Gocovri
Gocovri (amantadine) belongs to the drug class called NMDA antagonists. This medication is for adults with Parkinson’s disease (PD). It helps people taking levodopa medications with sudden, uncontrolled body movements (dyskinesia). It also helps prevent "off" episodes when levodopa/carbidopa medications wear off. Gocovri (amantadine) is a capsule you take by mouth once a day at bedtime. Common side effects are hallucinations, dizziness, and dry mouth.
What is Gocovri (amantadine)?
What is Gocovri (amantadine) used for?
- Dyskinesia (uncontrolled movement) in adults with Parkinson's disease taking levodopa medications
- “Off” episodes in adults with Parkinson's disease taking levodopa/carbidopa
How Gocovri (amantadine) works
Gocovri (amantadine) is an N-methyl-D-aspartate (NMDA) antagonist. We don't exactly know how it works to help with movement problems from Parkinson's disease.
But researchers think the medication blocks the NMDA receptor in the brain. This raises dopamine levels in the brain. It's though to help relieve symptoms, like trembling, stiffness, and slow movement.
Drug facts
Side effects of Gocovri (amantadine)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Hallucinations (21%)
- Feeling dizzy (16%)
- Dry mouth (16%)
- Swelling in the arms, legs, or feet (16%)
- Feeling lightheaded or faint when standing (13%)
- Constipation (13%)
- Fall (13%)
- Urinary tract infection (10%)
Less Common Side Effects
- Nausea or vomiting
- Low appetite
- Headache
- Depression or depressed mood
- Anxiety
- Confusion
- Trouble sleeping
- Having strange dreams
- Trouble walking
- Blurry vision
- Dry eye
- Joint swelling
- Muscle spasms
- Cough
- Bruising
- Mottled skin (web-like purple-blue skin discoloration)
Gocovri (amantadine) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Suicidal thoughts or behaviors
- Suddenly falling asleep while doing something
- Neuroleptic malignant syndrome (NMS): very high fevers, irregular pulse, sweating, stiff muscles, confusion, changes in blood pressure
The following Gocovri (amantadine) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Eye pain, change in vision, vision loss
- Falling asleep during daily activities
- Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
- Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
- Trouble passing urine
- Urges to engage in impulsive behaviors such as gambling, binge eating, sexual activity, or shopping in ways that are unusual for you
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Blurry vision
- Confusion
- Constipation
- Dizziness
- Dry mouth
- Swelling of the ankles, hands, or feet
- Trouble sleeping
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Pros and cons of Gocovri (amantadine)
Pros
- Only taken once a day
- Taken with or without food
- An option for people who have trouble swallowing pills (capsules can be opened and sprinkled on food)
Cons
- Can make you dizzy
- Might interact with anticholinergic medications
- Not recommended to get live vaccines like the nasal spray flu vaccine during treatment
Pharmacist tips for Gocovri (amantadine)
- You can take Gocovri (amantadine) with or without food. This medication can sometimes upset your stomach. If this happens, try taking it with food next time to see if that helps.
- Swallow Gocovri (amantadine) whole. Don't crush, chew, or cut the capsule.
- You can also open the Gocovri (amantadine) capsule and sprinkle all the contents onto a teaspoon of soft food, like applesauce. Make sure swallow this mixture right away without chewing. Don't just let it sit around and wait to take it later.
- If you miss a dose of Gocovri (amantadine), skip the missed dose. Wait to take the medication at your usual dose the next night. Don't take two doses at the same time to make up for your missed dose. If you've forgotten to take Gocovri (amantadine) for many days, talk to your prescriber.
- Gocovri (amantadine) can make you feel very sleepy. It's possible to fall asleep in the middle of doing something, even when you weren't sleepy before. Don't drive or do anything that requires a lot of focus until you know how this medication affects you.
- Avoid drinking alcohol while taking Gocovri (amantadine). Alcohol can make you feel sleepier and raise the risk of accidents.
