zanamivir (Relenza)
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Indications
- influenza
- treatment of influenza A & influenza B
- prophylaxis for influenza A & influenza B
- marginal benefit in prevention & treatment of influenza[9]
- effective against H1N1 virus
- FDA approved for use in adults & children >= 7 years
Contraindications
Benefit/risk
- small benefit for preventing influenza-like illness[9]
- number needed to harm
Dosage
- 2 inhalations BID for 5 days
- start therapy within 2 days of onset
- prophylaxis: 4-6 weeks
Powder: (Dry), use only with supplied inhaler[5]
Pharmacokinetics
- elimination renal
Adverse effects
- may trigger bronchospasm
- nausea, vomiting[10]
- reports of delirium/abnormal behavior leading to injury[4]
Mechanism of action
- neuraminidase inhibitor
- reduce the severity & duration of flu symptoms
- effective if administered early[8]
Notes
- oseltamivir & zanamivir are modestly effective for symptoms of influenza in otherwise healthy adults
- when used prophylactically, they have no effect against in preventing influenza-like illness or asymptomatic influenza
- the drugs reduce influenza's symptoms by about a day
- benefit for very ill people in hospital is without supporting data[6]
More general terms
Additional terms
References
- ↑ Prescriber's Letter 6(11) Nov 1999
- ↑ Prescriber's Letter 7(8):43 2000
- ↑ Prescriber's Letter 11(1):1 2004
- ↑ 4.0 4.1 FDA MedWatch http://www.fda.gov/medwatch/safety/2008/safety08.htm#Relenza
- ↑ 5.0 5.1 Prescriber's Letter 16(11): 2009 CHART: Tamiflu Expiration Date Extension COMMENTARY: Potential Medication Errors with Tamiflu Oral Suspension COMMENTARY: 2009-2010 Influenza Season: Issues Concerning Tamiflu and Relenza PDF: Tamiflu Emergency Compounding Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=251104&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 6.0 6.1 Jefferson T et al Neuraminidase inhibitors for preventing and treating influenza in healthy adults: systematic review and meta-analysis BMJ 2009;339:b5106 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19995812 <Internet> http://www.bmj.com/cgi/content/full/339/dec07_2/b5106
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
- ↑ 8.0 8.1 Muthuri SG et al. Impact of neuraminidase inhibitor treatment on outcomes of public health importance during the 2009-2010 influenza A (H1N1) pandemic: A systematic review and metaanalysis in hospitalized patients. J Infect Dis 2013 Feb 15; 207:553. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23204175
Aoki FY and Hayden FG. The beneficial effects of neuraminidase inhibitor drug therapy on severe patient outcomes during the 2009-2010 influenza A virus subtype H1N1 pandemic. J Infect Dis 2013 Feb 15; 207:547. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23204176 - ↑ 9.0 9.1 9.2 Heneghan CJ et al Zanamivir for influenza in adults and children: systematic review of clinical study reports and summary of regulatory comments. BMJ 2014;348:g2547 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24811412 <Internet> http://www.bmj.com/content/348/bmj.g2547
Krumholz HM and Hines HH Neuraminidase inhibitors for influenza BMJ 2014;348:g2548 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24811413 <Internet> http://www.bmj.com/content/348/bmj.g2548
Jefferson T, Jones MA, Doshi P et al Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children. Cochrane Database Syst Rev. 2014 Apr 10;4:CD008965 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24718923 - ↑ 10.0 10.1 10.2 The NNT: Neuraminidase Inhibitors Given for Influenza. http://www.thennt.com/nnt/neuraminidase-inhibitors-for-influenza/