Overdose with Remantadine
Remantadine is an antiviral drug with activity against influenza type A viruses, as well as two types of herpes simplex virus, and also has an immunostimulating effect. The drug is widely used for the prevention and treatment of influenza, in this regard, cases of overdose are seasonal in nature - the largest number is observed in the autumn-winter period.
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How much remantadine is needed for an overdose?
For prophylactic purposes, adults are recommended 50 mg (1 tablet) of Remantadine per day for a month, for children - 50 mg per day for 15 days. If the daily dose is missed, the next day you should continue to take the drug as usual, without increasing the dose.
Another treatment regimen for influenza:
- adults - 300 mg (6 tablets) on the 1st day of illness, 200 mg (4 tablets) on the 2nd and 3rd days, 100 mg (2 tablets) on the 4th and 5th days;
- children 10-14 years old, 50 mg (1 tab.) 3 times a day;
- children 7-10 years old, 50 mg 2 times a day.
The total duration of the course of therapy should not exceed five days.
An overdose of Remantadine develops when the maximum permissible daily dose is exceeded (300 mg for an adult, 100-150 mg for a child).
Signs of overdose
An overdose of Remantadine is accompanied by the following symptoms:
- heartburn, nausea, vomiting;
- flatulence, diarrhea;
- skin rash;
- noise in ears;
- hoarseness of the voice;
- increased body temperature;
- hyperkinesis, violation of the coordinated action of various muscle groups (ataxia), swinging gait;
- drowsiness;
- violation of attention;
- depressed state;
- mental agitation, accompanied by a feeling of fear and anxiety (agitation);
- violation of the rhythm of the heart.
With a severe overdose of Remantadine, hallucinations and severe psychomotor agitation occur. As a result of an abnormal heart rhythm, cardiac arrest can occur.
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First aid for overdose with Remantadine
In case of an overdose with Remantadine, you should immediately call an ambulance and only then proceed to provide first aid.
- If less than 3 hours have passed since taking the drug, it is necessary to rinse the stomach: drink 0.5-1 liters of cool water and induce vomiting by pressing on the root of the tongue. Repeat 2-3 times.
- Take a suspension of activated carbon: grind tablets (at the rate of 1-2 tablets for every 10 kg of body weight) into powder, stir in ½ glass of water and drink in one gulp.
- Provide plenty of fluids. It is best to drink cranberry or lingonberry juice, weak tea with lemon, if they are not available, plain or mineral water will do.
Antidote
The antidote to Remantadine is physiostigmine (belongs to the group of anticholinesterase drugs of reversible action).
When is medical attention needed?
In all cases of overdose with Remantadine, emergency medical attention is required.
The victim is injected with 1-2 mg of physiostigmine, if necessary, repeating the injections at the same dosage every hour.
In this case, hemodialysis is ineffective (it allows you to remove no more than 5% of the toxin). Acidification of urine allows accelerating the elimination of Remantadine from the body, for which methionine, ammonium citrate, sodium phosphate, ascorbic acid are prescribed. Acidification of urine can be achieved by drinking acidic drinks, such as cranberry juice. In case of urinary retention, bladder catheterization is performed using a Faley-type urinary catheter.
The patient is closely monitored: monitoring the electrocardiogram, heart rate, blood pressure, body temperature. This allows you to timely identify the development of arrhythmia, hyperthermia and arterial hypotension, take timely measures and monitor the effectiveness of treatment.
Possible consequences
With a slight overdose and timely treatment started, the condition of the victims improves quickly and the consequences, as a rule, are not observed. The risk group for possible complications includes persons suffering from hypertension - in them, an overdose of Remantadine can provoke a sharp jump in blood pressure, which, in turn, can lead to myocardial infarction or stroke.
Severe overdose of Remantadine, even with medical care, can be fatal. If the victims are saved, they have long-term disorders of the functions of the central nervous system, and a predisposition to mental illness appears.
Prevention
When taking Remantadine, you should carefully adhere to the prescribed dosage regimen and regimen, and keep the drug out of the reach of children.
In 2011, a report by the US Centers for Disease Control and Prevention was published with information that at present, almost all strains of the type A influenza virus have acquired resistance to Remantadine, therefore, taking this agent for the prevention and treatment of influenza is not recommended.
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
