Rimantadine, tablets 50 mg 20 pcs

Remantadine is active against various strains of influenza A virus (especially type A2).
Being a weak base, Remantadine® acts by increasing the pH of the endosomes which have membrane vacuoles that surround the viral particles once they enter the cell.

The prevention of acidification in these vacuoles blocks the fusion of the viral envelope with the endosome membrane, thus preventing the transfer of viral genetic material into the cell cytoplasm. Remantadine® also inhibits the exit of viral particles from the cell, i.e. it interrupts transcription of the viral genome.

Pharmacokinetics.

After oral administration, Remantadine is almost completely absorbed in the intestine.

Absorption is slow. Binding to plasma proteins – about 40%. Volume of distribution: adults – 17-25 l/kg, children – 289 l/kg. Concentration in nasal secretion is 50% higher than in plasma. Maximum concentration (Cmax) of active substance in plasma in 100 mg once daily is 181 ng/ml, in 100 mg twice daily – 416 ng/ml.

Metabolized in the liver. The elimination half-life is 24-36 hours; 75-85% of the taken dose is excreted by the kidneys mainly as metabolites, 15% – unchanged.

In chronic renal insufficiency half-life is twice longer. In patients with renal insufficiency and in elderly people it can accumulate in toxic concentrations if the dose is not corrected in proportion to the decrease of creatinine clearance (CC).

Indications

Prevention and early treatment of Influenza A in adults and children over 7 years old.

Active ingredient

Composition

Active ingredient:

Rimantadine hydrochloride 50.0 mg.

Auxiliary substances:

Lactose 74.5 mg,

Potato starch 24.0 mg,

Stearic acid 1.5 mg.

How to take, the dosage

Overly, after a meal with water.

The treatment of influenza: to adults – 300 mg/day in 1-3 doses on day 1; on days 2 and 3 – 100 mg 2 times a day; on days 4 and 5 – 100 mg once a day; to children 7-10 years – 50 mg 2 times a day, 11-14 years – 50 mg 3 times a day, for 5 days.

Influenza prophylaxis: adults – 50 mg once daily, for 30 days.

Tick-borne encephalitis prophylaxis: not later than 48 hours after a tick bite – 100 mg twice daily, 12 hours apart, for 3-5 days; for risk groups (people living or staying in wooded areas) – 100 mg twice daily for 15 days.

The treatment of acute herpetic infection: 100 mg/d in 1 dose for 3 days; prevention of exacerbations – 100 mg once every 3 days.

Patients with epilepsy and anticonvulsant therapy in history are prescribed in maximum daily dose 100 mg/day (if anticonvulsant therapy is administered simultaneously because of risk of epileptic seizure). In the elderly and in patients with CKD, the dose should be reduced.

Interaction

Remantadine reduces the effectiveness of antiepileptic drugs.
Paracetamol and ascorbic acid reduce the maximum concentration of rimantadine in blood plasma by 11%.

Cimetidine decreases clearance of Remantadine by 18%.

Adsorbents, astringents and coating agents (acetazolamide, sodium bicarbonate, etc.) increase the effectiveness of Remantadine by reducing its excretion by the kidneys.

Urine acidifying agents (e.g. ascorbic acid) decrease the effectiveness of Remantadine® by increasing its excretion by the kidneys.

Special Instructions

When using Remantadine, exacerbation of chronic comorbidities is possible. In elderly patients with arterial hypertension, the risk of hemorrhagic stroke increases.

If there is a history of epilepsy and anticonvulsant therapy against the background of using Remantadine, the risk of an epileptic seizure increases. In such cases, Remantadine is used in a dose of up to 100 mg daily simultaneously with anticonvulsant therapy.

In case of influenza caused by the B virus, Remantadine has an antitoxic effect.
Prophylactic administration is effective in contacts with ill people, the spread of infection in closed groups and at high risk of disease during a flu epidemic.

The emergence of viruses resistant to the drug is possible.
Remantadine does not affect the ability to drive, but persons who experience dizziness, headache or other side effects from the central nervous system should exercise caution.
Use with caution in lactase deficiency, lactose intolerance, lactose/isomaltose malabsorption syndrome, because the drug contains lactose.

Contraindications

Side effects

Gastrointestinal tract: dry mouth, nausea, vomiting, loss of appetite, epigastric pain, flatulence;

Central nervous system: Headache, dizziness, insomnia, neurological reactions, impaired concentration, drowsiness, anxiety, increased excitability, fatigue;

Other: hyperbilirubinemia, allergic reactions (skin rash, itching, urticaria).

Overdose

Symptoms: agitation, hallucinations, arrhythmia.

Treatment: gastric lavage, symptomatic therapy: measures to maintain vital functions. Rimantadine is partially excreted by hemodialysis.

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