- Gocovri (amantadine) can also make you dizzy. Get up slowly after sitting or lying down. This helps prevent your blood pressure from dropping too fast, which can make you dizzy or lose your balance. Talk to your prescriber if these side effects start bothering you.
- Before getting any vaccines, let the healthcare professional know you're taking Gocovri (amantadine). They can make sure the vaccine is safe for you to get. You'll need to avoid getting live vaccines, like Varivax (varicella vaccine) or the nasal spray flu vaccine.
- Tell your prescriber and pharmacist about all the medications you take and plan to take. This includes over-the-counter products and supplements. Gocovri (amantadine) can interact with some medications, which can be harmful. Examples include sodium bicarbonate and anticholinergics. Your care team can check for drug interactions and make changes to keep you safe if needed.
- If you want to stop taking Gocovri (amantadine), it's important to talk to your prescriber first. They can tell you how to stop the medication safely. Don't stop the medication suddenly because it can cause serious problems. It can make your PD symptoms worse and possibly cause delusions, anxiety, and depression.
Common questions about Gocovri (amantadine)
No, Gocovri (amantadine) isn't a stimulant. Instead, it belongs to a drug class called NMDA antagonists. The medication is thought to work by raising the levels of dopamine in the brain. This helps relieve symptoms of Parkinson's disease, like slow movement and tremor.
No. Gocovri (amantadine) isn't approved by the FDA to treat ADHD, or attention-deficit hyperactivity disorder. This medication is only approved to help adults with Parkinson's disease.
In studies, Parkinson's symptoms started improving within 2 weeks of taking Gocovri (amantadine). These symptoms included tremor and "freezing" (when they stop moving all of a sudden). It also helped with daily things like getting out of bed and eating. Other studies showed that these improvements can last for at least 2 years. Keep taking Gocovri (amantadine) and your other Parkinson's medications as prescribed. If you think your treatment isn't helping enough, talk to your prescriber.
Gocovri (amantadine) is an extended-release medication. When you take it at bedtime, the medication gets slowly released from the capsule as you sleep. This helps the effects of the medication kick in during the daytime when you're awake. Ask your prescriber if you have other questions about when to take Gocovri (amantadine).
Yes, you can open up the Gocovri (amantadine) capsule to take the medication. If you do, sprinkle all the contents inside onto a teaspoon of soft food, like applesauce. Then, swallow the mixture without chewing right away. This is a good option if you have trouble swallowing pills whole.
No. Don't stop taking Gocovri (amantadine) suddenly. Otherwise, it can raise your risk of having dangerous withdrawal symptoms. This can include high fever, stiff muscles, and confusion. Stopping treatment suddenly can also make your Parkinson's disease symptoms worse. If you want to stop Gocovri (amantadine), talk to your prescriber. They can help lower your dose slowly over time so you can stop the medication safely.
After Gocovri (amantadine) became available, some people reported having a seizure. This is also a potential risk if your dose is too high or if you have a history of a seizure condition. Make sure to tell your prescriber about your full medical history before starting this medication.
If you're pregnant or thinking of getting pregnant, talk to your prescriber. They can explain the risks and benefits of taking Gocovri (amantadine) while pregnant. Animal studies show that it might harm an unborn baby. But it's also possible for Parkinson's symptoms to get worse during pregnancy. Your prescriber can help you find a safer option.
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Risks and warnings for Gocovri (amantadine)
Gocovri (amantadine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Feeling sleepy and falling asleep during daily activities
- Risk factors: History of sleep problems | Taking sedatives or medications that make you drowsy
People taking PD medications like Gocovri (amantadine) have fallen asleep in the middle of doing something. This can include driving, having conversations, and eating. You might not feel sleepy before this happens. This can be very dangerous, especially if you fall asleep while driving or using machines.
Before you start Gocovri (amantadine), tell your prescriber if you've ever had sleep issues. Also let them know if you take any medications that make you drowsy.
