Osmolex Er
Osmolex Er Uses, Dosage, Side Effects, Food Interaction and all others data.
The mechanism by which amantadine exerts its antiviral activity is not clearly understood. It appears to mainly prevent the release of infectious viral nucleic acid into the host cell by interfering with the function of the transmembrane domain of the viral M2 protein. In certain cases, amantadine is also known to prevent virus assembly during virus replication. It does not appear to interfere with the immunogenicity of inactivated influenza A virus vaccine.
Osmolex Er inhibits the replication of influenza A virus isolates from each of the subtypes, i.e., H1N1, H2N2 and H3N2. It has very little or no activity against influenza B virus isolates. A quantitative relationship between the in vitrosusceptibility of influenza A virus to amantadine and the clinical response to therapy has not been established in man. Sensitivity test results, expressed as the concentration of amantadine required to inhibit by 50% the growth of virus (ED50) in tissue culture vary greatly (from 0.1 µg/mL to 25.0 µg/mL) depending upon the assay protocol used, size of virus inoculum, isolates of influenza A virus strains tested, and the cell type used. Host cells in tissue culture readily tolerated amantadine up to a concentration of 100 µg/mL.
Osmolex Er is an antiviral drug which also acts as an antiparkinson agent, for which it is usually combined with L-DOPA when L-DOPA responses decline (probably due to tolerance). It is a derivate of adamantane, like a similar drug rimantadine. The mechanism of action of amantadine in the treatment of Parkinson's disease and drug-induced extrapyramidal reactions is not known. It has been shown to cause an increase in dopamine release in the animal brain, and does not possess anticholinergic activity.
Trade Name | Osmolex Er |
Availability | Prescription only |
Generic | Amantadine |
Amantadine Other Names | Amantadina, Amantadine, Amantadinum, Amantidine, Aminoadamantane |
Related Drugs | Sinemet, Rytary, Gocovri, Sinemet CR, diphenhydramine, Benadryl, ropinirole, pramipexole, benztropine, carbidopa / levodopa |
Type | |
Formula | C10H17N |
Weight | Average: 151.2487 Monoisotopic: 151.136099549 |
Protein binding | Approximately 67% bound to plasma proteins over a concentration range of 0.1 to 2.0 µg/mL. |
Groups | Approved |
Therapeutic Class | Respiratory viral infections (Influenza) |
Manufacturer | |
Available Country | United States |
Last Updated: | September 19, 2023 at 7:00 am |
Uses
Osmolex Er Hydrochloride is used for-
- Treatment of parkinsonism
- Treatment of drug-induced extrapyramidal reactions
- Prophylaxis and treatment of signs and symptoms of infection caused by various strains of influenza A virus
Osmolex Er is also used to associated treatment for these conditions: Cerebral Arteriosclerosis, Chorea, Extrapyramidal disorder caused by neuroleptic drugs without Tardive dyskinesia, Fatigue, Influenza A Virus Infection, Parkinson's Disease (PD), Parkinsonism, Parkinsonism post encephalitic, Restless Legs Syndrome (RLS)
How Osmolex Er works
The mechanism of its antiparkinsonic effect is not fully understood, but it appears to be releasing dopamine from the nerve endings of the brain cells, together with stimulation of norepinephrine response. It also has NMDA receptor antagonistic effects. The antiviral mechanism seems to be unrelated. The drug interferes with a viral protein, M2 (an ion channel), which is needed for the viral particle to become "uncoated" once it is taken inside the cell by endocytosis.
Dosage
Osmolex Er dosage
Parkinson's disease:
- Adult: Initially, 100 mg/day, increased to 100 mg bid after a wk or more. Max dose: 400 mg daily.
- Elderly: >65 yr: Lowest effective dose.
Prophylaxis of influenza A:
- Adult: 100 mg daily for up to 6 wk; when used with influenza vaccination: only up to 3 wk after vaccination.
- Child: 10-15 yr: 100 mg daily.
Influenza A:
- Adult: 100 mg daily for 5 days.
- Elderly: >65 yr: Daily dose of 1 day.
Herpes zoster in immunocompromised patients:
- Adult: 100 mg bid for 14 days, continued for another 14 days if pain persists.
Side Effects
The adverse effects of Osmolex Er are generally mild and, when they occur, may diminish or cease after a week or more on the medication. The most commonly reported side effects include nausea, dizziness/ lightheadedness, and insomnia.
