- Indications for Admission
- Rimantadine: instructions for use
- Flu Prevention
- Flu Treatment
- Tick-borne Encephalitis
- Contraindications to receive according to the instructions for the drug
- Adverse Effects
- Rimantadine: effects of taking higher doses of the drug
- Rimantadine in combination with other medicines
Rimantadine is a drug belonging to the group of antiviral drugs. Rimantadine is the official international name, Remantadine is a registered trademark. Both names, according to the information from the instructions, are synthetic derivatives of amantadine.was invented in 1963 when studying amantadine derivatives. In 1969, a group of Soviet chemists made improvements to the composition, which served to the wide distribution of the drug.
In 2007, the Formulary Committee of the Russian Academy of Medical Sciences described this drug as “outdated, with unproven effectiveness”. Studies conducted in the USA in the last 10 years prove the low efficiency of rimantadine against existing strains of the influenza virus, since mutations of viruses have contributed to the appearance of forms resistant to this drug. Nevertheless, rimantadine is quite actively used as part of preventive and antiviral therapy due to its spectrum of action and low cost of the drug.
Indications for Admission
Despite the proven low efficiency of the drug against common strains of influenza A and B, it is used for prophylactic and therapeutic purposes by blocking the synthesis of proteins necessary for synthesizing viral cells, and is also used in the treatment of suspected or infected with encephalitis virus and as part of herpes therapy.
Rimantadine: instructions for use
Instructions for use slightly differ for different types of drug, mainly due to the increased amount of active ingredient in Rimantadine. Standard recommendations are based on a dose of 50 mg, which corresponds to 1 tablet of rimantadine. Before taking it one should consult a specialist.
Reception is carried out regardless of the meal. Tablets and capsules must be swallowed whole, without opening, breaking, chewing, etc., and drink plenty of liquids. It is also important to observe equal time intervals between taking doses of the drug during the day, which is caused by the slow absorption of the active substance into the systemic circulation and low metabolic rate and its removal from the body. In case of violation of the equivalence of time intervals, there may be side effects or symptoms of drug overdose.
For prophylactic purposes, the drug is prescribed to patients over 10 years old without contraindications. Prevention is carried out in the season of epidemics and pandemics in the presence of a high risk of infection, contacts with the sick.
Dosage: 1 tablet (50 mg) once a day, for 1 month. When you skip the reception resume without increasing the dosage, following the usual mode of prevention.
When preventive measures in patients under the age of 10 years, the dosage is calculated based on the child’s body weight. To comply with the exact age dosage in children from 1 to 7, syrups are recommended from Orvirem, Algirem, liquid forms of rimantadine, developed for the early childhood period.
Acceptance of any form of amantadine derivatives by children under the age of 1 year is prohibited.
Therapy is effective in the early stages of the disease with the initial symptoms of the disease. The effect of the drug on viral cells manifests itself in the event that no more than 18 hours have passed from the moment of the first signs of infection to the reception. The dosage and frequency of the drug depends on the age of the patient.
Children from 7 to 10 years old take 1 tablet (50 mg) twice a day.
For children aged 11-14 years, the multiplicity of reception – 3 times a day, 1 tablet.
For children over 14 years old and adults, a phased therapy is recommended:
- on day 1 of the onset of symptoms, 6 tablets (300 mg) once or divided into 2-3 doses, but not more than 300 mg per 24 hours;
- 2 and 3 days of illness: 200 mg (4 tablets) in two doses;
- 4 and 5 days: 2 tablets once a day.
The course of treatment for flu of a different type – not longer than 5 days.
Early administration of the drug at the onset of the disease reduces the severity of intoxication, reduces the period of fever by 1 day compared to taking placebo, and helps the patient recover more quickly.
Rimantadine is effective for prophylactic and therapeutic use against viral encephalitis. For the prevention of tick-borne encephalitis, when visiting a place with a high probability of infection, take 1 tablet twice a day for 15 days.
With a tick bite, the dose is increased to 100 mg twice a day, the duration of treatment is 3-5 days.
Contraindications to receive according to the instructions for the drug
The instructions for the drug include contraindications for prophylaxis and therapy. There are unconditional contraindications and conditional restrictions.
Unconditional contraindications for which rimantadine cannot be taken include:
- enzyme and metabolic disorders: lactase deficiency, galactosemia, impaired glucose and galactose absorption;
- renal, liver failure;
- Children up to 7 years old;
- gestational period (pregnancy) due to the teratogenic effect of the active drug on the embryo and fetus detected in animal studies.
During lactation, it is not recommended to take the drug, if necessary, this type of antiviral therapy is to limit or stop the baby taking breast milk produced during the treatment of the mother.
Conditional contraindications that take into account when prescribing the drug and assess the risks include:
- allergic reactions;
- increased individual sensitivity to the components of the drug;
- heart rhythm disturbances
- diseases of the cardiovascular system
- diseases of the digestive system.
Rimantadine is a drug with a low number of side effects that occur with low frequency. Unlike Amantadin, dysfunction of the gastrointestinal tract is barely identified by the studies. Nevertheless, the instruction to the drug notes possible side effects from the courses of prevention and treatment with rimantadine. The following side effects may occur:
- dizziness, episodes of impaired concentration, psychomotor activity;
- low intensity, unexpressed headaches;
- sleep disorders;
- dryness of the mucous membranes of the mouth, nausea, vomiting episodes;
- increased bilirubin in the blood;
- abdominal pain, flatulence.
Allergic reactions when they appear are limited in most cases to the skin, appearing as a rash like urticaria and skin itchiness.
If any side effects occur, a specialist should be consulted to determine the appropriateness of continuing the course of therapy, changing the dosage or changing the drug / active ingredient.
Because of the likelihood of dizziness as side effects, it is not recommended to drive a car, to work that requires high concentration of attention, etc. during preventive and therapeutic courses of taking the drug.
Rimantadine: effects of taking higher doses of the drug
Antiviral medication should be taken in accordance with the age and individual characteristics of the patient in the indicated dosages. Excess doses and frequency of administration does not lead to increased antiviral and antitoxic effects, but may cause negative consequences. Dysfunctions of the organs of the gastrointestinal tract, episodes of impaired consciousness, pronounced allergy reactions are most often noted.
There is no specific antidote to rimantadine. Therapy is carried out by washing the cavity of the stomach, if necessary – observation in the hospital, the appointment of symptomatic means.
Rimantadine in combination with other medicines
Like other drugs, rimantadine should not be combined with the simultaneous use of absorbents, agents with astringent, enveloping the gastric mucosa, intestinal effects due to a decrease in the efficiency of the active substance.
According to the instructions for use, you should pay attention to the following effects from simultaneous use with certain groups of drugs:
- antiepileptic drugs while taking due to a decrease in the effectiveness of antiepileptic therapy;
- ascorbic acid and ammonium chloride reduce the effect of amantadine derivatives and reduce the antiviral effect;
- aspirin (various names of acetylsalicylic acid and the drugs in which it is present), paracetamol and derivatives reduce the effectiveness of this drug by 11% due to the effect on the amount of active substance entering the systemic circulation;
- when combined with sodium bicarbonate and acetosolamide, enhancing the antiviral activity of this drug.