Peramivir is an intravenous antiviral drug used for the treatment of influenza in adults who have had the flu for no longer than two days.
Peramivir is prescribed for the treatment of acute uncomplicated influenza in patients 18 years of age and above who have had the symptoms for not more than 2 days.
It works by stopping the spread of the flu virus in the body and prevents the new virus from emerging out of the infected cells.
Also, peramivir helps by shortening the time of flu symptoms such as runny or stuffy nose, fever, sore throat, cough, muscle or joint pain.
It is the only intravenous medicine approved by FDA available for treating swine flu when patients do not respond to other existing antiviral treatments (oseltamivir resistance or unable to take zanamivir inhalation).
Peramivir should not be used in patients with:
Allergy or hypersensitivity to the drug
Bacterial infections that occur as a complication of the flu
For treating patients with acute uncomplicated influenza:
The recommended adult dose is 600mg as a single dose by intravenous infusion for a time duration of 15 - 30 minutes.
For treating influenza patients with kidney disease:
Patients with creatinine clearance of
≥ 50 ml/min - 600mg intravenously once daily
30 - 49ml/min - 200mg intravenously once daily
10 - 29ml/min - 100mg intravenously once daily
In case of hemodialysis, the dosage has to calculated based on the kidney function after hemodialysis is performed.
Peramivir comes as a solution of 200mg/20ml (10mg/ml) in a single-use vial which can be injected intravenously (administered into a vein) with the help of a needle or catheter by a registered medical personnel.
The seal over the bottle should not be broken or missing and the solution should be clear and free from any visible particles.
The appropriate drug dosage may be diluted with 0.9% or 0.45% of sodium chloride, lactated Ringer's, or 5% dextrose to a maximum volume of 100 ml.
In case of a refrigerated diluted solution, the mixture should be allowed to come to room temperature before administration.
Peramivir injection is not a replacement for the yearly flu vaccine taken intranasally (sprayed into the nose) and a considerable time duration is required between these two doses.
Dosage adjustments are needed in patients suffering from kidney disease.
Drug susceptibility patterns have to be studied regularly to know the effectiveness against influenza because of the emergence of resistance or change in virus virulence.
If there is no improvement in the flu symptoms or if it gets worse, it is necessary to report to the physician at the earliest.
Gastrointestinal: Diarrhea, constipation, mouth ulcers or white spots in the mouth or on the lips
Cardiovascular system: Increased blood pressure, abnormal heartbeat
Central Nervous System: Hallucinations, confusion, restlessness, difficulty in sleeping, delirium and abnormal behavior
Respiratory: Hoarseness, cough, wheezing or difficulty in breathing
Skin: Erythema and Stevens-Johnson syndrome are notable side effects to be watched for
Others: Fever, chills, joint or muscle pain, swelling of the face or tongue, red or irritated eyes
Patients are advised to report as early as possible when serious skin reactions or neuropsychiatric reactions occur.
The use of peramivir should not be recommended for patients below 18 years of age as there is no safety data for these age groups.
Peramivir injection will make the intranasal flu vaccine less effective if it is taken either 2 weeks after or 48 hours before the vaccine administration.
Peramivir inhibits the viral replication and thereby decreases the vaccines efficacy when taken together with the live attenuated influenza vaccine. However, inactivated influenza vaccine can be taken at any time of peramivir treatment.
Peramivir injections are stored at a controlled room temperature in their original cartons between 20°C and 25°C.
A diluted portion of peramivir injections should be stored in a refrigerator at 2°C to 8°C for a maximum period of 24 hours. Unused solution should be discarded after 24 hours.
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