zanamivir, Relenza

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GENERIC NAME: zanamivir

BRAND NAME: Relenza

DRUG CLASS AND MECHANISM: Zanamivir is an inhaled drug that is used for treating and preventing influenza (the "flu"). Zanamivir decreases the spread of influenza A and B viruses, the viruses responsible for the flu. It does this by blocking the action of neuraminidase, an enzyme produced by the viruses that enables the viruses to spread from infected cells to healthy cells. By preventing the spread of virus from cell to cell, the symptoms and duration of influenza infection are reduced. On average, zanamivir reduces the duration of symptoms by one day if treatment is started within forty-eight hours after symptoms begin. The FDA approved zanamivir in July 1999.

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Inhalation Powder: 5 mg per inhalation

STORAGE: Zanamivir should be stored at room temperature, 15 C to 30 C (59 F to 86 F)

PRESCRIBED FOR: Zanamivir is used for the treatment of infection with the influenza viruses, including swine flu (H1N1), in individuals seven years of age or older with symptoms for no longer than two days. It also is used for preventing influenza in adults and children five years of age and older. It is not recommended for individuals with underlying airways disease, and it is not a substitute for annual flu vaccination.

DOSING: Zanamivir is administered by oral inhalation. The recommended dose is two inhalations (5 mg per inhalation) twice daily (approximately 12 hours apart) for five days. Two doses (separated by at least two hours) should be administered on the first day of treatment. For best results, treatment should begin as soon as symptoms develop. The recommended dose for prevention of influenza in a household setting is 10 mg once daily for 10 days. The recommended dose for preventing influenza in a community setting is 10 mg once daily for 28 days.

DRUG INTERACTIONS: Zanamivir potentially may interfere with the action of injections of live attenuated flu vaccine because zanamivir prevents viral replication. Therefore, live attenuated flu vaccine should not be administered from 2 weeks before to 48 hours after administration of zanamivir. Trivalent inactivated influenza vaccine can be administered while using zanamivir.

PREGNANCY: The Centers for Disease Control (CDC) states that pregnancy is not a contraindication for use of zanamivir in pregnant women because the benefits outweigh the risks.

NURSING MOTHERS: It is not known whether zanamivir is excreted in breast milk. However, the CDC recommends that nursing women who develop flu after child birth should be treated with antiviral drugs.

SIDE EFFECTS: The most frequent side effects are headaches, diarrhea, nausea, cough, vomiting, disturbance in temperature regulation, and dizziness. Sinusitis, ear, nose, and throat infections may occur. Skin reactions, muscle or joint pain, allergic reactions, bronchospasm, and behavioral disturbances have been reported. Patients with respiratory diseases may experience breathing problems when treated with zanamivir due to irritation of the breathing tubes by the particles from the inhaler. If breathing problems occur, zanamivir should be discontinued. Patients who have asthma or other breathing problems that make them sensitive to inhaled particles should have a fast acting, inhaled bronchodilator available to treat any breathing problem that may occur when zanamivir is used.

REFERENCE:

Relenza FDA Prescribing Information

CDC.gov. What You Should Know About Flu Antiviral Drugs. September 17, 2013.


Last Editorial Review: 2/21/2014




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