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Miscellaneous

Amantadine and rimantadine for preventing and treating influenza A in adults

  1. TO Jefferson*,
  2. V Demicheli,
  3. JJ Deeks,
  4. D Rivetti

Editorial Group: Cochrane Acute Respiratory Infections Group

Published Online: 22 JUL 2002

DOI: 10.1002/14651858.CD001169


How to Cite

Jefferson TO, Demicheli V, Deeks JJ, Rivetti D. Amantadine and rimantadine for preventing and treating influenza A in adults. The Cochrane Database of Systematic Reviews 2002, Issue 3. Art. No.: CD001169. DOI: 10.1002/14651858.CD001169.

Author Information

  1. Anguillara Sabazia, Roma, ITALY

*TO Jefferson, Via Adige 28a, Anguillara Sabazia, Roma, 00061, ITALY. toj1@aol.com.

Publication History

  1. Publication Status: Commented
  2. Published Online: 22 JUL 2002

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This is not the most recent version of the article. View current version (19 APR 2006)

 

Abstract

  1. Top of page
  2. Abstract
  3. Synopsis

Background

Amantadine hydrochloride and rimantadine hydrochloride have antiviral properties, but they are not widely used due to a lack of knowledge of their potential value and concerns about possible adverse effects.

Objectives

The objective of this review was to assess the effects and safety of amantadine and rimantadine in healthy adults.

Search strategy

We searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE and reference lists of articles. We also contacted manufacturers, researchers and authors.

Selection criteria

Randomised and quasi-randomised studies comparing amantadine and/or rimantadine with placebo, control antivirals or no intervention, or comparing doses or schedules of amantadine and/or rimantadine in healthy adults.

Data collection and analysis

For prevention trials the numbers of participants with clinically defined influenza, with serologically confirmed clinical influenza A and adverse effects were analysed. Analysis for treatment trials was of the mean duration of fever and adverse effects.

Main results

Amantadine prevented 23% of clinical influenza cases (95% confidence interval 11% to 34%), and 63% of serologically confirmed clinical influenza A cases (95% confidence interval 42% to 76%). Amantadine reduced duration of fever by one day (95% confidence interval 0.7 to 1.3). Rimantadine demonstrated comparable effectiveness, but there were fewer trials and the results for prevention were not statistically significant. Both amantadine and rimantadine induced significant gastrointestinal adverse effects. Adverse effects of the central nervous system and study withdrawals were significantly more common with amantadine than rimantadine.

Reviewers' conclusions

Amantadine and rimantadine have comparable effectiveness in the prevention and treatment of influenza A in healthy adults, although rimantadine induces fewer adverse effects than amantadine.

[This abstract has been prepared centrally.]

 

Synopsis

  1. Top of page
  2. Abstract
  3. Synopsis

Synopsis

The drugs amantadine and rimantadine can both help prevent and relieve influenza A in adults, but amantadine has more adverse effects

The flu (influenza) can be caused by many different viruses. One type is influenza A, with headaches, coughs and runny noses that can last for many days and lead to serious illnesses such as pneumonia. Amantadine and rimantadine are antiviral drugs. The review of trials found that both drugs are similarly helpful in preventing or treating influenza A in adults, but only when there is a high probability that the cause of the flu is influenza A (a known epidemic, for example). Both have adverse gastrointestinal (stomach and gut) effects, but amantadine can also have serious effects on the nervous system.