Infectious Disease Book

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Neuraminidase Inhibitor

Aka: Neuraminidase Inhibitor, Zanamivir, Relenza, Oseltamivir, Tamiflu
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  1. See Also
    1. Influenza
    2. Influenza Vaccine
    3. Amantadine
  2. Indications: Covers both Influenza A and Influenza B
    1. Influenza
    2. Influenza prophylaxis
  3. Contraindications: Zanamivir (Relenza)
    1. Asthma
    2. COPD
  4. Precautions
    1. Influenza A (H1N1 Strain) was resistant to Tamiflu in 2008 (Relenza was used)
  5. Dosing: Zanamivir (Relenza)
    1. Contraindicated in bronchospastic disease
    2. Treatment (age 7 years and older)
      1. Dose: 10 mg (2 inhalations) twice daily for 5 days
    3. Prevention (age 5 years and older)
      1. Dose: 10 mg (1 inhalation daily) for 10 days
  6. Dosing: Oseltamivir (Tamiflu)
    1. Indicated for age 1 year old and over
    2. Treatment
      1. Dose: 2 mg/kg/dose up to 75 mg orally twice daily for 5 days
      2. Weight <15 kg: 30 mg orally twice daily for 5 days
      3. Weight 15 to 23 kg: 45 mg orally twice daily for 5 days
      4. Weight 23 to 40 kg: 60 mg orally twice daily for 5 days
      5. Weight >40kg or Adult: 75 mg orally twice daily for 5 days
      6. Advanced renal disease (Creatinine Clearance 10-30)
        1. 75 mg daily for 5 days or
        2. 30 mg after Dialysis
    3. Prevention
      1. Weight <15 kg: 30 mg orally daily for 10 days
      2. Weight 15 to 23 kg: 45 mg orally daily for 10 days
      3. Weight 23 to 40 kg: 60 mg orally daily for 10 days
      4. Weight >40kg or Adult: 75 mg orally daily for 10 days
      5. Advanced renal disease (Creatinine Clearance 10-30)
        1. 75 mg every other day or 30 mg orally daily for 10 days
      6. Nursing Home
        1. Treat for at least 2 weeks and for at least 7 days after the last infected case in Nursing Home
        2. Isolate index patient to room and follow standard droplet precautions
  7. Adverse effects
    1. Bronchospasm (with Relenza only)
  8. References
    1. (2002) Pediatrics 110(6):1246-52
    2. Stiver (2003) CMAJ 168(1):49-57
Medication Costs
Relenza Diskhaler (on 2/9/2012 at DrugStore.com)
Relenza Diskhaler 20 5mg/blister Powder Inhaler #1 for $75.73 ($75.73/unit)
Tamiflu (on 2/9/2012 at DrugStore.com)
Tamiflu 10 75mg Capsules Disp Pack #1 for $110.99 ($110.99/unit)
Tamiflu 10 45mg Capsules Box #1 for $110.08 ($110.08/unit)
Tamiflu 10 30mg Capsules Box #1 for $110.08 ($110.08/unit)
Tamiflu 12mg/ml Suspension Per The Manufacturer, This Product Is Mixed Prior To Dispensing. The Suspension Must Be Used Within 10 Days. #1 for $53.54 ($53.54/unit)
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Relenza (C0876148)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D053243
English Relenza, Biota Brand of Zanamivir, Glaxo Wellcome Brand of Zanamivir, GlaxoSmithKline Brand of Zanamivir, Zanamivir Biota Brand, Zanamivir GlaxoSmithKline Brand, relenza
German Relenza
Czech Relenza
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Oseltamivir (C0874161)

Definition (NCI) A synthetic derivative prodrug of ethyl ester with antiviral activity. Oseltamivir interferes with the final life cycle stage of influenza virus (host cell release of completed viral particles) by blocking neuraminidases on the surface of flu viruses. (NCI04)
Definition (MSH) An acetamido cyclohexene that is a structural homolog of SIALIC ACID and inhibits NEURAMINIDASE.
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D053139
SnomedCT 386142008, 412261005
English ethyl (3R,4R,5S)-4-acetamido-5-amino-3-pentan-3-yloxy-cyclohexene-1-carboxylate, Oseltamivir [Chemical/Ingredient], oseltamivir, Oseltamivir, Oseltamivir (product), Oseltamivir (substance), OSELTAMIVIR
Portuguese Oseltamivir
Spanish Oseltamivir, oseltamivir (producto), oseltamivir, oseltamivir (sustancia)
Russian ТАМИФЛУ, ОЗЕЛТАМИВИР, GS 4071, ТАМИФЛЮ, TAMIFLU, OZELTAMIVIR, TAMIFLIU
Italian Oseltamivir
German Oseltamivir
Finnish Oseltamiviiri
Czech oseltamivir
Japanese オセルタミビル
Swedish Oseltamivir
French Oséltamivir
Polish Oseltamiwir
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Tamiflu (C0876173)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D053139
English Tamiflu, oseltamivir phosphate (Tamiflu), tamiflu
French Tamiflu
German Tamiflu
Italian Tamiflu
Czech Tamiflu
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Zanamivir (C0216660)

