Zanamivir

Indications
 Inhalation
Influenza A and B
Adult: 10 mg (2 inhalations) bid for 5 days, admin as soon as possible (within 48 hr) after the onset of symptoms. 2 doses should be taken on 1st day of treatment provided there is at least an interval of at least 2 hr between doses, subsequent doses to be given every 12 hr.
Child: >7 yr: 10 mg (2 inhalations) bid for 5 days, admin as soon as possible (within 48 hr) after the onset of symptoms. 2 doses should be taken on 1st day of treatment, if possible, provided there is at least an interval of at least 2 hr between doses, subsequent doses to be given every 12 hr.
Inhalation
Prophylaxis of influenza A and B
Adult: For community outbreak: 10 mg (2 inhalations) once daily for 28 days, to be started within 5 days of outbreak. For prophylaxis in household setting: 10 mg (2 inhalations) once daily for 10 days, to be started within 36 hr of exposure.
Child: For community outbreak: >12 yr: 10 mg (2 inhalations) once daily for 28 days, started within 5 days of outbreak. For prophylaxis in household setting: ≥5 yr: 10 mg (2 inhalations) once daily for 10 days, to be started within 36 hr of exposure.
Contraindications
 Hypersensitivity.
Warnings / Precautions
 Pregnancy, lactation. High risk of bronchospasm in chronic respiratory diseases. Fast-acting bronchodilator should be readily available for asthma/COPD patients; avoid in severe asthma. Bronchodilators to be inhaled before zanamivir admin. Discontinue if bronchospasm develops or there is decrease in respiratory function.
Adverse Reactions
 Nasal symptoms, headache, dizziness, GI disturbances, cough, infection, rash, bronchitis. Rarely, hypersensitivity reactions, arrhythmias, bronchospasm, dyspnoea, facial oedema, seizures and syncope.
Drug Interactions
 Do not admin live attenuated influenza vaccine intranasal within 2 wk before or 48 hr after zanamivir admin to improve response to vaccine.
See Below for More zanamivir Drug Interactions
Mechanism of Actions
 Zanamivir, a sialic acid derivative, potentially inhibits viral neuraminidase of influenza virus, thus altering virus particle aggregation and release. It is active against influenza A and B virus replication.
Absorption: Poorly absorbed from GI tract. Bioavailability: 2% (Oral). 10-20% of inhaled dose absorbed. Peak serum concentration: 1-2 hr (after inhalation).
Distribution: Protein binding: <10%.
Excretion: Excreted unchanged in urine. Serum half life: 2.6-5 hr.
Storage Conditions
 Inhalation: Store at 25°C (77°F).
ATC Classification
 J05AH01 - zanamivir ; Belongs to the class of neuraminidase inhibitors. Used in the systemic treatment of viral infections.
Storage
 Inhalation: Store at 25°C (77°F).
Available As
  • Zanamivir 5 mg

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