Other side effects may include edema of ankles, livedo reticularis; anxiety, elevation of mood, headache, lethargy, hallucinations, ataxia, slurred speech, blurred vision, loss of concentration, nervousness, depression, myalgia, palpitations, orthostatic hypotension, dry mouth, anorexia, constipation and diaphoresis.
Toxicity
Deaths have been reported from overdose with amantadine. The lowest reported acute lethal dose was 2 grams. Drug overdose has resulted in cardiac, respiratory, renal or central nervous system toxicity. Cardiac dysfunction includes arrhythmia, tachycardia and hypertension. Pulmonary edema and respiratory distress (including ARDS) have been reported. Renal dysfunction including increased BUN, decreased creatinine clearance and renal insufficiency can occur. Central nervous system effects that have been reported include insomnia, anxiety, aggressive behavior, hypertonia, hyperkinesia, tremor, confusion, disorientation, depersonalization, fear, delirium, hallucination, psychotic reactions, lethargy, somnolence and coma. Seizures may be exacerbated in patients with prior history of seizure disorders. Hyperthermia has also been observed in cases where a drug overdose has occurred.
Precaution
Osmolex Er should not be discontinued abruptly in patients with Parkinson's disease since a few patients have experienced a parkinsonian crisis, i.e., a sudden marked clinical deterioration, when this medication was suddenly stopped. The dose of anticholinergic drugs or of Osmolex Er Hydrochloride should be reduced if atropine-like effects appear when these drugs are used concurrently. Abrupt discontinuation may also precipitate delirium, agitation, delusions, hallucinations, paranoid reaction, stupor, anxiety, depression and slurred speech.
Interaction
Concurrent administration of Osmolex Er and anticholinergic agents or levodopa may increase confusion, hallucinations, nightmares, gastro-intestinal disturbances, or other atropine-like side effects. Psychotic reactions have been observed in patients receiving Osmolex Er and Levodopa.
Concurrent administration of Osmolex Er and drugs or substances (e.g. alcohol) acting on the CNS may result in additive CNS toxicity. Close observation is recommended.
Food Interaction
- Avoid alcohol.
- Take with or without food. The absorption is unaffected by food.
Osmolex Er Drug Interaction
Unknown: aspirin, aspirin, rasagiline, rasagiline, duloxetine, duloxetine, omega-3 polyunsaturated fatty acids, omega-3 polyunsaturated fatty acids, carbidopa / levodopa, carbidopa / levodopa, levothyroxine, levothyroxine, acetaminophen, acetaminophen, cyanocobalamin, cyanocobalamin, ascorbic acid, ascorbic acid, cholecalciferol, cholecalciferol
Osmolex Er Disease Interaction
Major: psychoses/depression, renal dysfunction, seizure disorders, hypotension, psychosisModerate: CHF/edema, hypotension
Volume of Distribution
- 3 to 8 L/kg [healthy subjects]
Elimination Route
Osmolex Er is well absorbed orally from the gastrointestinal tract.
Half Life
Mean half-lives ranged from 10 to 14 hours, however renal function impairment causes a severe increase in half life to 7 to 10 days.
Clearance
- 0.2 - 0.3 L/hr/kg
- 0.10 +/- 0.04 L/hr/kg [healthy, elderly male]
Elimination Route
It is primarily excreted unchanged in the urine by glomerular filtration and tubular secretion.
Pregnancy & Breastfeeding use
Pregnancy category C. No well-controlled studies have been done in pregnant women to evaluate Osmolex Er's safety. Osmolex Er may be used during pregnancy when the potential benefits outweigh the potential but unknown risks to the fetus.
Osmolex Er is excreted into breast milk in low concentrations. As no information is available on the effects in infants, therefore amantadine should be used cautiously in women who are breastfeeding.
Contraindication
Osmolex Er is contraindicated in patients with known hypersensitivity to the active substances or to any of the excipients.
Special Warning
Patients with renal impairment: The dose should be reduced. This can be achieved by either reducing the total daily dose, or by increasing the dosage interval in accordance with the creatinine clearance. For example:
- CrCl <15 ml/min: Contraindicated
- CrCl 15-35 ml/min: 100 mg every 2 to 3 days
- CrCl >35 ml/min: 100mg every day
Patients with hepatic impairment: Use with caution
Storage Condition
Store at 20-25°C in dry place. Protect from light.
Innovators Monograph
You find simplified version here Osmolex Er
Osmolex Er contains Amantadine see full prescribing information from innovator Osmolex Er Monograph, Osmolex Er MSDS, Osmolex Er FDA label