Medical Editor: John P. Cunha, DO, FACOEP
Gocovri (amantadine extended release capsules) is an antivirial and anti-Parkinson drug indicated for the treatment of dyskinesia in patients with Parkinson's disease receiving levodopa-based therapy, with or without concomitant dopaminergic medications. Common side effects of Gocovri include:
- dry mouth,
- swelling of extremities,
- and dizziness on standing (orthostatic hypotension).
Other side effects of Gocovri include:
- abnormal dreams,
- muscle cramps,
- gait disturbance,
- urinary tract infection,
- changes in skin pigmentation,
- decreased appetite,
- blurred vision,
- dry eyes,
- joint swelling,
- muscle spasms,
- benign prostatic hyperplasia (BPH),
- and cough.
The initial daily dosage of Gocovri is 137 mg, administered orally once daily at bedtime. After one week, increase to the recommended dosage of 274 mg (two 137 mg capsules) once daily at bedtime. Gocovri may interact with other anticholinergic drugs, carbonic anhydrase inhibitors, sodium bicarbonate, alcohol, and “live” vaccines. Tell your doctor all medications and supplements you use and all vaccines you recently received. Gocovri is not recommended for use during pregnancy; it may harm a fetus. Gocovri passes into breast milk but its effect on nursing infants is unknown. Gocovri may alter breast milk production or excretion. Consult your doctor before breastfeeding.
Our Gocovri (amantadine extended release capsules) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
The following serious adverse reactions are described in more detail elsewhere in the labeling:
- Falling Asleep During Activities of Daily Living and Somnolence [see WARNINGS AND PRECAUTIONS]
- Suicidality and Depression [see WARNINGS AND PRECAUTIONS]
- Hallucinations/Psychotic Behavior [see WARNINGS AND PRECAUTIONS]
- Dizziness and Orthostatic Hypotension [see WARNINGS AND PRECAUTIONS]
- Withdrawal-Emergent Hyperpyrexia and Confusion [see WARNINGS AND PRECAUTIONS]
- Impulse Control/Compulsive Behaviors [see WARNINGS AND PRECAUTIONS]
Clinical Trial Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
GOCOVRI was evaluated in two double-blind, placebo-controlled efficacy trials of similar design and population: Study 1 (123 patients) and Study 2 (75 patients). The study population was approximately 56% male and 94% white, with a mean age of 65 years (age range from 34 years to 82 years). The mean duration of levodopa-induced dyskinesia was 4 years (range 0.1 to 14 years). Active treatment started at 137 mg once daily for one week, followed by a dose increase to 274 mg once daily. The treatment duration was 25 weeks for Study 1 and 13 weeks for Study 2. Of the 100 patients in the safety population described below, 39 patients were treated with GOCOVRI for 24 weeks. The safety data for these trials were pooled.
The most common adverse reactions reported in >10% of GOCOVRI-treated patients and more frequently than on placebo were: hallucination, dizziness, dry mouth, peripheral edema, constipation, falls, and orthostatic hypotension.
The overall rate of discontinuation because of adverse reactions for GOCOVRI-treated patients was 20%, compared to 8% for placebo-treated patients. Adverse reactions that led to treatment discontinuation in at least 2% of patients were hallucination (8% GOCOVRI vs. 0% placebo), dry mouth (3% GOCOVRI vs. 0% placebo), peripheral edema (3% GOCOVRI vs. 0% placebo), blurred vision (GOCOVRI 3% vs. 0% placebo), postural dizziness and syncope (GOCOVRI 2% vs. 0% placebo), abnormal dreams (GOCOVRI 2% vs. 1% placebo), dysphagia (GOCOVRI 2% vs. 0% placebo), and gait disturbance (GOCOVRI 2% vs. 0% placebo).
Table 1: Adverse Reactions Reported for ≥ 3% of Patients Treated with 274 mg
GOCOVRI in Study 1 and Study 2 (Pooled Analysis)
|Nervous system disorders|
|General disorders and administration site conditions|
|Injury, poisoning and procedural complications|
|Infections and infestations|
|Urinary tract infection||10||5|
|Skin and subcutaneous tissue disorders|
|Metabolism and nutrition disorders|
|Musculoskeletal and connective tissue disorders|
|Reproductive system and breast disorders|
|Benign prostatic hyperplasiad||6||2|
|Respiratory, thoracic and mediastinal disorders|
a=Includes visual hallucinations and auditory hallucinations
b=Includes anxiety and generalized anxiety
c=Includes orthostatic hypotension, postural dizziness, syncope, presyncope, and hypotension
d=The denominator is all male patients in the safety population randomized to GOCOVRI (n=54) or placebo (n=57)
Other clinically relevant adverse reactions observed at <3% included somnolence, fatigue, suicide ideation or attempt, apathy, delusions, illusions, and paranoia [see WARNINGS AND PRECAUTIONS].
Difference In The Frequency Of Adverse Reactions By Gender
Adverse reactions reported more frequently in women treated with 274 mg of GOCOVRI (n=46), compared to men (n=54), were: dry mouth (22% women, 11% men), nausea (13% women, 4% men), livedo reticularis (13% women, 0% men), abnormal dreams (9% women, 0% men) and cataracts (7% women, 0% men).
Men treated with 274 mg of GOCOVRI reported the following adverse reactions more frequently than women: dizziness (20% men, 11% women), peripheral edema (19% men, 11% women), anxiety (11% men, 2% women), orthostatic hypotension in (7% men, 2% women) and gait disturbance (6% men, 0% women).
Difference In The Frequency Of Adverse Reactions By Age
Hallucinations (visual or auditory) were reported in 31 % of GOCOVRI-treated patients age 65 years and over (n=52), compared to 10 % in patients below the age of 65 years (n=48). Falls were reported in 17% of GOCOVRI-treated patients age 65 and over, compared to 8% of patients below age 65. Orthostatic hypotension was reported in 8% of patients age 65 and over, compared to 2% of patients below age 65.
Read the entire FDA prescribing information for Gocovri (Amantadine Extended Release Capsules, for Oral Use)