[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Anti-influenza agents](https://durgical.com/en/pharmacology/classes/anti-influenza-agents/) › Rimantadine

# Rimantadine

## Anti-influenza agents?

Anti-influenza agents

An oral adamantane that blocks the M2 channel of influenza A. It is no longer recommended because most circulating viruses are resistant.

Updated Nov 1, 2026

## Quick facts

**Group**
[Anti-influenza agents](https://durgical.com/en/pharmacology/classes/anti-influenza-agents/)

**Target**
Influenza A M2 proton channel

**Used for**
Historically prevention and treatment

**Key effects**
Upset stomach and loss of appetite · Nervousness

**Monitor**
Mental status and sleep · Liver function

**ATC**
J05AC02

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

⇅**Influenza A M2 proton channel**Rimantadine

ⓘ The figure shows rimantadine inside the pore of the influenza A M2 proton channel.

**Target in 3D:** Influenza A M2 proton channel. PDB structure 6US9 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/6US9) · Drag to rotate · pinch to zoom

Rimantadine, like amantadine, blocks the M2 protein of influenza A, a proton channel in the viral envelope. Protons entering through M2 inside the endosome let the viral ribonucleoprotein separate from the matrix protein (uncoating); blocking it stops this early step. It has no activity against influenza B, which lacks M2. A single mutation in the M2 transmembrane region gives high-level resistance, and it appears quickly during treatment.

- M2 lets protons into the virion in the endosome
- Rimantadine plugs the M2 channel
- The viral genome is not released (no uncoating)
- One M2 mutation abolishes the effect

## Indications

- Historically prevention and treatment of influenza A; not recommended now because of high resistance [Influenza (flu) →](https://durgical.com/en/conditions/influenza/)

## Adverse effects

### Common

- Upset stomach and loss of appetite
- Nervousness, light-headedness and difficulty concentrating
- Insomnia
- Tiredness

### Serious (rare, important)

- Worsening of seizure disorders
- Confusion or mood changes
- Yellowing of skin or eyes

## Contraindications

- Hypersensitivity to rimantadine

## Key interactions

**Aspirin and paracetamol (acetaminophen)**
Listed as interacting; reviewed before combining

**Antihistamines, psychotropic or anticholinergic drugs**
Adamantane central nervous system effects may increase, especially in older adults

## What is monitored

- Mental status and sleep
- Seizure control in people with epilepsy
- Liver function

## Administration and safety

- Oral, with food if it upsets the stomach
- Do not confuse with amantadine, the related drug also used in Parkinson disease

## Pregnancy and breastfeeding

No adequate human data are available; it is not used in pregnancy now that better options exist.

## Nursing care

- Check local resistance data: adamantanes are not used for current influenza
- Ask about epilepsy, liver disease and kidney disease
- Teach to report confusion, mood change or yellow skin
- Remind that vaccination remains the main prevention

## Pharmacokinetics

**Absorption**
Oral

**Metabolism**
Extensively metabolised in the liver before excretion

**Elimination**
Mainly as metabolites in the urine; elimination depends on liver function

## Memory aid

RIM blocks the M2 «rim» of the pore; influenza A slipped past it long ago.

## Test yourself

Think of the answer, then tap the question to see it.

## Which protein does rimantadine block?

The M2 proton channel of influenza A.

## Why does rimantadine not work against influenza B?

Influenza B has no M2 protein.

## Why are adamantanes not recommended for influenza today?

Most circulating influenza A viruses carry M2 mutations that make them resistant.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/rimantadine/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

- [Amantadine](https://durgical.com/en/pharmacology/amantadine/)
- [Oseltamivir](https://durgical.com/en/pharmacology/oseltamivir/)
- [Baloxavir marboxil](https://durgical.com/en/pharmacology/baloxavir-marboxil/)

## Related conditions 1

- [Influenza (flu)](https://durgical.com/en/conditions/influenza/)

[← Back to the class: Anti-influenza agents](https://durgical.com/en/pharmacology/classes/anti-influenza-agents/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Rimantadine: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a698029.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [Influenza Antiviral Medications: Summary for Clinicians](https://www.cdc.gov/flu/hcp/antivirals/summary-clinicians.html) (Centers for Disease Control and Prevention, 2025); [Influenza A M2 proton channel wild type TM domain bound to R-rimantadine](https://www.rcsb.org/structure/6US9) (RCSB Protein Data Bank, 2020).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/pharmacology/rimantadine/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/rimantadine/