Inhibitors of Viral Uncoating

Amantadine and Rimantadine

Mechanism of action
Amantadine and rimantadine appear to work, at least in part,
by preventing newly synthesized viruses from being released
from the host cell (see Fig. 4-9).
Clinical use
Amantadine and rimantadine are effective for reducing the
duration of influenza A if given within 24 hours of symptom
onset and may prevent the infection in close contacts of
affected individuals.
Adverse effects
Amantadine is associated with central nervous system side effects
(nervousness, lightheadedness, insomnia, and seizures),
especially in the elderly. In addition, amantadine is associated
with anticholinergic side effects and may promote dopamine
release. Because of these additional mechanisms, amantadine
is sometimes used for managing symptoms associated with
Parkinson disease. Use caution and consider dose reductions
in patients with renal impairment.