Avoid drinking alcohol while taking Gocovri (amantadine) because it can make you even sleepier. And, don't do anything that needs your full attention, like driving, until you know how this medication affects you.
If you feel very sleepy during the day or fall asleep while doing normal things, tell your prescriber right away. They can help you decide if it's safe to keep taking Gocovri (amantadine).
Suicidal thoughts or behavior and depression
- Risk factors: History of depression | History of suicidal thoughts or behavior
In studies, a few people taking Gocovri (amantadine) had thoughts of suicide or suicidal behavior. Some people also started feeling depressed or confused.
Watch for signs of depression while taking Gocovri (amantadine). Let your prescriber know if you or someone close to you notices this and is worried. Also call 911 right away if you start thinking about hurting yourself.
Hallucinations and strange behavior
- Risk factors: History of psychosis | Taking or suddenly stopping Gocovri (amantadine)
Gocovri (amantadine) can sometimes cause psychotic behavior. This can include hallucinations, like seeing or hearing things that aren't real. It can also include delusions (believing things that aren't true) or paranoia.
Don't take Gocovri (amantadine) if you have a history of psychotic behavior. Your mental health can get worse. Also, don't stop taking the medication suddenly. This might raise your risk of having these strange thoughts and behaviors.
If you or anyone around you notices you having hallucinations, tell your prescriber. Watch for hallucinations when you start Gocovri (amantadine) and switch to a higher dose.
Low blood pressure and dizziness
- Risk factors: Drinking alcohol | Taking higher dose of Gocovri (amantadine)
Gocovri (amantadine) can lower your blood pressure. This can make you feel dizzy, lightheaded, or faint. Some medical conditions and blood pressure medications can raise your risk of these side effects. Tell your healthcare team about your medical history and all the medications you take. They can check that Gocovri (amantadine) is safe for you to take.
During treatment, it's important to be aware of when you feel dizzy, lightheaded, or faint. This is especially true when you stand up after sitting or lying down. Be sure to get up slowly and hold onto something stable.
If you feel dizzy or faint while taking Gocovri (amantadine), let your care team know. Your prescriber can adjust your dose as needed.
High fever and confusion after stopping Gocovri (amantadine)
It's rare, but serious side effects can happen if you suddenly stop Gocovri (amantadine) or lower your dose. These side effects are similar to those of neuroleptic malignant syndrome (NMS). It can cause high fevers, confusion, irregular pulse, sweating, stiff muscles, and changes in blood pressure. This can sometimes be very dangerous.
Don't stop taking Gocovri (amantadine) or lower your dose without talking to your prescriber. They can help you stop the medication safely.
Worsening symptoms after stopping Gocovri (amantadine)
Suddenly stopping Gocovri (amantadine) can make your PD symptoms worse. It might also cause delirium, agitation, and anxiety. Delusions and hallucinations are also possible.
Don't stop taking Gocovri (amantadine) without talking to your prescriber first. They can work with you to stop the medication safely.
Unusual urges and impulsive behaviors
Gocovri (amantadine) can cause changes in people's behavior. This can include strong sexual or gambling urges, urges to spend a lot of money, and binge eating. It can sometimes be hard to control these urges.
If you or someone close to you notices that you have strong urge that start causing problems in your life, let your prescriber know. They can help with this problem. Usually, taking a lower dose or stopping the medication can help these urges go away.
Gocovri (amantadine) dosage
Capsule| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 68.5mg | 30 capsules | $20.00 | $0.67 |
| 137mg | 60 capsules | $20.00 | $0.33 |
Typical dosage for Gocovri (amantadine)
The typical starting dose is 137 mg by mouth once a day at bedtime.
Your prescriber will raise your dose after a week. The typical maintenance dose is 274 mg once a day at bedtime.
Your dose might differ if you have kidney problems.
How much does Gocovri (amantadine) cost?
$20.00
Gocovri (amantadine) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Gocovri (amantadine) will not be safe for you to take.
