What is Amantadine: Uses, Dosage, Side Effects and More

Amantadine is a prescription medication that helps treat Parkinson's disease symptoms and certain types of flu. Originally developed as an antiviral drug in the 1960s, doctors discovered it also helps people with movement disorders feel more steady and coordinated.

This medication works in two main ways in your body. It can fight off specific flu viruses and help balance brain chemicals that control movement and mood. Many people find it gives them more energy and helps reduce stiffness or tremors.

What is Amantadine?

Amantadine belongs to a class of medications called adamantanes. It's a synthetic drug that looks similar to a natural brain chemical called dopamine. Your doctor might prescribe it as capsules, tablets, or liquid that you take by mouth.

The medication has been safely used for decades to help millions of people. It's considered a moderate-strength drug that works gently in your system. Unlike some stronger medications, amantadine typically causes fewer severe side effects while still providing meaningful relief.

What is Amantadine Used For?

Doctors prescribe amantadine for several specific conditions. The most common use is treating Parkinson's disease symptoms like tremors, stiffness, and slow movement. It can also help with drug-induced movement problems that sometimes occur with certain psychiatric medications.

Here are the main conditions amantadine helps treat:

• Parkinson's disease symptoms (tremors, rigidity, slow movement)
• Drug-induced movement disorders from antipsychotic medications
• Influenza A virus infections (though less commonly used now)
• Fatigue in multiple sclerosis (off-label use)
• Some cases of traumatic brain injury recovery

Your doctor will determine if amantadine is right for your specific situation. The medication works best when it's part of a comprehensive treatment plan that might include other medications, physical therapy, or lifestyle changes.

How Does Amantadine Work?

Amantadine works by increasing dopamine levels in your brain. Dopamine is a chemical messenger that helps control movement, mood, and motivation. When you have conditions like Parkinson's disease, your brain doesn't make enough dopamine.

The medication also blocks certain receptors in your brain called NMDA receptors. This blocking action helps reduce abnormal movements and can improve your overall motor control. Think of it as helping to smooth out the communication between your brain and muscles.

As an antiviral, amantadine prevents flu viruses from entering your cells and multiplying. However, many flu strains have developed resistance to it, so doctors now rarely prescribe it for flu treatment. The movement disorder benefits remain its primary use today.

How Should I Take Amantadine?

Take amantadine exactly as your doctor prescribes, usually once or twice daily. You can take it with or without food, though taking it with food may help reduce stomach upset. Swallow capsules or tablets whole with a full glass of water.

It's best to take amantadine early in the day, preferably in the morning. Taking it too late in the evening can interfere with your sleep since it may cause mild stimulation. If you're taking it twice daily, space the doses evenly throughout the day.

Here are some important guidelines for taking amantadine safely:

• Take it at the same time each day to maintain steady levels
• Don't crush, chew, or break extended-release capsules
• Measure liquid forms carefully with the provided measuring device
• Stay well-hydrated while taking this medication
• Avoid alcohol, which can increase dizziness and drowsiness

If you have kidney problems, your doctor may adjust your dose or monitor you more closely. The medication is cleared from your body through your kidneys, so any kidney issues can affect how long it stays in your system.

How Long Should I Take Amantadine For?

The length of amantadine treatment depends on your specific condition and how well you respond to it. For Parkinson's disease, you may need to take it long-term as part of ongoing management. Your doctor will regularly evaluate whether it's still helping your symptoms.

Some people notice improvements within a few days, while others may need several weeks to feel the full benefits. Don't stop taking amantadine suddenly, as this can cause withdrawal symptoms or make your original symptoms worse. Your doctor will gradually reduce your dose if you need to stop.

For movement disorders caused by other medications, you might only need amantadine temporarily. Once the problematic medication is stopped or adjusted, your doctor may slowly taper off the amantadine. Regular follow-up appointments help ensure you're getting the right dose for the right amount of time.

What Are the Side Effects of Amantadine?

