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Caution is required when prescribing amantadine to patients with renal impairment, as the drug is primarily excreted unchanged in the urine.
Amantadine hydrochloride is an antiviral agent effective in the prophylaxis and symptomatic management of respiratory tract infections caused by type A influenza viruses. The realization that amantadine has a broad spectrum of activity against influenza A subtypes and that new antigenic variants, such as Hsw1N1 (swine) and H1N1 (Russian), are also suppressed, has prompted recommendations for a broader use of amantadine in the prophylaxis and treatment of influenza infections. 1 While amantadine appears to be a relatively safe drug, widespread use may lead to complications, unless its pharmacokinetics are more widely appreciated. Amantadine is not metabolized in man, and more than 90% of an ingested dose can be recovered unchanged in the urine. 2 The importance of urinary excretion is underlined by studies in hemodialysis patients, which reveal that plasma amantadine levels remain elevated for a prolonged period in patients with negligible renal function. 3 Not surprisingly, toxic effects of amantadine
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Todd S. Ing (1980) studied this question.
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