## Breadcrumb - [Home](/) - [Living with Parkinson's](/living-with-parkinsons) - [Treatment](/living-with-parkinsons/treatment) - [Prescription Medications](/living-with-parkinsons/treatment/prescription-medications) ## Breadcrumb - [Home](/) - [Living with Parkinson's](/living-with-parkinsons) - [Treatment](/living-with-parkinsons/treatment) - [Prescription Medications](/living-with-parkinsons/treatment/prescription-medications) # Amantadine ## 💡 Quick Summary - The medication amantadine helps reduce [tremor](/understanding-parkinsons/movement-symptoms/tremor "Tremor") and can be combined with [levodopa](/living-with-parkinsons/treatment/prescription-medications/levodopa "Levodopa") to manage levodopa-induced dyskinesia in people with Parkinson’s. - Extended-Release Amantadine Gocovri and Osmolex ER is FDA-approved to treat dyskinesia and “off” episodes, providing a once-daily treatment option for people with PD who experience [involuntary movements](/understanding-parkinsons/movement-symptoms/dyskinesia "Dyskinesia"). - Available in capsules, tablets and liquid forms. - Common side effects are dizziness, low blood pressure, nausea, insomnia and hallucinations. ![Woman holding three pills in her hands](/sites/default/files/styles/no_sizing/public/images/amantadine.jpg?itok=3Dyg7LBF) Immediate-release amantadine has historically been used in Parkinson’s disease (PD) to help tremor. In recent years, amantadine has also been found to be useful for some in reducing [dyskinesias](/understanding-parkinsons/movement-symptoms/dyskinesia "Dyskinesia") (involuntary movements) that occur with dopamine medication. In 2017, an extended-release form of amantadine (Gocovri) was the first drug approved by the FDA specifically to treat dyskinesia in Parkinson's. ## Quick Facts - Amantadine was initially developed as an antiviral medication to treat influenza in the 1960s; later it was it was found to be potentially useful for treatment for Parkinson’s, which was later confirmed in clinical trials. - Immediate-release amantadine can be used alone for Parkinson’s motor symptoms or as combination therapy with levodopa for levodopa-induced dyskinesia. - Extended-release amantadine is used as combination therapy with levodopa for levodopa-induced dyskinesia and [“off” episodes](/library/fact-sheets/managing-off-time "Managing "Off" Time in Parkinson's"), (changes in the ability to move as a levodopa dose wanes). - Immediate-release amantadine is most commonly available in 100 mg capsules, although liquid and tablet forms can also be obtained. Most people take multiple doses per day. - Extended-release amantadine is a once-per-day treatment option. People who are doing well on multiple doses per day of generic amantadine may not benefit from switching to one-a-day Gocovri or Osmolex ER, but people who experience side effects from amantadine now have another option. - No trial has been done comparing immediate- and extended-release amantadine, but many trials show that amantadine in any formulation can be effective at suppressing dyskinesia. ## Forms of Amantadine Your doctor will work with you to determine what medications and formulations are right for you and to make you aware of potential drug interactions. - ### Amantadine (Symmetrel) **Available Doses:** 100 mg capsules; 100 mg tablets, 50 mg/5 mL syrup **Typical Treatment Regimen**: 100 mg 2 to 3 times/day **Common Side Effects**: Dizziness, hallucination, paranoia, nausea, confusion, leg discoloration, dizziness/low blood pressure from seated to standing, dry mouth, constipation, urinary retention and potential effect of arrythmias **Indications for Usage**: Monotherapy (alone) for slowness, stiffness, and tremor; combination therapy with levodopa for levodopa-induced dyskinesia - ### Amantadine Extended-release Capsules (Gocovri) **Available Doses:** 68.5 mg, 137 mg **Typical Treatment Regimen**: 137 to 274 mg once per day at bedtime **Common Side Effects**: Dizziness, hallucination, paranoia, nausea, confusion, leg discoloration, dizziness/low blood pressure from seated to standing, dry mouth, constipation, urinary retention and potential effect of arrythmias **Indications for Usage**: Dyskinesia in people with levodopa therapy; “off” episodes in Parkinson disease - ### Amantadine Extended-release Tablets (Osmolex ER) **Available Doses:** 129 mg, 193 mg, 258 mg **Typical Treatment Regimen**: 129 to 322 mg once/day (upon waking) **Common Side Effects**: Dizziness, hallucination, paranoia, nausea, confusion, leg discoloration, dizziness/low blood pressure from seated to standing, dry mouth, constipation, urinary retention, and potential effect of arrythmias **Indications for Usage**: Dyskinesia in people with levodopa therapy; “off” episodes in Parkinson disease ## Side effects ### Common side effects: - Dizziness - Low blood pressure - Nausea - Insomnia - Confusion - Paranoia - Hallucinations - Leg discoloration ### Uncommon side effects: - Urinary retention - Livedo reticularis: a lacey, purplish discoloration of the skin on the legs with some leg swelling. **This occurs in less than 1% of people with PD who take this medication.** - ### Disclaimers Please note that the side effects listed in the tables that accompany each class of medication are the most *commonly experienced*. Not all individuals will experience such side effects. Careful adjustments to dosage or the timing of individual doses can often effectively limit or eliminate side effects for many people. Speak to your doctor immediately if you experience any side effects. For a complete description of each drug and its possible side effects, please request a “package insert” from your pharmacist for each drug used. **It is recommended that all prescriptions be filled at the same pharmacy to avoid interactions between medications.** Interactions can be dangerous and even life-threatening, so make sure the pharmacist knows of all medications and supplements being taken, including over-the-counter medications and supplements. **Caution:** Parkinson’s medications may have interactions with certain foods, other medications, vitamins, herbal supplements, over-the-counter cold pills and other remedies. Anyone taking a PD medication should talk to their doctor and pharmacist about potential drug interactions. *Page reviewed by Dr. Chauncey Spears, Clinical Assistant Professor and Dr. Amelia Heston, Movement Disorders Fellow at the University of Michigan.* ## Related Materials Books ### [ Medications: A Treatment Guide to Parkinson’s Disease ](/library/books/medications) [Read Now](/library/books/medications) Podcasts ### [ Episode 96: PD Medications and Side Effects ](/library/podcast/96) [Listen Now](/library/podcast/96) ## Related Blog Posts ![Couple buying medication in a store](/sites/default/files/styles/500x360/public/images/pdmednew-bloghero.png?h=ed9ce7df&itok=xE6j_DbB) Raise Awareness ### [ PD and Medication: What's New? ](/blog/tips/2019-medication-update) READ NOW ![giving medications to older man](/sites/default/files/styles/500x360/public/images/medicationadvancingtreatment-blog.jpg?h=f2fcf546&itok=_oFS4UXr) Advancing Research ### [ PD and Medication: Advancing Treatment ](/blog/research/medication-treatment) READ NOW ![Woman dizzy](/sites/default/files/styles/500x360/public/images/dizzypassingout-blog.jpg?h=ed9ce7df&itok=zuW5pKiH) Advancing Research ### [ What's Hot in PD? If you are Dizzy or Passing Out, it could be Your Parkinson’s Disease or Parkinson’s Medications ](/blog/research/passing-out) READ NOW ### Order a Parkinson’s Hospital Safety Guide The Hospital Safety Guide is a resource for people with Parkinson's and their care partners filled with useful tools and information to prepare for and navigate a hospital stay. [ORDER NOW](/resources-support/pd-library/order-publications) [LEARN MORE](/resources-support/hospital-safety-guide) - Share on Facebook - Share on X - Share on LinkedIn