Clinical Uses

Amantadine and rimantadine are used for the treatment of diseases caused by influenza A strains. When these agents are administered within 48 hours of the onset of symptoms, they reduce the duration of fever and systemic complaints by 1 to 2 days and may decrease the duration of viral shedding. Evidence is insufficient to suggest that treatment with these drugs will prevent the development of influenza A virus pneumonitis or other complications in high-risk patients.

The Centers for Disease Control's (CDC) Immunization Practices Advisory Committee recommends annual vaccination as the method of choice in the prevention of influenza infection. However, when vaccination is contraindicated or early vaccination is not possible, amantadine and rimantadine are effective prophylactic agents that have been shown to protect approximately 70 to 90% of patients from influenza A infection. Since these drugs do not prevent the host immune response to influenza A, they may be used to prevent infection during the 2- to 4-week period required to develop immunity following vaccination. An additional use of amantadine, unrelated to its antiviral activity, is in the therapy of Parkinson's disease (see Chapter 31).

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