• See Also
  1. Zanamivir
  2. Oseltamivir
  3. Influenza
  4. Influenza Vaccine
  5. Baloxavir Marboxil
  6. Amantadine
  • Indications
  1. Neuraminidase Inhibitors covers both Influenza A and Influenza B
  2. Indicated in hospitalized Influenza patients with <2 days of symptoms AND
  3. Unable to take oral Oseltamivir (Tamiflu)
  • Precautions
  1. See Oseltamivir
  • Efficacy
  1. IV Antiviral with no better efficacy than Oseltamivir (Tamiflu) except in resistant cases, at 10 times the cost
  • Dosing
  1. Adult
    1. Dose 600 mg IV over 15 to 30 minutes as single dose
    2. Off label, Peramivir is continued for 5 days (until able to switch to Oseltamivir )
  2. Child (age >= 6 years, per CDC, not FDA approved)
    1. Dose 10 mg/kg (up to 600 mg) IV over 15 to 30 minutes daily for 5 days
  3. Renal Dosing
    1. Administer doses after Hemodialysis
    2. Age 2 to 12 years old
      1. eGFR 30 to 49: 4 mg/kg (up to 600 mg) IV daily
      2. eGFR 10 to 29: 2 mg/kg (up to 600 mg) IV daily
    3. Age >=13 years (and adults)
      1. eGFR 30 to 49: 200 mg IV daily
      2. eGFR 10 to 29: 100 mg IV daily
  • Adverse effects
  1. Diarrhea (common with Peramivir)
  2. Neuropsychiatric effects
  3. Stevens-Johnson Syndrome (rare)
  • Safety
  1. Unknown safety in Pregnancy
  2. Unknown safety in Lactation
  • Resources
  1. Peramivir
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=fe04f6cd-e71c-4bd4-abac-97720bba2a0d
  2. CDC InfluenzaAntivirals summary
    1. http://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm
  • References
  1. (2014) Presc Lett 21(12): 70
  2. (2002) Pediatrics 110(6):1246-52 [PubMed]
  3. Stiver (2003) CMAJ 168(1):49-57 [PubMed]