Peramivir

Indications

Peramivir is used for: Influenza

Adult Dose

Influenza Indicated for treatment of acute uncomplicated influenza in patients aged >2 years who have been symptomatic for no more than 2 days 600 mg IV as a single dose Infuse diluted IV over 15-30 minutes

Child Dose

Influenza Indicated for treatment of acute uncomplicated influenza in patients aged ?2 years who have been symptomatic for no more than 2 days <2 years: Safety and efficacy not established 2-12 years: 12 mg/kg IV as a single dose; not to exceed 600 mg/dose >13 years: 600 mg IV as a single dose

Renal Dose

Renal impairment CrCl 30-49 mL/min: 200 mg IV as a single dose CrCl 10-29 mL/min: 100 mg IV as a single dose

Administration

IV Preparation Contains no preservatives or bacteriostatic agents; do not use if seal over vial opening is broken or missing Inspect vial for particulate matter and discoloration Dilute appropriate dose in 0.9% or 0.45% NaCl, D5W, or lactated Ringer solution to a maximum volume of 100 mL IV Administration Administer IV over 15-30 minutes Do not mix or coinfuse peramivir with other IV medications

Contra Indications

Known serious hypersensitivity or anaphylaxis to peramivir or any component of the product; severe allergic reactions have included anaphylaxis, erythema multiforme, and Stevens-Johnson Syndrome

Precautions

Serious skin reactions reported including erythema multiforme and Stevens-Johnson syndrome; discontinue and initiate appropriate treatment (see Contraindications) Influenza can be associated with neurologic and behavioral symptoms including hallucinations, delirium, and abnormal behavior, in some cases resulting in fatal outcomes

Pregnancy-Lactation

Pregnancy Limited available data with use in pregnant women are insufficient to determine a drug- associated risk of adverse developmental outcomes; there are risks to the mother and fetus associated with influenza in pregnancy Animal studies Administered during organogenesis in rats Dose 8 x human recommended dose Single IV bolus injection: No adverse effects observed Continuous IV infusion: Reduced renal papilla and dilated ureters were observed Administered in rabits Administration of drug during organogenesis at exposures 8 times those in humans at recommended dose resulted in developmental toxicity (abortion or premature delivery) at a maternally toxic dose Lactation There are no data on presence of drug in human milk, effects on breastfed infant, or on milk production; drug is present in rat milk limited clinical data during lactation preclude a clear determination of risk of therapy to an infant during lactation; therefore, developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from drug or from underlying maternal condition

Interactions

Side Effects

Side effects of Peramivir : 1-10% Diarrhea (8%) Neutrophils <1 x 10^9/L (8%) Increased serum glucose (>160 mg/dL) (5%) Creatine phosphokinase (>6 xULN) (5%) Constipation (4%) Insomnia (3%) AST and ALT increased (3%) Hypertension (2%)

Mode of Action

Elicits antiviral activity by inhibiting influenza virus neuraminidase, an enzyme that releases viral particles from the plasma membrane of infected cells