Peramivir

What is peramivir?

• Peramivir (RAPIVAB) is an influenza virus neuraminidase inhibitor used for the treatment of influenza.

What are the uses of this medicine?

• This medicine is used for the treatment of acute uncomplicated influenza in patients 6 months and older who have been symptomatic for no more than 2 days.

Limitations of Use:

• Efficacy of RAPIVAB is 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. Emergence of resistance substitutions could decrease drug effectiveness. Other factors (for example, changes in viral virulence) might also diminish clinical benefit of antiviral drugs. Prescribers should consider available information on influenza drug susceptibility patterns and treatment effects when deciding whether to use RAPIVAB .
• The efficacy of RAPIVAB could not be established in patients with serious influenza requiring hospitalization.

How does this medicine work?

• Peramivir is an inhibitor of influenza virus neuraminidase, an enzyme that releases viral particles from the plasma membrane of infected cells.
• The antiviral activity of peramivir against laboratory strains and clinical isolates of influenza virus was determined in cell culture.
• The relationship between the antiviral activity in cell culture, inhibitory activity in the neuraminidase assay, and the inhibition of influenza virus replication in humans has not been established.

Who Should Not Use this medicine ?

This medicine cannot be used in patients with:

• with known serious hypersensitivity or anaphylaxis to peramivir or any component of the product.

What drug interactions can this medicine cause?

• The concurrent use of RAPIVAB with live attenuated influenza vaccine (LAIV) intranasal has not been evaluated.
• Because of the potential for interference between these two products, avoid use of LAIV within 2 weeks before or 48 hours after administration of RAPIVAB unless medically indicated.

Is this medicine FDA approved?

• This medicine is approved in the year 2014.

How should this medicine be used?

• Administer RAPIVAB within 2 days of onset of symptoms of influenza.

Recommended Dosage: Adults and Adolescents (13 years of age and older)

• The recommended dosage of RAPIVAB in adult and adolescent patients 13 years of age or older with acute uncomplicated influenza is a single 600 mg dose, administered via intravenous infusion for 15 to 30 minutes.

Pediatric Patients (6 months to 12 years of age)

• The recommended dosage of RAPIVAB in pediatric patients 6 months to 12 years of age with acute uncomplicated influenza is a single 12 mg/kg dose (up to a maximum dose of 600 mg), administered via intravenous infusion for 15 to 30 minutes.

Administration

• Use aseptic technique during the preparation of RAPIVAB to prevent inadvertent microbial contamination.
• Follow the steps below to prepare a diluted solution of RAPIVAB:
• Do not use if seal over bottle opening is broken or missing.
• Visually inspect RAPIVAB for particulate matter and discoloration prior to administration.
• Dilute an appropriate dose of RAPIVAB 10 mg/mL solution in 0.9% or 0.45% sodium chloride, 5% dextrose, or lactated Ringer's. The maximum infusion volume is provided in Table 3. The final concentration of diluted RAPIVAB for administration should be between 1 mg/mL and 6 mg/mL.
• Administer the diluted solution via intravenous infusion for 15 to 30 minutes.
• Discard any unused diluted solution of RAPIVAB after 24 hours.
• Once a diluted solution of RAPIVAB has been prepared, administer immediately or store under refrigerated conditions (2° to 8°C or 36° to 46°F) for up to 24 hours. If refrigerated, allow the diluted solution of RAPIVAB to reach room temperature then administer immediately.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Injection: 200 mg in 20 mL (10 mg/mL) in a single-use vial

This medicine is available in fallowing brand namesː

• RAPIVAB

What side effects can this medication cause?

The most common side effects of this medicine include:

• diarrhea

What special precautions should I follow?

• Cases of anaphylaxis and serious skin/hypersensitivity reactions such as Stevens-Johnson syndrome and erythema multiforme have occurred with RAPIVAB. Discontinue RAPIVAB and initiate appropriate treatment if anaphylaxis or serious skin reaction occurs or is suspected.
• Influenza can be associated with a variety of neurologic and behavioral symptoms that can include events such as hallucinations, delirium, and abnormal behavior, in some cases resulting in fatal outcomes may occur with RAPIVAB.
• There is no evidence for efficacy of RAPIVAB in any illness caused by agents other than influenza viruses.

What to do in case of emergency/overdose?

• There is no human experience of acute overdosage with RAPIVAB.

Management of overdosage:

• Treatment of overdosage with RAPIVAB should consist of general supportive measures including monitoring of vital signs and observation of the clinical status of the patient.
• There is no specific antidote for overdose with RAPIVAB.
• RAPIVAB is cleared by renal excretion and can be cleared by hemodialysis.

