Amantadine Dosing Considerations in Parkinson's Disease

Patient-Specific Dosing Adjustments

• In patients 65 years and older, the American Geriatrics Society recommends reducing the daily dose to 100 mg total to account for age-related decline in renal function and reduce CNS side effects 1
• Elderly women are at higher risk for side effects due to smaller average body size, according to the Centers for Disease Control and Prevention 2

Renal Impairment Considerations

• The National Kidney Foundation suggests consulting the drug package insert for creatinine clearance <50 mL/min/1.73m², as plasma amantadine concentrations increase significantly with renal dysfunction 3, 1

Safety Precautions

• The American Academy of Neurology recommends monitoring for nervousness, anxiety, insomnia, difficulty concentrating, and lightheadedness, and avoiding taking the second dose too close to bedtime 1
• Patients with seizure disorders should be observed closely for increased seizure activity, as advised by the Centers for Disease Control and Prevention 2

Common Pitfalls to Avoid

• Failing to reduce dose in elderly patients (≥65 years) can lead to adverse effects, and the American Geriatrics Society recommends a maximum dose of 100 mg/day in this population 1
• Not adjusting for renal impairment can result in amantadine accumulation, and the National Kidney Foundation suggests dose reduction for CrCl ≤50 mL/min/1.73m² 1