In Poland, drugs with amantadine are available in the form of tablets or capsules orally and as an injection solution. They can only be obtained with a prescription and should be used after detailed consultation with your doctor.
On the Polish pharmaceutical market, commercial preparations containing amantadine are mainly Amantix and Viregyt-K. Due to the relatively high popularity of these drugs in recent times, there may be problems with their availability in pharmacies. In monotherapy, it is prescribed only in light cases, where the main symptom is hypokinesia. Most often it is used together with levodopa or other anti-parkin drugs.
Amantadine is rapidly and completely absorbed. In the form of intravenous injections, it is especially effective in the case of akinetic breakthroughs, i.e. the patient’s inability to move.
Amantadine in influenza A infection
Amantadine was originally synthesized to fight flu viruses. Currently, the safety data sheet contains information on indications in the case of only type A viral infections, but as it turns out, it is currently not very effective, because the influenza virus has developed a high resistance to this drug. The mechanism of action in the fight against influenza A is mainly based on inhibiting the early stage of its replication by blocking the proton pump of the viral M2 protein, thereby removing the virus envelope and inhibiting the release of its genetic material, i.e. a key stage in replication.
Amantadine for neurology.
In later years, potential efficacy in Parkinson’s was discovered by accident. One patient in the 1960s with symptoms of Parkinson’s disease was taking amantadine to prevent influenza. She then noticed a significant improvement in muscle stiffness, tremors and slowness. Currently, its main indication is the treatment of symptoms occurring in Parkinson’s disease and parkinsonian syndromes, such as stiffness, tremors, hypokinesia and akinesia.
The mechanism of action is based primarily on increasing the release of dopamine from the neuronal part. It stimulates dopamine receptors in the CNS by increasing the release of dopamine from the neuronal part into the synaptic space. The clinical efficacy of amantadine is considered to be due to its antagonism of the NMDA subtype of glutamate receptors. The hyperactivity of glutamatergic neurotransmission influences the development of parkinsonian symptoms. Moreover, amantadine has a significant influence on the accumulation and release of catecholamines in the CNS.
Like every drug, amantadine can also cause numerous side effects, but it is worth being aware that the benefits of taking the drug in justified cases, when the drug is indicated for use – usually outweigh the side effects.
Very common side effects of taking the drug may be: swelling around the ankles, cyanosis (usually after high doses or long-term use). There may also be incidents related to: anxiety, lethargy, hallucinations, confusional states, nightmares, nervousness, depression, insomnia, headache, slurred speech, inability to concentrate, visual disturbances, palpitations, orthostatic hypotension, gastrointestinal disorders (nausea, vomiting, constipation), anorexia, dry mouth, sweating, muscle pain. psychosis, tremors, dyskinesias (involuntary movements) and convulsions.
Amantadine and COVID-19
The time of a global epidemic in which we all found ourselves reminded us of what is at the most in the hierarchy of values of every human being. Health, because national borders were closed in its defense, flights were canceled, the economy was halted, tens of millions of people were unemployed … It is known that the virus has spread practically all over the world and so far no effective remedy has been developed. Recently, there has been a lot of talk about amantadine as a drug that could help fight today’s epidemic. Are there really reasons for this?
Based on the current scientific research conducted around the world, a publication was created in which people with positive results for the coronavirus and struggling with Parkinson’s disease and simultaneously taking amantadine did not show clinical symptoms of severe COVID-19 disease. The researchers’ hypothesis is that amantadine, thanks to its lipophilicity, penetrates inside the virus and blocks the COVID-19 viroporin channel, preventing the release of the viral nucleus into the cell cytoplasm. Despite the lack of clear evidence, amantadine can be defined as a drug that is believed to reduce the severity of symptoms generated by the coronavirus.
Numerous experiments are currently being conducted throughout Poland regarding the impact of amantadine on the fight against the SARS-CoV-1 virus. An example is the research conducted by the neurologist prof. Konrad Rejdak, on the influence of amantadine on the course of the disease in patients with coronavirus. According to the professor, there are quite serious indications that this drug could be effective, especially in the earliest stages of infection, because it inhibits viral replication and prevents further cells from being infected. However, it should also be emphasized that when severe pneumonia and other complications develop, its effectiveness may be limited.
As of today (22/11/2020) it is worth noting that there are no published official recommendations for the use of amantadine in the treatment of patients with COVID-19. There are no clear studies and evidence that would confirm the effectiveness and, above all, the safety of this pharmacotherapy, so it is worth considering for a longer time the too hasty use of this drug in patients infected with the SARS-CoV-2 virus.
Sources:
- Araujo, J. D., Aranda-Martınez, G. E. Aranda-Abreu, Amantadine Treatment for People with COVID-19, Archives of Medical Research 51 (2020), Published by Elsevier Inc.
- E. Aranda-Abreu, M. E. Hernández Aguilar, D. H. Covarrubias, F. R. Durán, Amantadine as a drug to mitigate the effects of COVID-19, Medical Hypotheses, Published by Elsevier Inc.
- Mutschler, G. Geisslinger, H. K. Kroemer, P. Ruth, Mutschler Pharmacology and Toxicology.
- Pharmacodynamics, a textbook for Students of Pharmacy
