peramivir (Rx)

Brand and Other Names:Rapivab
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

IV solution

  • 200mg/20mL (10mg/mL)
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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)
more...

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
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Interactions

Interaction Checker

and peramivir

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            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

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            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

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            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.

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            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

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            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

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            Images

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            Formulary

            FormularyPatient Discounts

            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.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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