Trade Name(s)

  • Flumadine

Ther. Class.



  • Prevention and treatment of influenza A infection in high-risk adults.
  • Prevention of influenza A infection in high-risk children.

Unlabeled Use(s):

Treatment of influenza A infection in children.


Diminishes replication of influenza A virus by inhibiting uncoating of the virus.

Therapeutic Effect(s):

When given prophylactically, prevents infection with influenza A virus. When administered within 48 hr of onset of infections, decreases the duration of fever and other associated symptoms.


Absorption: Well absorbed after oral administration.

Distribution: Unknown.

Metabolism and Excretion: Mostly metabolized by the liver; <25% excreted unchanged in urine.

Half-life: 25 hr (range 13–65 hr).

TIME/ACTION PROFILE (blood levels)

POrapid6 hrN/A


Contraindicated in:

  • Hypersensitivity to rimantadine or amantadine
  • Lactation:  Lactation.

Use Cautiously in:

  • History of seizures
  • Severe hepatic or renal impairment (dose ↓ recommended if CCr <30 mL/min)
  • Geri:  May be at ↑ risk for GI effects
  • OB:  Safety not established.

Adverse Reactions/Side Effects

Derm: rash

EENT: tinnitus

GI: abdominal pain, anorexia, diarrhea, dry mouth, dyspepsia, nausea, vomiting

Neuro: agitation, dizziness, fatigue, headache, impaired concentration, insomnia, mental depression, SEIZURES

Resp: dyspnea

* CAPITALS indicate life-threatening.
Underline indicate most frequent.



  •  Aspirin  and  acetaminophen  may ↓ levels.
  • May interfere with efficacy of  intranasal influenza virus vaccine, do not administer within 48 hr before or 2 wk after.


PO (Adults): Prevention- 100 mg twice daily (duration range = 11 days-6 wk).  Treatment- 100 mg twice daily for 7 days.

PO (Geriatric Patients , Patients with Severe Hepatic or Severe Renal Impairment [CCr <30 mL/min]): Prevention- 100 mg daily.

PO (Children  10–16 yr): Prevention- 100 mg twice daily (duration range = 5–6 wk).

PO (Children  1–9 yr): Prevention- 5 mg/kg/day as a single dose (not to exceed 150 mg/day) (duration range = 5–6 wk).

Availability (generic available)

Tablets: 100 mg


  • Monitor respiratory status (rate, breath sounds, sputum) and temperature periodically. Supportive treatment is indicated if symptoms occur.


  • Do not administer within 48 hr before or 2 wk after administration of intranasal influenza virus vaccine ( FluMist ).

    • Consider available information on influenza drug susceptibility patterns and treatment effects before using rimantadine.
  • PO Do not administer last dose of medication near bedtime; this drug may produce insomnia in some patients.

Patient/Family Teaching

  • Advise patient to take medication as directed at evenly spaced times for full course of therapy, even if feeling well. Take missed doses as soon as possible unless almost time for next dose; do not double up on missed doses.
  • May cause dizziness. Advise patient to avoid driving or other activities that require alertness until response to the drug is known.
  • Advise patient to consult health care professional about receiving a flu vaccination.
  • Inform patient that frequent mouth rinses, good oral hygiene, and sugarless gum or candy may decrease dry mouth.
  • Advise patient to consult health care professional before taking OTC medications or herbal products, especially aspirin or acetaminophen, or drinking alcoholic beverages.
  • Instruct patient and family to notify health care professional if influenza symptoms occur.

Evaluation/Desired Outcomes

Avoidance of or reduction in symptoms associated with influenza A infection.