Definition (NCI) A sialic acid-analogue neuraminidase inhibitor with antiviral activity. Administered into the respiratory tract by aerosol inhalation, zanamivir selectively binds to and inhibits influenza A and B virus neuraminidase-mediated cleavage of sialic acid residues in host cell membrane-bound glycoprotein receptors for influenza viruses, preventing the release of progeny viruses from host cell surfaces and, so, further viral replication.
Definition (NCI) A drug used to prevent and to treat influenza virus infections. It blocks the release of the virus from infected cells. It is a type of antiviral agent.
Definition (MSH) A guanido-neuraminic acid that is used to inhibit NEURAMINIDASE.
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D053243
SnomedCT 116100000, 387010007
English 4-Guanidino-2,4-dideoxy-2,3-dehydro-N-acetylneuraminic Acid, 5-Acetamido-2,6-anhydro-3,4,5-trideoxy-4-guanidino-D-glycero-D-galacto-non-2-enonic Acid, GANA, Zanamivir, 5-acetylamino-4-guanidino-6-(1,2,3-trihydroxypropyl)-5,6-dihydro-4H-pyran-2-carboxylic acid, Acid, 4-Guanidino-2-Deoxy-2,3-Didehydro-N-Acetylneuraminic, 2,3-Didehydro-2,4-Dideoxy-4-Guanidino-N-Acetyl-D-Neuraminic Acid, 2,3-Didehydro-2,4-Dideoxy-4-Guanidinyl-N-Acetylneuraminic Acid, 4 Guanidino 2 Deoxy 2,3 Didehydro N Acetylneuraminic Acid, 4 Guanidino Neu5Ac2en, 4-Guanidino-2,4-Dideoxy-2,3-Didehydro-N-Acetylneuraminic Acid, 4-Guanidino-2-Deoxy-2,3-Didehydro-N-Acetylneuraminic Acid, 5-Acetylamino-2,6-Anhydro-4-Guanidino-3,4,5-Trideoxy-D-Galacto-Non-Enoic Acid, 4-Guanidino-Neu5Ac2en, zanamivir, zanamivir (medication), ZANAMIVIR, Zanamivir [Chemical/Ingredient], Zanamivir (product), Zanamivir (substance)
Portuguese Zanamivir
Spanish Zanamivir, zanamivir (producto), zanamivir (sustancia), zanamivir
Russian ЗАНАМИВИР, 4-ГУАНИДИНО-2,4-ДИДЕЗОКСИ-2,3-ДИДЕГИДРО-N-АЦЕТИЛНЕЙРАМИНОВАЯ КИСЛОТА, ZANAMIVIR, 4-GUANIDINO-2,4-DIDEZOKSI-2,3-DIDEGIDRO-N-ATSETILNEIRAMINOVAIA KISLOTA
Italian Zanamivir
German 2,3-Didehydro-2,4-Dideoxy-4-Guanidino-N-Acetyl-D-Neuraminsäure, 4-Guanidino-2,4-Dideoxy-2,3-Didehydro-N-Acetylneuraminsäure, 4-Guanidino-2-Deoxy-2,3-Didehydro-N-Acetylneuraminsäure, 4-Guanidino-Neu5Ac2en, Zanamivir, 2,3-Didehydro-2,4-Dideoxy-4-Guanidinyl-N-Acetylneuraminsäure
French Zanamivir, Acide 5-acétamido-2,6-anhydro-4-guanidino-3,4,5-tridésoxy-D-glycéro-D-galacto-non-2-énonique, Acide N-acétyl-2,3-déhydro-2,4-didésoxy-4-guanidino-neuraminique
Finnish Tsanamiviiri
Czech zanamivir
Japanese ザナミビル
Swedish Zanamivir
Polish Zanamiwir
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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