Zanamivir parenteral
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Solution for infusion containing zanamivir.
Drugs List
Therapeutic Indications
Uses
Treatment of influenza A
Treatment of influenza B
Treatment of complicated and potentially life-threatening influenza A or B virus infection in adults and children aged 6 months of age and older, in cases where the patient's influenza virus is known or suspected to be resistant to other anti-influenza medicines or when other anti-viral products are not suitable.
Dosage
Adults
600mg twice daily for 5 to 10 days.
Children
Children aged 6 years to 18 years of age
12mg/kg twice daily for 5 to 10 days, maximum daily dose of 600mg twice daily.
Children aged 6 months to 6 years of age
14mg/kg twice daily for 5 to 10 days.
Patients with Renal Impairment
Adults and children aged 6 years to 18 years of age weighing 50kg and above
Creatinine clearance 50ml/minute to less than 80ml/minute
Initial dose: 600mg.
Maintenance dose: 400mg twice daily, to be given 12 hours after the initial dose.
Creatinine clearance 30ml/minute to less than 50ml/minute
Initial dose: 600mg.
Maintenance dose: 250mg twice daily, to be given 12 hours after the initial dose.
Creatinine clearance 15ml/minute to less than 30ml/minute
Initial dose: 600mg.
Maintenance dose: 150mg twice daily, to be given 24 hours after the initial dose.
Creatinine clearance less than 15ml/minute
Initial dose: 600mg.
Maintenance dose: 60mg twice daily, to be given 48 hours after initial dose.
Adults and children aged 6 years to 18 years of age weighing less than 50kg and above
Creatinine clearance 50ml/minute to less than 80ml/minute
Initial dose: 12mg/kg
Maintenance dose: 8mg/kg twice daily, to be given 12 hours after the initial dose.
Creatinine clearance 30ml/minute to less than 50ml/minute
Initial dose: 12mg/kg
Maintenance dose: 5mg/kg twice daily, to be given 12 hours after the initial dose.
Creatinine clearance 15ml/minute to less than 30ml/minute
Initial dose: 12mg/kg.
Maintenance dose: 3mg/kg twice daily, to be given 24 hours after the initial dose.
Creatinine clearance less than 15ml/minute
Initial dose: 12mg/kg.
Maintenance dose: 1.2mg/kg twice daily, to be given 48 hours after initial dose.
Adults and children aged 6 months to 6 years of age weighing 42.8kg and above
Creatinine clearance 50ml/minute to less than 80ml/minute
Initial dose: 600mg.
Maintenance dose: 400mg twice daily, to be given 12 hours after the initial dose.
Creatinine clearance 30ml/minute to less than 50ml/minute
Initial dose: 600mg.
Maintenance dose: 250mg twice daily, to be given 12 hours after the initial dose.
Creatinine clearance 15ml/minute to less than 30ml/minute
Initial dose: 600mg.
Maintenance dose: 150mg twice daily, to be given 24 hours after the initial dose.
Creatinine clearance less than 15ml/minute
Initial dose: 600mg.
Maintenance dose: 60mg twice daily, to be given 48 hours after initial dose.
Adults and children aged 6 months to 6 years of age weighing less than 42.8kg
Creatinine clearance 50ml/minute to less than 80ml/minute
Initial dose: 14mg/kg.
Maintenance dose: 9.3mg/kg twice daily, to be given 12 hours after the initial dose.
Creatinine clearance 30ml/minute to less than 50ml/minute
Initial dose: 14mg/kg.
Maintenance dose: 5.8mg/kg twice daily, to be given 12 hours after the initial dose.
Creatinine clearance 15ml/minute to less than 30ml/minute
Initial dose: 14mg/kg.
Maintenance dose: 3.5mg/kg twice daily, to be given 24 hours after the initial dose.
Creatinine clearance less than 15ml/minute
Initial dose: 14mg/kg.
Maintenance dose: 1.4mg/kg twice daily, to be given 48 hours after initial dose.
Contraindications
Children under 6 months
Within 2 weeks of administration of live influenza virus vaccine
Precautions and Warnings
Children under 6 years
Immunosuppression
Breastfeeding
Haemodialysis
Pregnancy
Renal impairment - creatinine clearance below 80ml/min
Reduce dose and/or alter dose interval in patients with renal impairment
Treatment to be initiated and supervised by a specialist
Monitor patients for behavioural changes
Monitor renal function regularly
Monitor viral markers frequently
Discontinue if allergic reaction occurs
Pregnancy and Lactation
Pregnancy
Use zanamivir with caution during pregnancy.
The manufacturer recommends that zanamivir should only be used during pregnancy if the potential benefits to the mother outweigh the potential risks to the foetus.
At the time of writing there is limited published information regarding the use of zanamivir during pregnancy. Animal studies do not show teratogenic effects.
Lactation
Use zanamivir with caution during breastfeeding.
The manufacturer recommends that zanamivir should only be used during breastfeeding if the potential benefits to the mother outweigh the potential risks to the foetus.
It is unknown if zanamivir is excreted in breast milk. In animal studies, zanamivir has been shown to be expressed into breast milk at low levels.
Effects on exposed infants are unknown.
Side Effects
Alanine aminotransferase increased
Anaphylactic reaction
Anaphylactoid reaction
Aspartate aminotransferase increased
Behavioural disturbances
Convulsions
Delirium
Diarrhoea
Erythema multiforme
Facial oedema
Hallucinations
Hepatocellular damage
Impaired consciousness
Increase in alkaline phosphatase
Oropharyngeal oedema
Rash
Severe skin reactions
Stevens-Johnson syndrome
Toxic epidermal necrolysis
Urticaria
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: January 2020
Reference Sources
Summary of Product Characteristics: Dectova 10mg/ml solution for infusion. GlaxoSmithKline UK. Revised October 2019.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 21 October 2021
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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