II. Indications
- Neuraminidase Inhibitors covers both Influenza A and Influenza B
- Indicated in hospitalized Influenza patients with <2 days of symptoms AND
- Unable to take oral Oseltamivir (Tamiflu)
III. Precautions
- See Oseltamivir
IV. Efficacy
- IV Antiviral with no better efficacy than Oseltamivir (Tamiflu) except in resistant cases, at 10 times the cost
V. Dosing
- Adult
- Dose 600 mg IV over 15 to 30 minutes as single dose
- Off label, Peramivir is continued for 5 days (until able to switch to Oseltamivir )
- Child (age >= 6 years, per CDC, not FDA approved)
- Dose 10 mg/kg (up to 600 mg) IV over 15 to 30 minutes daily for 5 days
-
Renal Dosing
- Administer doses after Hemodialysis
- Age 2 to 12 years old
- eGFR 30 to 49: 4 mg/kg (up to 600 mg) IV daily
- eGFR 10 to 29: 2 mg/kg (up to 600 mg) IV daily
- Age >=13 years (and adults)
- eGFR 30 to 49: 200 mg IV daily
- eGFR 10 to 29: 100 mg IV daily
VI. Adverse effects
- Diarrhea (common with Peramivir)
- Neuropsychiatric effects
- Stevens-Johnson Syndrome (rare)
VII. Safety
- Unknown safety in Pregnancy
- Unknown safety in Lactation
VIII. Resources
IX. References
- (2014) Presc Lett 21(12): 70
- (2002) Pediatrics 110(6):1246-52 [PubMed]
- Stiver (2003) CMAJ 168(1):49-57 [PubMed]
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Definition (NCI) | A cyclopentane derivative with activity against influenza A and B viruses. Peramivir is a neuraminidase inhibitor which prevents normal processing of virus particles such that virus particles are not released from infected cells. |
Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
MSH | C414210 |
English | Peramivir, (1S,2S,3R,4R)-3-((1S)-1-acetylamino-2-ethylbutyl))-4-((aminoiminomethyl)amino-2-hydroxycyclopentanecarboxylic acid, trihydrate, peramivir, PERAMIVIR, 3-(1-acetamido-2-ethyl-butyl)-4-guanidino-2-hydroxy-cyclopentane-1-carboxylic acid |