Home Drug Guide Rimantadine Hydrochloride

Drug Guide

Generic Name

Rimantadine Hydrochloride

Brand Names Flumadine

Classification

Therapeutic: Antiviral, Anti-influenza agent

Pharmacological: Adamantane antiviral

FDA Approved Indications

  • Prophylaxis of influenza A in high-risk populations
  • Treatment of influenza A in adults

Mechanism of Action

Rimantadine inhibits the replication of influenza A virus by blocking the M2 proton channel, which prevents viral uncoating and release of viral RNA into host cells.

Dosage and Administration

Adult: 200 mg once daily for prophylaxis; 200 mg twice daily for treatment, for 5 days

Pediatric: Not FDA approved for pediatric use; limited data suggest use in adolescents at similar doses as adults; consult specific guidelines

Geriatric: Dose adjustments generally not required but evaluate renal function regularly

Renal Impairment: Reduce dosage; typically 100 mg daily, depending on severity

Hepatic Impairment: Use with caution; no specific adjustments documented

Pharmacokinetics

Absorption: Well-absorbed orally

Distribution: Widely distributed including CSF, breast milk

Metabolism: Primarily hepatic, minimal

Excretion: Renal (unchanged and metabolites)

Half Life: 24-36 hours

Contraindications

  • Hypersensitivity to rimantadine or other adamantanes

Precautions

  • History of psychiatric disorders, seizures, renal impairment, pregnancy/lactation—use with caution

Adverse Reactions - Common

  • Nausea (Common)
  • Insomnia (Common)
  • Dizziness (Common)

Adverse Reactions - Serious

  • Psychosis, hallucinations, confusion (Rare)
  • Seizures (Rare)
  • Skin rash, angioedema (Rare)

Drug-Drug Interactions

  • Amantadine (additive side effects)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for neuropsychiatric symptoms, renal function

Diagnoses:

  • Risk for neuropsychiatric effects

Implementation: Administer with food if GI upset occurs; educate about side effects

Evaluation: Assess for efficacy in preventing or treating influenza; monitor side effects

Patient/Family Teaching

  • Take medication as prescribed, do not stop abruptly
  • Report neuropsychiatric symptoms immediately
  • Maintain good hygiene practices

Special Considerations

Black Box Warnings:

  • Neuropsychiatric effects in children and young adults

Genetic Factors: None specific

Lab Test Interference: None

Overdose Management

Signs/Symptoms: Nausea, vomiting, agitation, hallucinations, seizures

Treatment: Supportive care; activated charcoal if recent ingestion; dialysis if severe

Storage and Handling

Storage: Store at room temperature (20-25°C)

Stability: Stable for at least 2 years when stored properly

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.