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Rimantadine: a clinical perspective
1Ohio State University, Columbus 43210, USA.
The Annals of Pharmacotherapy
|March 1, 1995
Summary
Rimantadine is effective for preventing and treating influenza A virus infections, with a favorable pharmacokinetic profile allowing once-daily dosing. It shows a low incidence of adverse effects, making it a good option for elderly patients and those with renal impairment.
Area of Science:
- Pharmacology
- Virology
- Infectious Diseases
Background:
- Influenza A virus poses a significant public health threat, necessitating effective antiviral agents.
- Rimantadine is an antiviral medication used for influenza A.
- Understanding its properties is crucial for clinical application.
Purpose of the Study:
- To review rimantadine's antiviral activity, pharmacokinetics, efficacy, and safety.
- To compare rimantadine with amantadine.
- To provide information on influenza A virus and its clinical features.
Main Methods:
- Literature search of English-language publications from 1966-1994.
- Review of open and controlled studies for antiviral activity, pharmacokinetics, and adverse effects.
- Evaluation of double-blind studies for efficacy in prophylaxis and treatment.
Main Results:
- Rimantadine is well-absorbed, with nasal concentrations higher than plasma.
- Elimination half-life supports once-daily dosing; dosage adjustment needed for renal/hepatic impairment.
- Effective in 85-90% for illness prevention and 50-65% for infection prevention; reduces symptom duration by 1-3 days.
- Most common adverse effects are CNS and GI related, with lower incidence in elderly at reduced doses.
Conclusions:
- Rimantadine is a viable option for influenza A treatment and prophylaxis.
- It is particularly suitable for elderly patients with prior amantadine CNS adverse effects and those with mild/moderate renal impairment.
- Its pharmacokinetic profile supports once-daily dosing, and it demonstrates effectiveness with a low adverse effect profile.