Pharm

Peramivir

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Peramivir, Rapivab

  • 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
  • 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