Can this medicine be used in pregnancy?

• Limited available data with RAPIVAB use in pregnant women are insufficient to determine a drug-associated risk of adverse developmental outcomes.

Can this medicine be used in children?

• The safety and effectiveness of RAPIVAB for the treatment of influenza has been established in pediatric patients 6 months to 17 years of age.
• Safety and effectiveness of RAPIVAB in pediatric patients less than 6 months of age have not been established.
• No data are available for RAPIVAB use in pediatric patients 6 months to less than 2 years with creatinine clearance less than 50 mL/min to inform a recommendation for dosage adjustment.

What are the active and inactive ingredients in this medicine?

Active ingredient:

• peramivir

Inactive ingredients:

• Sodium Chloride
• Hydrochloric Acid
• Sodium Hydroxide
• Water

Who manufactures and distributes this medicine?

• Packager: BioCryst Pharmaceuticals, Inc.

What should I know about storage and disposal of this medication?

• Store vials of RAPIVAB injection in original cartons at 20° to 25°C (68° to 77°F).
• Excursions are permitted to 15° to 30°C (59° to 86°F).
• Do not use if seal over bottle opening is broken or missing.

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• Alpha Interferon, Adefovir, Emtricitabine, Entecavir, Lamivudine, Telbivudine, Tenofovir

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HCV NS5A Inhibitors

• Daclatasvir, Elbasvir, Ledipasvir, Ombitasvir, Pibrentasvir, Velpatasvir

HCV NS5B Inhibitors (Polymerase inhibitors)

• Dasabuvir, Sofosbuvir

HCV Protease Inhibitors

• Asunaprevir, Boceprevir, Glecaprevir, Grazoprevir, Paritaprevir, Simeprevir, Telaprevir, Voxilaprevir

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• Epclusa, Harvoni, Mavyret, Technive, Viekira Pak, Vosevi, Zepatier

Drugs for Herpes Virus

• infections (HSV), CMV, others

Acyclovir, Cidofovir, Famciclovir, Foscarnet, Ganciclovir, Valacyclovir, Valganciclovir

Drugs for Influenza

• Amantadine, Oseltamivir, Peramivir, Rimantadine, Zanamivir

• Dailymed label info on Peramivir
• FDA Peramivir

Peramivir Resources
Latest articles Most recent articles Ongoing trials	Wikipedia

Drugs for HIV Infection, in the Subclass Antiretroviral Agents

• Fusion Inhibitors (HIV)
  • Enfuvirtide, Maraviroc

• Integrase Inhibitors (HIV)
  • Dolutegravir, Elvitegravir, Raltegravir

• Monoclonal Antibodies
  • Ibalizumab

• Nonnucleoside Reverse Transcriptase Inhibitors (HIV)
  • Delavirdine, Efavirenz, Etravirine, Nevirapine, Rilpivirine

• Nucleoside Analogues (HIV)
  • Abacavir, Didanosine, Emtricitabine, Lamivudine, Stavudine, Tenofovir, Zidovudine

• Protease Inhibitors (HIV)
  • Amprenavir, Atazanavir, Darunavir, Fosamprenavir, Indinavir, Lopinavir, Nelfinavir, Ritonavir, Saquinavir, Tipranavir

Drugs for Hepatitis B

• Alpha Interferon, Adefovir, Emtricitabine, Entecavir, Lamivudine, Telbivudine, Tenofovir

Drugs for Hepatitis C

• Interferon Based Therapies
  • Alpha Interferon and Peginterferon, Ribavirin

HCV NS5A Inhibitors

• Daclatasvir, Elbasvir, Ledipasvir, Ombitasvir, Pibrentasvir, Velpatasvir

HCV NS5B Inhibitors (Polymerase inhibitors)

• Dasabuvir, Sofosbuvir

HCV Protease Inhibitors

• Asunaprevir, Boceprevir, Glecaprevir, Grazoprevir, Paritaprevir, Simeprevir, Telaprevir, Voxilaprevir

Combination Therapies

• Epclusa, Harvoni, Mavyret, Technive, Viekira Pak, Vosevi, Zepatier

Drugs for Herpes Virus

• infections (HSV), CMV, others

Acyclovir, Cidofovir, Famciclovir, Foscarnet, Ganciclovir, Valacyclovir, Valganciclovir

Drugs for Influenza

• Amantadine, Oseltamivir, Peramivir, Rimantadine, Zanamivir

• Dailymed label info on Peramivir
• FDA Peramivir

Peramivir Resources
Latest articles Most recent articles Ongoing trials	Wikipedia