Amantrel
✅ Prevents flu infections
✅ Treats Parkinson’s symptoms
✅ Reduces tremors
✅ Boosts mobility
✅ Elevates energy levels
Amantrel contains Amantadene.
✓ Medisch beoordeeld door Morgan Ellis — Apotheekonderzoeker · 8 jaar ervaring · Laatst beoordeeld: mei 2026
⚡ Quick Answer
Amantrel is een oraal amantadine (100 mg) capsule with a unique dual mechanism: it both releases dopamine from presynaptic stores and blocks NMDA glutamate receptors. In Parkinson disease it has two distinct uses: (1) modest symptomatic benefit in early disease (especially for tremor and rigidity), and (2) one of the only effective treatments for levodopa-induced dyskinesia in advanced disease. Common, often dose-limiting side effects: ankle oedema, livedo reticularis (a mottled purple-blue skin pattern), confusion, hallucinations (particularly in older patients), insomnia. Amantadine was historically also used to prevent and treat influenza A — a use abandoned because of resistance.
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What Is Amantrel?
Amantrel is an oral capsule containing amantadine 100 mg. Amantadine was originally licensed in the 1960s as an anti-influenza drug; its anti-Parkinson action was discovered serendipitously when a flu-treated patient with Parkinson disease unexpectedly improved. The originator brand is Symmetrel. Amantrel is manufactured by a WHO-GMP certified facility and is bioequivalent at 100 mg.
How Does Amantrel (Amantadine) Work?
Amantadine is unique among Parkinson medications in having two complementary mechanisms:
- Dopaminergic enhancement. It increases presynaptic dopamine release, blocks dopamine re-uptake, and may modestly stimulate dopamine receptors. This produces direct anti-parkinsonian effect, especially for rigidity and tremor.
- NMDA receptor antagonism. Amantadine is a non-competitive blocker of N-methyl-D-aspartate (NMDA) glutamate receptors. Excessive striatal NMDA activity drives levodopa-induced dyskinesia — the involuntary writhing movements that emerge after years of levodopa therapy. By dampening this glutamate signal, amantadine reduces dyskinesia zonder reducing the levodopa benefit. This is its most distinctive role.
It also has weak anticholinergic activity, which contributes both to symptom benefit and to the cognitive side effects in older patients.
Who Is Amantrel For?
- Early Parkinson disease — as monotherapy or adjunct to MAO-B inhibitor or dopamine agonist, providing modest symptom relief while delaying introduction of levodopa.
- Advanced Parkinson disease with levodopa-induced dyskinesia — this is amantadine’s strongest evidence-based indication. Adding 100–300 mg/day reduces dyskinesia by approximately 50% in many patients.
- Drug-induced extrapyramidal symptoms — from antipsychotics; sometimes used as alternative to anticholinergics, particularly in older patients where anticholinergics worsen cognition.
- Multiple sclerosis-related fatigue — off-label, modest evidence.
- Influenza A — no longer recommended: virtually all circulating influenza A strains are resistant to amantadine since the mid-2000s.
Dosing and Administration
| Indicatie | Startdosis | Usual maintenance |
|---|---|---|
| Parkinson disease (early monotherapy) | 100 mg once daily for 1 week | 100 mg twice daily; max 300 mg/day |
| Levodopa-induced dyskinesia | 100 mg twice daily | 100 mg 2–3 times daily; up to 400 mg/day in selected patients |
| Drug-induced parkinsonism | 100 mg twice daily | 100–300 mg/day |
| Renal impairment (CrCl < 50 ml/min) | Verminder met 50% | CrCl 15–30: 100 mg every 2–3 days; haemodialysis: 100 mg/week |
Time of day matters. Avoid evening doses — amantadine is stimulating and frequently causes insomnia and vivid dreams. Take morning and afternoon doses with or without food.
Veelvoorkomende bijwerkingen
Vaak voorkomend: insomnia, vivid dreams, nausea, dizziness, dry mouth, constipation, peripheral oedema (ankle swelling), livedo reticularis (purplish mottled rash on the legs — benign but cosmetically alarming).
Minder vaak: blurred vision, urinary retention, postural hypotension, agitation, depression.
More serious (mostly in elderly or renal impairment): confusion, visual hallucinations, paranoia, suicidal ideation, seizures, neuroleptic malignant-like syndrome on abrupt withdrawal.
