What is Remantadine
A drug based on rimantadine hydrochloride, an adamantane derivative. This substance blocks the reproduction of certain groups of influenza and encephalitis viruses at the early stage of infection, due to which the development of diseases stops.
Remantadine is available in the form of tablets in a dosage of 50 mg and capsules of 100 mg. The pills also contain auxiliary components: talc, starch, calcium stearate, lactose.
For the treatment of children, antiviral syrups containing rimantadine on a matrix carrier are produced - Algirem and Orvirem.
In what cases are these drugs prescribed?
What are the indications for tablets called "Remantadine"? The instructions for use say that this is a drug against viral infections such as influenza and many others, including, for example, encephalitis. Also, according to the instructions, Remantadine is used for prophylactic purposes to prevent infection by viruses with which it can bind.
When can you be prescribed Rimantadine? The instructions say that this is a preventive remedy, as well as a remedy for the treatment of viral diseases. That is, in simple terms, the reasons for prescribing these two medications are the same.
Mechanism of action
Remantadine prevents the transmission of viral RNA into the cytoplasm; its particles surround pathogens and block the fusion of their membranes with cell membranes. The drug is effective against pathogens of influenza serotype A and encephalitis. It is able to prevent the multiplication of infection during initial contacts with viruses, weakens the symptoms of the developed disease and shortens its course. The therapeutic effect is most pronounced when the product is used in the first 10–15 hours after infection.
It has been established that the drug has a moderate antitoxic effect in acute respiratory viral infections, relieves fever, and improves the well-being of those suffering from influenza.
Remantadine is absorbed slowly from the gastric cavity. Most of the substance is concentrated in nasal mucus. In plasma its content is less than 50%. Transformed in the liver. Metabolites are filtered and excreted by the kidneys within 1–1.5 days after administration. With reduced function of the urinary system, this period doubles.
So, what should you choose?
We have analyzed how the two presented medications differ in composition. Medical professionals say that the drug Remantadine has been studied much more deeply than its analogue. Thanks to this, its instructions are more complete - more side effects are described there, because the drug has been thoroughly tested, which means it is safer than its analogue. Therefore, it is definitely worth choosing “Remantadine”, if, for example, a woman is breastfeeding. But if you are still in doubt, ask your doctor what the difference is between Rimantadine and Remantadine. The doctor will certainly tell you about this in more detail and you will not leave him without valuable advice. Do not be ill!
Instructions: at what age, when and how much to take Remantadine
The drug can be used as a prophylaxis:
- during seasonal epidemics of ARVI and influenza;
- after contact with infected and sick people;
- to prevent tick-borne encephalitis when possible carriers are detected on the body.
Prevention of influenza requires taking tablets for 10–30 days: 1 pc. in a day. If you are bitten by a tick, it is important to take medicine in the first 3 days: 2 tablets. twice a day.
For ARVI symptoms, take 2 tablets of Remantadine on the first day. three times a day, in the next 2 days - reduce the dose by ⅓, on the fourth day take 2 tablets.
Children from 1 year of age are prescribed syrups with rimantadine:
- infants under 3 years old: 20 mg (2 tsp) three times a day for 4 days, reducing the daily dose by ⅓;
- children 3–7 years old: 3 tsp. three times a day, similarly reducing the dose every day.
Tablets are approved for use by children over 7 years old: 1 pc. three times a day for 4–5 days when treating influenza. For prevention, drink the drug 1 tablet. no more than 1 time per day. The course is up to 15 days.
The medicine is taken 1–1.5 hours after meals, washed down with a large volume of water.
Price issue
Every time you are prescribed a drug, you wonder how much it will cost you. Many employees of Russian pharmacies say that the patient often begins to choose a cheaper substitute for the drug prescribed to him. However, there are situations when this should not be done, because a cheaper analogue does not always have the same effect as the original drug, and if you take a cheap analogue, the consequences for you may be sad.
Is it possible to take Remantadine during pregnancy and lactation?
The antiviral substance penetrates the placental barrier and can disrupt the normal development of the fetus. Pregnant women need to choose other groups of medications for treatment. It is also undesirable to use it during breastfeeding due to the high risk of allergic reactions in the child. If infection with influenza is suspected and prophylaxis with Remantadine is necessary, it is recommended that nursing mothers temporarily change the type of child’s diet by switching to adapted formulas or reserves of expressed milk.
Side effects
In some cases, while taking the drug, the following are likely:
- dyspepsia: loss of appetite, dry mouth, nausea, stomach pain;
- impaired concentration, increased drowsiness, anxiety;
- headache.
In case of overdose, the body's negative reactions intensify. Acute intoxication leads to a metallic taste, uncontrollable vomiting, confusion, panic attacks, and hallucinations. In such cases, urgent gastric lavage and drug detoxification are required.
