Treatment of acute uncomplicated influenza in patients who have had symptoms for 2 days or less.
Inhibits the enzyme neuraminidase, which may alter virus particle aggregation and release.
Reduced duration or prevention of flu-related symptoms.
Absorption: IV administration results in complete bioavailability.
Metabolism and Excretion: Mostly eliminated unchanged by kidneys (> 90%).
Half-life: 20.8 hr.
TIME/ACTION PROFILE (blood levels)
|IV||rapid||end of infusion||unknown|
Use Cautiously in:
- Renal impairment (dose ↓ required for CCr <50 mL/min)
- Geri: Consider age-related ↓ in hepatic, renal, cardiac function, concurrent diseases and drug therapy;
- OB: Use only if clearly needed
- Lactation: Consider benefits of breastfeeding, need for peramivir, and potential for adverse effects;
- Pedi: Safety and effectiveness not established.
Adverse Reactions/Side Effects
CNS: insomnia, neuropsychiatric events
Derm: ERYTHEMA MULTIFORME, STEVENS-JOHNSON SYNDROME
Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS)
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
Avoid use of live attenuated influenza vaccine within 2 wk prior and 48 hr after peramivir; interference may occur.
IV (Adults and Children ≥13 yr): 600 mg x 1 dose.
IV (Children 2–12 yr): 12 mg/kg (max = 600 mg) x 1 dose.
IV (Adults and Children ≥13 yr): CCr 30–49 mL/min– 200 mg x 1 dose; CCr 10–29 mL/min– 100 mg x 1 dose.
IV (Children 2–12 yr): CCr 30–49 mL/min– 4 mg/kg (max = 600 mg) x 1 dose; CCr 10–29 mL/min– 2 mg/kg (max = 600 mg) x 1 dose.
Solution for injection: 10 mg/mL
- Assess for signs and symptoms of influenza (fever, dyspnea, tachypnea, tachycardia, hypotension) prior to and at least daily during therapy. Patient must be symptomatic for no more than 2 days to receive peramivir.
- Monitor for signs of neuropsychiatric symptoms (hallucinations, delirium, abnormal behavior) during therapy.
- Assess patient for skin rash during therapy. Monitor closely and treat symptomatically.
Lab Test Considerations:
May cause ↑ serum ALT, AST, glucose, creatine kinase, and ↓ neutrophils.
- Risk for infection (Indications)
- Intermittent Infusion: Diluent: 0.9% NaCl or 0.45% NaCl, D5, or LR to a maximum volume of 100 mL. Solution is clear and colorless; do not administer solution that is discolored or contains a precipitate. Upon dilution, administer immediately or refrigerate up to 24 hrs; discard after 24 hrs. Allow to reach room temperature prior to administration. Discard unused portion of single use vial.
- Rate: Infuse over 15 to 30 min.
- Y-Site Incompatibility: Do not administer simultaneously with any other medication.
- Explain purpose of peramivir to patient.
- Advise patient to notify health care professional if signs and symptoms of anaphylaxis or rash, or neuropsychiatric symptoms occur.
- Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
Resolution of sign and symptoms of influenza.
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