Dosing & Uses
Dosage Forms & Strengths
IV solution
- 200mg/20mL (10mg/mL)
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
Dosage Modifications
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
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 emergence of resistance substitutions could decrease drug effectiveness
- Efficacy could not be established in patients with serious influenza requiring hospitalization
Dosage Forms & Strengths
IV solution
- 200mg/20mL (10mg/mL)
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
Also see Administration; must dilute before administration
Dosage Modifications
Renal impairment
- 2-12 years
- CrCl 30-49 mL/min: 4 mg/kg IV as a single dose
- CrCl 10-29 mL/min: 2 mg/kg IV as a single dose
- ≥13 years
- CrCl 30-49 mL/min: 200 mg IV as a single dose
- CrCl 10-29 mL/min: 100 mg IV as a single dose
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Adverse Effects
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%)
Postmarketing Reports
Dermatologic: Stevens-Johnson syndrome, exfoliative dermatitis, rash
General disorders and administration site conditions: anaphylactic/anaphylactoid reactions
Psychiatric: abnormal behavior, hallucination
Warnings
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
Cautions
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
Pregnancy Categories
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Pharmacology
Mechanism of Action
Elicits antiviral activity by inhibiting influenza virus neuraminidase, an enzyme that releases viral particles from the plasma membrane of infected cells
Administration
IV Compatibilities
0.9% NaCl
0.45% NaCl
Dextrose 5% in water
Lactated Ringer solution
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
Storage
Unopened vials: Store in original cartons at 20-25°C (68-77°F); excursions are permitted to 15-30°C (59-86°F)
Diluted solution: Administer immediately or store refrigerated (2-8°C [36-46°F]) for up to 24 hr
If refrigerated, allow the diluted solution to reach room temperature then administer immediately
Images
Patient Handout
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
