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Zanamivir

Class
Antiviral agents
Subclass
Neuraminidase inhibitors
Substance name
Zanamivir
Brand names
Relenza®
Common formulations
Powder for oral inhalation
Dosage and administration
Adults patients
Treatment of influenza virus infection • Uncomplicated, type A, type B, symptomatic for no more than 2 days
•
10 mg INH BID for 5 days
Other off-label uses
•
Treatment of novel influenza A viruses infection
Indications for use
Labeled indications
Adults
•
Treatment of influenza virus infection (uncomplicated, type A, type B, symptomatic for no more than 2 days)
Off-label indications
Adults
•
Treatment of novel influenza A viruses infection
Safety risks
Contraindications
Who is hypersensitive to the drug or to any component of the formulation, including those with milk protein hypersensitivity
•
Patients with a history of angioedema or severe allergic reactions to Zanamivir should not use this medication.
Warnings and precautions
Bronchospasm
•
Use caution with underlying pulmonary disease. Assess patients for a history of bronchospasm or respiratory conditions before prescribing zanamivir. If bronchospasm occurs, stop Zanamivir immediately, and seek medical attention. Use bronchodilators or other respiratory medications as needed.
Cardiac event risk
•
Use caution with a history of cardiac disease. The benefits and risks should be carefully assessed before prescribing the medication, especially in patients with a history of cardiac events. Patient should seek immediate medical attention for appropriate evaluation and management of the cardiac condition.
Psychosis
•
Use caution with a history of neuropsychiatric events or behavioral problems. Monitor patients for signs of psychiatric symptoms or history of psychosis before prescribing Zanamivir. If psychosis occurs, discontinue Zanamivir and seek immediate psychiatric evaluation and appropriate treatment.
Specific populations
Renal impairment
eGFR 0-90 mL/min/1.73 m²
•
Use acceptable. No dose adjustment required.
Renal replacement therapy
Any modality
•
Use acceptable. No dose adjustment required.
Hepatic impairment
Child-Pugh A (mild)
•
Maximal dose of 5 mg qHS.
Child-Pugh B (moderate)
•
Maximal dose of 5 mg qHS.
Any severity
•
No guidance available.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: B1
•
Use only if clearly needed. Evidence of fetal harm in animals.
Breastfeeding
Acceptable for use during breastfeeding.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Very common > 10%
•
Cough, headache, infection
Common 1-10%
•
Laryngeal edema, anorexia, ↑ appetite, arthralgia, chills, diarrhea, dizziness, fever, musculoskeletal pain, myalgia, malaise, fatigue, nausea, vomiting, sinus tenderness, nausea, urticaria, abdominal pain
Unknown frequency
•
Anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, ↓ blood lymphocyte count, psychosis, dyspnea, delirium, confusion, hallucinations, ↑ liver enzymes, ↓ blood neutrophil count, seizure, angioedema, bronchospasm, exacerbation of arrhythmia, skin rash, anxiety, nightmares, agitation, emotional lability, syncope
Interactions
Drug(s)
Check Interactions
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