, dyspepsia, dyspnea, euphoria, hallucination, heart block, hyperkinesia, hypertension, lactation, palpitations, pallor, pedal edema, seizure, skin rash, syncope, tachycardia, tinnitus, tremor
Hypersensitivity to rimantadine, other adamantanes (eg, amantadine), or any component of the formulation
Disease-related concerns:
• Hepatic impairment: Use with caution in patients with hepatic impairment.
• Renal impairment: Use with caution in patients with renal impairment.
• Seizures: Use with caution in patients with a history of seizure disorder; an increase in seizure incidence may occur. Discontinue if seizures occur.
Special populations:
• Older adult: The elderly are at higher risk for CNS (eg, dizziness, headache, weakness) and gastrointestinal (eg, nausea/vomiting, abdominal pain) adverse events; dosage adjustment is recommended in patients >65 years of age.
Other warnings/precautions:
• Resistance: May develop during treatment; viruses exhibit cross-resistance between amantadine and rimantadine.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet, Oral, as hydrochloride:
Generic: 100 mg
Yes
Tablets (riMANTAdine HCl Oral)
100 mg (per each): $3.25
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Oral: May be taken without regard to food.
Influenza A: The CDC and the Infectious Diseases Society of America do not recommend rimantadine for the treatment or prophylaxis of influenza A due to high resistance rates (CDC 2021; IDSA [Uyeki 2019]).
RiMANTAdine may be confused with amantadine, raNITIdine, Rimactane
Flumadine may be confused with fludarabine, flunisolide, flutamide
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Influenza Virus Vaccine (Live/Attenuated): Antiviral Agents (Influenza A and B) may diminish the therapeutic effect of Influenza Virus Vaccine (Live/Attenuated). Management: Avoid administration of live influenza virus vaccine (LAIV) within 2 weeks before or 48 hours after administration of antiviral agents. Consider avoiding LAIV if peramivir was given within the last 5 days or baloxavir was given within the last 17 days. Risk D: Consider therapy modification
Adverse events have been observed in animal reproduction studies. Untreated influenza infection is associated with an increased risk of adverse events to the fetus and an increased risk of complications or death to the mother. Neuraminidase inhibitors are currently recommended for the treatment or prophylaxis influenza in pregnant women and women up to 2 weeks postpartum. Appropriate antiviral agents are currently recommended as an adjunct to vaccination and should not be used as a substitute for vaccination in pregnant women (CDC 60[1] 2011; CDC March 13, 2014; CDC January 2015).
Health care providers are encouraged to refer women exposed to influenza vaccine, or who have taken an antiviral medication during pregnancy to the Vaccines and Medications in Pregnancy Surveillance System (VAMPSS) by contacting The Organization of Teratology Information Specialists (OTIS) at 1-877-311-8972.
It is not known if rimantadine is excreted in breast milk. Due to the potential for serious adverse reactions in the nursing infant, breast-feeding is not recommended by the manufacturer.
Influenza may cause serious illness in postpartum women and prompt evaluation for febrile respiratory illnesses is recommended (Louie 2011).
Monitor for CNS or GI effects in elderly or patients with renal or hepatic impairment
Exerts its inhibitory effect on three antigenic subtypes of influenza A virus (H1N1, H2N2, H3N2) early in the viral replicative cycle, possibly inhibiting the uncoating process; it has no activity against influenza B virus and is two- to eightfold more active than amantadine
Onset of action: Antiviral activity: No data exist establishing a correlation between plasma concentration and antiviral effect
Absorption: Oral: Well absorbed
Distribution: Vd: Children: 289 L (Anderson 1987); Adults: 727 to 768 L
Protein Binding: ~40%, primarily to albumin
Metabolism: Extensively hepatic via hydroxylation and glucuronidation
Half-life elimination:
Children 5 to 8 years: 24.8 ± 9.4 hours (Anderson 1987)
Adults: 25.4 hours (range: 13 to 65 hours); Elderly (71 to 79 years of age): 32 hours (range: 20 to 65 hours)
Time to peak: 6 hours
Excretion: Urine (<25% as unchanged drug)
Altered kidney function: Cmax, AUC0 to Tau, and half-life increased by 75%, 81%, and 49%, respectively, in patients with severe renal impairment (CrCl 5 to 29 mL/minute). There was a 1.6-fold increase in half-life and 40% decrease in apparent Cl of rimantadine in hemodialysis patients.
Hepatic function impairment: AUC was about 3-fold larger, elimination half-life was about 2-fold longer, and apparent Cl was 50% lower in patients with severe hepatic impairment.
Older adult: 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.
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