Contraindications
You should stop taking Remantadine:
- children under 1 year old;
- with renal or liver failure;
- severe forms of hypertension;
- for epilepsy;
- thyrotoxicosis;
- individual intolerance;
- at all stages of pregnancy and during pregnancy.
The drug should be taken with caution in patients with atherosclerosis and cerebrovascular accidents. Rimantadine increases the risk of hemorrhagic stroke.
When should these medications not be prescribed?
Then the differences begin. What is the main difference between the tablets "Remantadine" and "Rimantadine"? The first type of medication is not prescribed during pregnancy. Also, according to the instructions, it cannot be prescribed for liver pathology, thyrotoxicosis and intolerance to individual components of the drug.
Let’s open the instructions for the Rimantadine tablets and turn to the “Contraindications” section. It says that the drug should not be taken by children under seven years of age, as well as by women during the period when they are pregnant or breastfeeding. Restrictions are also imposed on those patients who have problems with the liver, kidneys and thyroid gland. To this, as in the first case, is added an allergy to one of the components of the tablet. As you can see, despite the fact that the drugs have the same active ingredient, the second version of the drug, Rimantadine, has more contraindications.
Which is better: Remantadine, Arbidol or Kagocel
Due to the constant mutation of influenza viruses, Remantadine may be powerless against the next infection. For these reasons, it is important not only to use antiviral therapy, but also immunomodulators - agents that increase the body’s specific defense against certain pathogens.
Arbidol and Kagocel are not analogues of Remantadine, although they are also used for the prevention and treatment of influenza at an early stage. These drugs stimulate the production of their own interferons, which destroy the infection. They are effective against several groups of pathogens. The advisability of prescribing a particular medication can only be determined by the attending physician after examination.
Rimantadine
Rimantadine is an antiviral drug that is a derivative of adamantane and is used in the prevention and treatment of the early stages of influenza. The mechanism of the antiviral action of the drug is based on the suppression of the early phase of specific reproduction from the moment the virus enters the cell and before the start of RNA transcription. The pharmacological effectiveness of rimantadine is ensured by its ability to inhibit viral reproduction at the earliest stage of the infectious process. The drug exhibits its activity against strains of influenza A virus (primarily type A2), as well as against viruses of Central European and Russian spring-summer tick-borne encephalitis. After oral administration, it is slowly but almost completely absorbed from the gastrointestinal tract. The concentration of the active substance in the nasal mucosa is 50% higher than in the blood plasma. The half-life of the drug is 24-36 hours; excreted along with urine, partly - unchanged, partly - in the form of metabolites. In persons suffering from chronic renal failure, the half-life is doubled, which can cause the accumulation of the active substance in toxic concentrations (the same is true for elderly patients). The dosage regimen of the drug is individual and determined by the indications, the age of the patient and the treatment regimen used. Diseases such as hypertension, epilepsy, cerebral vascular atherosclerosis, although not direct contraindications to the use of rimantadine, require special caution when prescribing it. Rimantadine may cause an exacerbation of diseases already present in the patient. Elderly patients with hypertension are at risk of developing hemorrhagic stroke. If the patient has (including a history of) epilepsy, taking rimantadine may provoke an epileptic seizure. In such situations, the drug is used at a dose of 100 mg per day in combination with anticonvulsant therapy. As a preventive agent, it is advisable to use rimantadine in direct contact with infected people, during the spread of the disease in closed groups and during periods of epidemic trouble.
At the same time, the emergence of viruses resistant to the drug cannot be ruled out. It is not recommended to combine rimantadine with astringents, enveloping agents and adsorbents, since all these drugs impair its absorption. Drugs that shift the pH of urine to the “acidic” side (vitamin C, ammonium chloride) reduce the effectiveness of rimantadine due to the accelerated excretion of the latter by the kidneys.
Not so long ago, the “area” of prevalence of rimantadine did not extend beyond the borders of post-Soviet countries (for reference: it was first synthesized in the Latvian SSR), but today this drug is recognized overseas. Thus, according to a comparative analysis of costs and benefits conducted by American scientists, rimantadine in combination with influenza vaccination is the most effective strategy for combating the incidence of influenza among the healthy US population. As the study showed, the prescription of rimantadine led to the receipt of economic bonuses that more than covered the costs of purchasing drugs for symptomatic anti-influenza therapy. If we operate in less global categories, then for mere mortals this will mean obvious recognition of the effectiveness of rimantadine by competent foreign experts. There is, however, a small fly in the ointment here: despite the fact that the prescription of rimantadine was considered the most cost-effective (and, therefore, therapeutically effective) among all antiviral treatment options, a slightly higher number of undesirable side reactions were observed with its use. If we look in more detail at the prevention of influenza A, then the effectiveness of rimantadine in such cases, according to various estimates, ranges from 70 to 90%. If taking the drug is combined with vaccination, then the development of stable immunity should be expected at about 14-15 days. In addition, rimantadine can be used in those individuals for whom vaccination is contraindicated.
