Start with a low dose of amantadine for older adults, typically 100 mg once daily, carefully monitoring for side effects before increasing. Adjustments should be made based on individual tolerance and response.
Renal Impairment
Reduce the amantadine dosage in patients with kidney problems. For those with moderate to severe renal impairment, dosage reduction is necessary, often requiring significantly lower doses or extended dosing intervals. Always consult renal function tests (creatinine clearance) to guide dosage adjustments.
Hepatic Impairment
While amantadine is primarily eliminated by the kidneys, monitor patients with liver disease closely for any unusual side effects. Dosage adjustments may be necessary, though data specifically on hepatic impairment is limited. Close monitoring is key.
Children
Amantadine is not typically used in children for Parkinson’s disease. Off-label use should only be considered under strict medical supervision, with careful monitoring for side effects. Dosage should be significantly lower than adult doses and tailored to the child’s weight and response.
Pregnancy and Breastfeeding
Use amantadine with caution during pregnancy and breastfeeding. The potential risks to the fetus or infant should be carefully weighed against the benefits of treatment for the mother. Alternative therapies should be considered whenever possible.
