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 (age >13 years)
- 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 months to 13 years, per CDC, not FDA approved)
- Dose 10-12 mg/kg (up to 600 mg) IV over 15 to 30 minutes daily for single dose
- May be used up to 5 days (or may switch to Oseltamivir)
-
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