Livedo reticularis is a hallmark side effect — a lacy, purple-red mottled pattern over the lower legs and arms. It is harmless and reverses fully over weeks to months after stopping the drug. Many patients can keep using amantadine despite the appearance.
Geneesmiddelinteracties
- Anticholinergics (trihexyphenidyl, benztropine, hyoscine, oxybutynin) — additive dry mouth, blurred vision, constipation, confusion. Particularly problematic in older patients.
- CNS stimulants — pseudoephedrine, methylphenidate: additive insomnia, agitation.
- Trimethoprim and trimethoprim-sulfamethoxazole — competes with amantadine for renal tubular secretion, raises levels.
- Quinine, quinidine — reduce renal clearance of amantadine.
- Live attenuated influenza vaccine — theoretical interference with replication; allow 48 hours between amantadine and the vaccine.
- Alcohol — additive CNS effects, increased dizziness and confusion. Avoid heavy use.
Veelgestelde vragen
How is amantadine different from other Parkinson drugs?
It is the only Parkinson drug that meaningfully reduces levodopa-induced dyskinesia — the involuntary movements that emerge after years of levodopa therapy. Most other anti-Parkinson drugs add to dyskinesia rather than reduce it. Its NMDA-antagonist action is what makes this possible.
How quickly will Amantrel start working?
Some patients notice symptom benefit within days; the effect on dyskinesia takes 1–2 weeks to be obvious. The full benefit is usually clear within 4 weeks. If you see no benefit by 6 weeks, it is unlikely to help further.
Why do I have to take it in the morning and afternoon, not at night?
Amantadine is stimulating and frequently causes insomnia and vivid dreams. Taking the last dose by mid-afternoon avoids this. If you forget and take a late dose, expect a poor night’s sleep.
What is livedo reticularis and should I be worried?
It is a harmless lacy purple-red mottled pattern over the legs and arms, caused by amantadine altering small-vessel tone. It is cosmetically obvious but causes no medical harm and reverses fully over weeks to months after stopping the drug. Many patients keep using amantadine despite the appearance.
Can I take Amantrel for influenza?
No. Almost all circulating influenza A strains have been resistant to amantadine since the mid-2000s, and amantadine has never had useful activity against influenza B. Use an active antiviral — oseltamivir, zanamivir, baloxavir — instead.
Why does my doctor ask about my kidney function before prescribing this?
Amantadine is cleared almost entirely by the kidneys. If your creatinine clearance is low, the drug accumulates and toxic effects (confusion, hallucinations, myoclonus, seizures) follow within days. Renal dosing is essential, especially in older patients.
Can Amantrel cause hallucinations?
Yes — particularly in older patients, those with cognitive impairment, or in renal impairment. Visual hallucinations are most common. If they occur, contact your doctor — usually the solution is dose reduction or discontinuation.
Will Amantrel cause weight gain?
It can cause peripheral oedema (ankle swelling) but does not cause true weight gain. Some patients also have mild appetite suppression early on.
Can I stop Amantrel abruptly?
No. Sudden withdrawal can precipitate a neuroleptic malignant-like syndrome (rigidity, fever, autonomic instability, raised CK). Taper over 1–2 weeks under medical supervision.
Can I drink alcohol with Amantrel?
Avoid heavy or regular drinking — alcohol increases dizziness, confusion and can worsen postural hypotension. Occasional light drinking is usually acceptable.
How does MedsBase ship Amantrel?
Worldwide shipping in discreet packaging from a WHO-GMP certified manufacturer. Capsules are shipped in original sealed blister packs. Track your order from your MedsBase account.
Opslag
Store at room temperature (15–30°C / 59–86°F), protected from heat, moisture and direct light. Keep in the original container with the lid tightly closed. Keep out of reach of children. Do not use beyond the expiry date printed on the packaging.
Medische Disclaimer
This information is provided for educational purposes only and is not a substitute for the advice of a qualified clinician. Parkinson disease and parkinsonian syndromes require individualised neurology care. Discuss all medications, supplements and pre-existing conditions with your doctor before starting, changing or stopping treatment. Do not abruptly discontinue dopaminergic therapy — sudden withdrawal can precipitate a neuroleptic malignant-like syndrome.
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| Sterkte | 100 mg |
|---|---|
| Hoeveelheid | 30 Capsule/s, 60 Capsule/s, 90 Capsule/s, 180 Capsule/s |
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