Expiration date: 01/2025

Composition: Each tablet contains as the active substance of rimantadine hydrochloride 50 mg
Description: white pills valium with chamfer
Pharmacotherapeutic group: antiviral agent
Pharmacodynamics: the Antiviral agent derived from adamantane is effective against strains of influenza a virus, Herpes simplex type I and II viruses, tick-borne encephalitis viruses (Central European and Russian spring-summer from the group of arboviruses of semes. Flaviviridae). It has antitoxic and immunomodulatory effect. The polymer structure provides long-term circulation of rimantadine in the body, which allows it to be used not only for therapeutic but also for preventive purposes. As a weak base, increases the pH of the endosomes, having a membrane of vacuoles and surrounding viral particles after their penetration into the cell. Prevention of acidification in these vacuoles blocks the fusion of the viral membrane with the endosome membrane, thus preventing the transmission of viral genetic material in the cytoplasm of the cell. Rimantadine also inhibits the release of viral particles from the cell, i.e. interrupts the transcription of the viral genome. Prophylactic administration of rimantadine in a daily dose of 200 mg reduces the risk of influenza, as well as reduces the severity of symptoms of influenza and serological reaction. Some therapeutic effect may also occur when it is prescribed in the first 18 hours after the development of the first symptoms of influenza.
Pharmacokinetics: after ingestion almost completely absorbed in the intestine. Absorption is slow. The time to maximum concentration (TCmax) is 1-4 hours Connection with the plasma protein - about 40%. Volume of distribution: adults between 17 and 25 l/kg, children – 289 L. the Concentration in the nose secret 50% higher than plasma. The maximum concentration (Cmax) when taking 100 mg 1 time per day – 181 ng/ml, 100 mg 2 times a day – 416 ng/ml. Metabolized in the liver. Half-life (T1 / 2) in adults 20-44 years – 25-30 h, in elderly patients (71-79 years) and in patients with chronic liver failure – about 32 h, in children 4-8 years – 13-38 h, more than 90% is excreted by the kidneys for 72 h, mainly in the form of metabolites, 15% - unchanged. In chronic renal failure (CKD) T1/2 increases 2 times. In persons with renal insufficiency and in the elderly may accumulate in toxic concentrations, if the dose is not adjusted in proportion to the decrease in creatinine clearance (CC). Hemodialysis has little effect on the clearance of rimantadine.
Indications: Early treatment and prevention of influenza a in adults and children over 7 years.
Contraindications:

• - Hypersensitivity to rimantadine.
• - Acute liver disease,
• - Acute and chronic kidney disease,
• - Thyrotoxicosis,
• - Pregnancy and lactation,
• - Child age (up to 7 years).

With caution
Arterial hypertension, epilepsy (including history), atherosclerosis of cerebral vessels, chronic renal failure, liver failure
Dosage and administration: Inside (after eating), drinking water, according to the following scheme:
Adults are prescribed on the first day of the disease 100 mg 3 times, on the second and third days can be 100 mg 2 times, on the fourth day 100 mg once. On the first day of the disease may use the drug once in a dose of 300 mg.
Children from 7 to 10 years appoint 50 mg 2 times a day, 11-14 years 50 mg 3 times a day.
Treatment of influenza a should begin within 24-48 hours after the onset of symptoms and continue for 5-7 days. The optimal duration has not been established.
For the prevention of influenza in adults, 50 mg is prescribed once a day for 10-15 days, depending on the source of infection.
For the treatment of influenza in CPN (CC less than 10 ml / min), severe liver failure, elderly patients in nursing homes – 100 mg once a day.
Side effect: Rimantadine is usually well tolerated. Sometimes there are:
From the gastrointestinal tract: epigastric pain, flatulence, dry mouth, anorexia, nausea, vomiting,
from the Central nervous system: headache, dizziness, insomnia, neurological reactions, impaired concentration, drowsiness, anxiety, increased excitability, fatigue,
other: hyperbilirubinemia, allergic reactions (rash, itching, urticaria, etc.).
Interaction with other drugs: Pharmacodynamic: rimantadine reduces the effectiveness of antiepileptic drugs.
Pharmacokinetic: adsorbents, astringents and enveloping agents reduce the absorption of rimantadine.
Acidifying urine means (ammonium chloride, ascorbic acid, etc.) reduce the effectiveness of rimantadine, due to the more rapid release of the latter by the kidneys.
Alkalizing urine means (diacarb, sodium bicarbonate, etc.) increase the effect of rimantadine, due to a decrease in its excretion by the kidneys.
Paracetamol and acetylsalicylic acid reduce the Cmax of rimantadine by 11 and 10% respectively.
Cimetidine reduces the clearance of rimantadine by 18%.
Special instructions: in comparison with amantadine has a higher clinical efficacy and
less toxic.
The appearance of drug-resistant viruses is possible.
In influenza caused by virus B, rimantadine has an antitoxic effect.
When using rimantadine may exacerbate chronic comorbidities. In elderly patients with hypertension increases the risk of hemorrhagic stroke. With indications in the history of epilepsy and anticonvulsant therapy on the background of the use of rimantadine increases the risk of epileptic seizure. In such cases, rimantadine is used at a dose of 0, 1 g per day simultaneously with anticonvulsant therapy.
Prophylactic administration is effective in contacts with patients (taking the drug is necessary for at least 10 days after contact), with the spread of infection in closed groups and with a high risk of disease during the flu epidemic.
During the period of treatment must be careful when driving and occupation of other potentially hazardous activities, require high concentration and psychomotor speed reactions.
Product: Tablets of 50 mg.
Storage conditions: The list is in a dry place, protected from light at a temperature not higher than 25 ° C. Keep out of reach of children.
Shelf life: 5 years. Do not use after the date stated on the package.