rimantadine (Rx)

Brand and Other Names:Flumadine
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

syrup

  • 50mg/5mL

tablet

  • 100mg

Influenza A Virus

Prophylaxis

  • 100 mg PO q12hr

Treatment

  • 100 mg PO q12hr preferably within 48 hours after onset of signs and symptoms of influenza A infection

Dosage Forms & Strengths

tablet

  • 100mg

Influenza A Virus

Children 1-10 years and Children >10 years but <40 kg: 5 mg/kg PO qDay or q12hr; not to exceed 150mg/day  

Children >10 years and >40 kg: 100mg PO q12hr

Severe renal (CrCl <10 mL/min) or liver impairment: Administer qDay

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Interactions

Interaction Checker

and rimantadine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (0)

                Monitor Closely (8)

                • aclidinium

                  aclidinium, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.

                • atropine IV/IM

                  atropine IV/IM, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.

                • glycopyrrolate inhaled

                  glycopyrrolate inhaled, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.

                • henbane

                  henbane, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.

                • hyoscyamine spray

                  hyoscyamine spray, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.

                • oxybutynin

                  oxybutynin, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.

                • oxybutynin transdermal

                  oxybutynin transdermal, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.

                • rapacuronium

                  rapacuronium, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.

                Minor (8)

                • aclidinium

                  rimantadine increases effects of aclidinium by pharmacodynamic synergism. Minor/Significance Unknown.

                • atropine IV/IM

                  rimantadine increases effects of atropine IV/IM by pharmacodynamic synergism. Minor/Significance Unknown.

                • glycopyrrolate

                  rimantadine increases effects of glycopyrrolate by pharmacodynamic synergism. Minor/Significance Unknown.

                • glycopyrrolate inhaled

                  rimantadine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Minor/Significance Unknown.

                • henbane

                  rimantadine increases effects of henbane by pharmacodynamic synergism. Minor/Significance Unknown.

                • hyoscyamine spray

                  rimantadine increases effects of hyoscyamine spray by pharmacodynamic synergism. Minor/Significance Unknown.

                • oxybutynin transdermal

                  rimantadine increases effects of oxybutynin transdermal by pharmacodynamic synergism. Minor/Significance Unknown.

                • rapacuronium

                  rimantadine increases effects of rapacuronium by pharmacodynamic synergism. Minor/Significance Unknown.

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                Adverse Effects

                1-10%

                Dizziness (2%)

                Nervousness (1-2%)

                Fatigue (1%)

                Headache (1%)

                Insomnia (2%)

                Difficulty in concentrating (<2%)

                Anxiety (1%)

                Anorexia (2%)

                Weakness (1%)

                Nausea (3%)

                Vomiting (2%)

                Xerostomia (2%)

                Abdominal pain (1%)

                Anorexia (2%)

                < 1%

                Dyspnea

                Agitation

                Ataxia

                Tachycardia

                Tremor

                Convulsions

                Heart block

                Hyperkinesias

                Bronchospasm

                Gait abnormality

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                Warnings

                Contraindications

                Hypersensitivity to amantadine, rimantadine or any drug component

                Cautions

                CDC advises against use for treatment or prophylaxis of influenza in the US during the 2008-09 influenza season

                Caution in patients with history of seizures; discontinue if seizures occur

                Avoid use in patients with psychosis (active or uncontrolled)

                Caution in renal impairment

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                Pregnancy & Lactation

                Pregnancy Category: C

                Lactation: enters breast milk

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Mechanism of Action

                Inhibits viral replication of three subtypes of influenza A (H1N1, H2N2, H3N2) early in the viral replicative cycle. Has no activity against influenza B virus.

                Pharmacokinetics

                Onset of action: antiviral activity: no data exist establishing a correlation between plasma concentration & antiviral effect

                Absorption: tablet and syrup formulations are equally absorbed

                Metabolism: Hepatic (extensive)

                Protein binding: 40% (primarily to albumin)

                Half-life: 25.4 hr; prolonged in elderly as well as severe renal and hepatic impairment

                Peak Plasma Time: 6 hr

                Excretion: Urine (<25% as unchanged drug)

                Clearance: Hemodialysis does not contribute to clearance

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                Flumadine oral
                -
                100 mg tablet
                rimantadine oral
                -
                100 mg tablet

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                rimantadine oral

                RIMANTADINE - ORAL

                (ri-MAN-ta-deen)

                COMMON BRAND NAME(S): Flumadine

                USES: Rimantadine is used to prevent or treat a certain type of flu virus (influenza A). If you have been infected with the flu, this medication may help make your symptoms less severe and shorten the time it will take you to get better. Taking rimantadine if you have been or will be exposed to the flu may help to prevent you from getting the flu. This medication is an antiviral that is believed to work by stopping the growth of the flu virus. This medication is not a vaccine. To increase the chance that you will not get the flu, it is important to get a flu shot once a year at the beginning of every flu season, if possible.The Centers for Disease Control (CDC) recommends that rimantadine should not be used for the treatment or prevention of influenza A because the current influenza A virus in the United States is resistant to this medication. For more details, talk to your doctor or pharmacist.

                HOW TO USE: Take this medication by mouth with or without food as directed by your doctor. When this medication is taken to prevent flu, children younger than 10 should usually take it once a day, and children older than 10 and adults should take it twice a day. When used to treat flu in adults, the medication is taken twice a day. Do not increase your dose or take rimantadine more often than prescribed.Dosage is based on your medical condition and response to therapy. In children, the dosage is also based on body weight.Begin taking rimantadine as soon as possible after being exposed to the flu or developing flu symptoms. Take this medication for the full time prescribed. Stopping this medication too soon may allow the virus to continue to grow, which can lead to severe flu infection.If you are taking the syrup, measure the dose carefully with a medication spoon/cup.Inform your doctor if your condition persists or worsens.

                SIDE EFFECTS: Trouble sleeping, nausea, vomiting, loss of appetite, dry mouth, weakness, dizziness, drowsiness, or nervousness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: mental/mood changes (e.g., depression), seizures.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before taking rimantadine, tell your doctor or pharmacist if you are allergic to it; or to amantadine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, seizures.This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Older adults may be at a greater risk for dizziness, headache, or weakness while using this drug.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. However, similar drugs pass into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

                DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.A product that may interact with this drug is: flu vaccine inhaled through the nose.

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include mental/mood changes (e.g., agitation, hallucinations), irregular heartbeat, trouble breathing, change in amount of urine, unconscious, fever, or seizures.

                NOTES: Do not share this product with others.This medication works best at reducing the length and severity of the flu when taken within 24 to 48 hours of the first appearance of flu symptoms.

                MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

                STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

                Information last revised September 2021. Copyright(c) 2021 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

                Adding plans allows you to compare formulary status to other drugs in the same class.

                To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                Adding plans allows you to:

                • View the formulary and any restrictions for each plan.
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                • Compare formulary status to other drugs in the same class.
                • Access your plan list on any device – mobile or desktop.

                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
                Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.