Peramivir

Peramivir is used to treat influenza.

Peramivir is available under the following different brand names: Rapivab.

Dosages of Peramivir:

Adult and Pediatric Dosage Forms and Strengths

IV Solution

• 200 mg/20mL (10mg/mL)

Dosage Considerations – Should be Given as Follows:

Influenza

• Indicated for the treatment of acute uncomplicated influenza in patients aged 2 years and older who have been symptomatic for no more than 2 days
• Adults and children 13 years and older: 600 mg intravenously (IV) as a single dose
• Children 2-12 years: 12 mg/kg IV as a single dose; not to exceed 600 mg/dose
• Infuse diluted IV over 15-30 minutes

Dosage Modifications

Renal impairment, adults and children 13 years and older

• CrCl 30-49 mL/minute: 200 mg IV as a single dose
• CrCl 10-29 mL/minute: 100 mg IV as a single dose

Renal impairment, children 2-12 years

• CrCl 30-49 mL/minute: 4 mg/kg IV as a single dose
• CrCl 10-29 mL/minute: 2 mg/kg IV as a single dose

Dosing Considerations

Limitations of use

• Efficacy based on clinical trials of naturally occurring influenza in which the predominant influenza infections were influenza A virus; a limited number of subjects infected with influenza B virus were enrolled
• Influenza viruses change over time and the emergence of resistance substitutions could decrease drug effectiveness
• Efficacy could not be established in patients with serious influenza requiring hospitalization
• Children under 2 years: Safety and efficacy not established

Common side effects of Peramivir include:

• Diarrhea
• Neutrophils less than 1 x 10^9/L
• Increased serum glucose (greater than 160 mg/dL)
• Creatine phosphokinase (6 xULN and greater)
• Constipation
• Insomnia
• AST and ALT increased
• High blood pressure (hypertension)

Postmarketing side effects of peramivir reported include:

• Dermatologic: Stevens-Johnson syndrome, exfoliative dermatitis, rash
• General disorders and administration site conditions: anaphylactic/anaphylactoid reactions
• Psychiatric: abnormal behavior, hallucination

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Peramivir has no listed severe interactions with other drugs.
• Serious interactions of peramivir include:
  • influenza virus vaccine quadrivalent, intranasal
• Peramivir has moderate interactions with at least 30 different drugs.
• Peramivir has no listed mild interactions with other drugs.

Warnings

• This medication contains peramivir. Do not take Rapivab if you are allergic to peramivir or any ingredients contained in this drug.

Contraindications

• 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

Effects of Drug Abuse

• No information is available.

Short-Term Effects

• See "What Are Side Effects Associated with Using Peramivir?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Peramivir?"

Cautions

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

Pregnancy and Lactation

• The limited available data with the use of peramivir 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.
• There are no data on the presence of peramivir in human milk, its effects on breastfed infants, or milk production. Peramivir is present in rat milk. Limited clinical data during lactation preclude a clear determination of the risk of therapy to an infant during lactation; therefore, the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on the breastfed child from peramivir or the underlying maternal condition.