• Generic Name: amantadine extended release capsules, for oral use
  • Brand Name: Gocovri
Last updated on MDtodate: 10/6/2022


The following serious adverse reactions are described in more detail elsewhere in the labeling:

  • Falling Asleep During Activities of Daily Living and Somnolence.
  • Suicidality and Depression.
  • Hallucinations/Psychotic Behavior.
  • Dizziness and Orthostatic Hypotension.
  • Withdrawal-Emergent Hyperpyrexia and Confusion.
  • Impulse Control/Compulsive Behaviors.

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.

Placebo-Controlled Trials

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)

Adverse Reactions GOCOVRI 274 mg
Psychiatric disorders
  Hallucinationa 21 3
  Anxietyb 7 3
  Insomnia 7 2
  Depression/Depressed mood 6 1
  Abnormal dreams 4 2
  Confusional state 3 2
Nervous system disorders
  Dizziness 16 1
  Headache 6 4
  Dystonia 3 1
Gastrointestinal disorders
  Dry mouth 16 1
  Constipation 13 3
  Nausea 8 3
  Vomiting 3 0
General disorders and administration site conditions
  Peripheral edema 16 1
  Gait disturbance 3 0
Injury, poisoning and procedural complications
  Fall 13 7
  Contusion 6 1
Infections and infestations
  Urinary tract infection 10 5
Skin and subcutaneous tissue disorders
  Livedo reticularis 6 0
  Pigmentation disorder 3 0
Metabolism and nutrition disorders
  Decreased appetite 6 1
Vascular disorders
  Orthostatic hypotensionc 13 1
Eye disorders
  Blurred vision 4 1
  Cataract 3 1
  Dry eye 3 0
Musculoskeletal and connective tissue disorders
  Joint swelling 3 0
  Muscle spasms 3 0
Reproductive system and breast disorders
  Benign prostatic hyperplasiad 6 2
Respiratory, thoracic and mediastinal disorders
  Cough 3 0
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.

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.