Most people tolerate amantadine well, but like all medications, it can cause side effects. The good news is that serious side effects are uncommon, and many mild side effects improve as your body adjusts to the medication.

Common side effects you might experience include:

• Nausea or stomach upset
• Dizziness or lightheadedness
• Trouble sleeping or vivid dreams
• Dry mouth
• Constipation
• Swelling in ankles or feet
• Purple or red blotchy skin patches (livedo reticularis)

The skin discoloration, while concerning in appearance, is usually harmless and often fades when you stop the medication. However, you should still mention it to your doctor during your next visit.

More serious but rare side effects require immediate medical attention:

• Severe confusion or hallucinations
• Difficulty breathing or chest pain
• Severe swelling of face, lips, or throat
• Thoughts of self-harm or unusual behavior changes
• Signs of heart rhythm problems (fast, slow, or irregular heartbeat)

If you experience any of these serious symptoms, contact your doctor immediately or seek emergency care. Most people who take amantadine as prescribed experience only mild, manageable side effects that don't interfere with daily life.

Who Should Not Take Amantadine?

Amantadine isn't safe for everyone. Your doctor will review your medical history and current medications before prescribing it. Certain conditions and situations make this medication inappropriate or require special monitoring.

You should not take amantadine if you have:

• Known allergy to amantadine or similar medications
• Severe kidney disease or kidney failure
• Untreated narrow-angle glaucoma
• Severe heart rhythm disorders

Special caution is needed if you have these conditions:

• Mild to moderate kidney problems
• Heart disease or high blood pressure
• History of seizures or epilepsy
• Liver disease
• History of mental health conditions
• Prostate problems or difficulty urinating

Pregnancy and breastfeeding require careful consideration. While amantadine hasn't been proven harmful to developing babies, it's not recommended during pregnancy unless the benefits clearly outweigh the risks. The medication can pass into breast milk, so discuss alternatives with your doctor if you're nursing.

Amantadine Brand Names

Amantadine is available under several brand names, though the generic version works just as well. The most common brand name is Symmetrel, which has been available for many years. You might also see it sold as Gocovri, which is an extended-release version specifically approved for Parkinson's disease.

Other brand names include Osmolex ER, another extended-release formulation. These longer-acting versions may be more convenient since you take them less frequently. However, they're typically more expensive than generic amantadine.

Your pharmacy may substitute generic amantadine for the brand name unless your doctor specifically writes "brand name only" on your prescription. The active ingredient is identical, so you'll get the same therapeutic benefits at a lower cost.

Amantadine Alternatives

Several other medications can treat similar conditions if amantadine isn't right for you. For Parkinson's disease, alternatives include carbidopa-levodopa (the most common first-line treatment), dopamine agonists like pramipexole or ropinirole, and MAO-B inhibitors such as selegiline.

If you're dealing with drug-induced movement disorders, your doctor might try anticholinergic medications like benztropine or trihexyphenidyl. These work differently than amantadine but can be equally effective for certain types of movement problems.

For multiple sclerosis fatigue, alternatives include modafinil, methylphenidate, or even some antidepressants. Your doctor will consider your specific symptoms, other medications, and overall health when choosing the best alternative.

Is Amantadine Better Than Carbidopa-Levodopa?

Amantadine and carbidopa-levodopa serve different roles in treating Parkinson's disease. Carbidopa-levodopa is typically the first-line treatment because it's more effective for the main symptoms of Parkinson's disease. Amantadine is often added later to help with specific problems like involuntary movements (dyskinesia).

Carbidopa-levodopa directly replaces the missing dopamine in your brain, making it very effective for tremors, stiffness, and slow movement. However, after several years of use, it can cause troublesome involuntary movements. This is where amantadine shines - it helps reduce these medication-induced movements.

Many people end up taking both medications together. They work through different mechanisms and complement each other well. Your doctor will determine the best combination based on your symptoms, how long you've had Parkinson's, and how you respond to treatment.