Nurses Compass
Drug Guide
Peramivir
Classification
Therapeutic: Antiviral for Influenza A and B
Pharmacological: Neuraminidase inhibitor
FDA Approved Indications
- Treatment of acute uncomplicated influenza in patients aged 2 years and older who have been symptomatic for no more than 2 days
Mechanism of Action
Peramivir competitively inhibits viral neuraminidase, impairing viral release from infected cells and reducing spread of the infection.
Dosage and Administration
Adult: 600 mg as a single IV infusion over 15 to 30 minutes, administered once
Pediatric: 211 to 447 mg based on weight, administered as a single IV infusion over 15 to 30 minutes
Geriatric: No specific dosage adjustment recommended, but monitor renal function
Renal Impairment: Dose adjustment required in severe renal impairment (creatinine clearance <50 mL/min)
Hepatic Impairment: No specific dose adjustment noted
Pharmacokinetics
Absorption: Administered IV, so bioavailability is 100%.
Distribution: Widely distributed in body fluids and tissues.
Metabolism: Not metabolized significantly; primarily excreted unchanged.
Excretion: Renally excreted; renal clearance is the main elimination pathway.
Half Life: Approximately 20 hours
Contraindications
- Hypersensitivity to peramivir or any component of the formulation
Precautions
- Use with caution in patients with renal impairment; monitor renal function.
- Ensure accurate diagnosis of influenza, as antiviral therapy is most effective when started early.
Adverse Reactions - Common
- Diarrhea (Unknown)
- Nausea (Unknown)
Adverse Reactions - Serious
- Allergic reactions including hypersensitivity, anaphylaxis (Rare)
- Stevens-Johnson Syndrome and other severe skin reactions (Rare)
Drug-Drug Interactions
- None specifically identified, but use caution with other nephrotoxic drugs.
Drug-Food Interactions
- No significant interactions
Drug-Herb Interactions
- Limited data; consult current references.
Nursing Implications
Assessment: Monitor renal function and hydration status.
Diagnoses:
- Risk for impaired kidney function.
- Risk for allergic reaction.
Implementation: Administer IV infusion as prescribed. Monitor for adverse reactions during and after infusion.
Evaluation: Assess for reduction in influenza symptoms and adverse effects.
Patient/Family Teaching
- Explain the purpose of the medication and that it is given as a one-time infusion.
- Notify healthcare providers of signs of allergic reactions or adverse effects.
- Maintain hydration and report unusual symptoms.
Special Considerations
Black Box Warnings:
- None at this time
Genetic Factors: No specific genetic considerations known.
Lab Test Interference: Renal function tests should be monitored during therapy.
Overdose Management
Signs/Symptoms: Potential allergic reactions, hypotension, or other infusion-related reactions.
Treatment: Supportive care; corticosteroids or antihistamines may be used for allergic reactions. Dialysis may be considered in severe cases if needed.
Storage and Handling
Storage: Store vials at room temperature, 20°C to 25°C (68°F to 77°F).
Stability: Stable until the expiration date on the package.