Efficacy of oseltamivir-zanamivir combination compared to each monotherapy for seasonal influenza: a randomized placebo-controlled trial. This medication works best when the amount of medicine in your body is kept at a constant level. prescription products. Found inside – Page 1503CONTRAINDICATIONS Do not use in those with allergy history to any ingredient of product, including lactose (contains milk proteins). INTERACTIONS Drug Influenza nasal vaccine, live: Decreased effect of zanamivir: Use of zanamivir is not ... Found inside – Page 481... then maintenance of 900 mg once daily Zanamivir Preparation 0 Inhalation, 5 mg Dosing o Prophylaxis: 10 mg (2 inhalations) once daily for 10 days 0 Treatment: 10 mg (2 inhalations) twice daily for 5 days Contraindications and ... commonly, these are "non-preferred" brand drugs. Found inside – Page 1247PRECAUTIONS Contraindications: Hypersensitivity to zanamivir. Cautions: Not recommended in respiratory disease (e.g., COPD, asthma), renal/hepatic impairment. ACTION Inhibits influenza virus enzyme neuraminidase, essential for viral ... It was licensed to Glaxo in 1990 and approved in the US in 1999, only for use as a treatment for influenza. Can Early Influenza Vaccination Make a Difference in Cardiovascular Risk Reduction? g Receipt of specific antivirals (i.e., amantadine, rimantadine, zanamivir, or oseltamivir) 48 hours before vaccination. Tell your doctor right away of any signs of unusual behavior, including confusion, agitation, self-injury.A very serious allergic reaction to this drug is rare. Find out what health conditions may be a health risk when taken with zanamivir inhalation WillieEspinosa92 PLUS. RELENZA (zanamivir) Inhalation Powder, for oral inhalation . However, at this moment it is only approved for use as an inhaled formulation. Severe underlying airway conditions (e.g., chronic obstructive pulmonary disease or asthma). Found inside – Page 215Zanamivir • Assess improvement in influenza symptoms: fever reduction, less myalgia and headache, reduced coughing and sore throat, ... CLINICAL SCENARIO General Contraindications Pentamidine • Bronchospasm and cough are ... The recipient will receive more details and instructions to access this offer. Please confirm that you would like to log out of Medscape. Zanamivir is taken by oral inhalation, using a Diskhaler device. 46 0 obj <> endobj Immunosuppression (see contraindications and precautions section in chapter 19 of the Green Book) Immunosuppression due to disease or treatment, including patients undergoing chemotherapy leading to immunosuppression, bone marrow transplant, HIV infection at all stages, multiple myeloma or genetic disorders affecting the immune system (e.g . No systemic absorption. Administer only via the Diskhaler inhaler. NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Zanamivir side effects. The low potential for drug interactions with zanamivir. A Phase III, double-blind, study was conducted to evaluate the efficacy, antiviral activity and safety of zanamivir 600 mg twice daily intravenously compared to oral oseltamivir 75 mg twice daily and 300 mg zanamivir twice daily intravenously in hospitalised patients (>16 years of age) with influenza. Contraindications. They may be unable to breathe in deeply enough using this inhaler device to get enough drug to benefit them.During pregnancy, this medication should be used only when clearly needed. %PDF-1.5 %���� Approval: 1999 -----INDICATIONS AND USAGE ----- RELENZA, an influenza virus neuraminidase inhibitor (NAI), is indicated for: Treatment of acute, uncomplicated influenza type A and B infections in Found insideCATEGORY: Antiviral: neuraminidase inhibitor Rx; Preg Cat C BRAND NAMES oseltamivir phosphate Tamiflu (Roche) DOSAGE FORMS Capsule: 30, ... 2.5-5.1h 10% Via urine as 4-17% unchanged drug CONTRAINDICATIONS: Hypersensitivity. Avoid use of these antiviral drugs for 14 days after vaccination g Moderate or severe acute illness with or without fever g History of GBS within 6 weeks of previous influenza vaccine According to Infectious Disease Physicians, 2003 Contraindications and Cautions. Consult your doctor about the risks and important benefits of receiving a yearly flu shot to lower your chances of getting the flu. Zanamivir information from DrugsUpdate. As such this unique volume will be essential to basic researchers in drug discovery and viral pathogenesis, as well as clinicians involved in antiviral chemotherapy. Influenza neuraminidase cleaves terminal sialic acid residues on glycoconjugates and destroys the receptors recognized by viral . Safety and efficacy in children 7 y are unknown. Concurrent use of inhaled medication with inhaled zanamivir; pregnancy (category B), lactation. It is active against influenza A and B virus replication. Information last revised August 2021. 4 CONTRAINDICATIONS. -If possible, 2 doses should be taken on the first day, provided there are at least 2 hours between the doses. Zanamivir is a reversible competitive inhibitor of influenza neuraminidase. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer. Found inside – Page 1079Caution should be used when zanamivir is administered to a nursing mother . Contraindications Hypersensitivity to zanamivir or any component of the formulation Warnings / Precautions Patients must be instructed in the use of the ... Found inside – Page 1921The serum half-life of zanamivir following administration by oral inhalation ranges from 2.5 to 5.1 hours. ... Contraindications: • Do not use in patients with history of allergic reaction to any ingredient of zanamivir including milk ... Zanamivir is a dry powder, not an aerosol, and should not be administered by using nebulizers, ventilators, or other devices typically used for administering medications in aerosolized solutions. HOW TO USE: Read the Patient Information Leaflet provided by your pharmacist before you start using zanamivir and each time you get a refill. Also, because this medication is an inhaled powder, you may experience increased coughing after using it. A: Generally acceptable. 340 terms. Drugs, 2010 This drug is available at a higher level co-pay. This drug is available at a middle level co-pay. View the formulary and any restrictions for each plan. PLoS Med 2010;7:e1000362. For unvaccinated . This document does not contain all possible drug interactions. Some people using zanamivir (especially children) have had sudden unusual changes in mood or behavior. Concurrent use of inhaled medication with inhaled zanamivir; pregnancy (category B), lactation. Neuraminidase inhibitors include oseltamivir (oral), zanamivir (inhalation) and peramivir (IV); these drugs act by inhibiting neuraminidase, the enzyme that cleaves off the new virus particle. >7 years: 10 mg inhaled every 12 hourly for 5 days. Side Effects: Nasal and throat discomfort. Your list will be saved and can be edited at any time. 6. a Cautious Use. Found inside – Page 559Oseltamivir (Tamiflu) and zanamivir (Relenza) are neuraminidase inhibitors, which are effective against both influenza A and B. ... Oseltamivir and zanamivir can be used for chemoprophylaxis by individuals who have contraindications to ... This review focuses on resistance to the NAIs. Now is a perfect time to join our contributor community and help make acute medical knowledge open and readily available to all. Found inside – Page 1650CONTRAINDICATIONS Hypersensitivity to zanamivir . CAUTIOUS USE Concurrent use of inhaled medication with inhaled zanamivir ; pregnancy ( category B ) , lactation . Safety and efficacy in children < 7 y are unknown . Individual plans may vary Zanamivir is also given to prevent influenza in pre-exposed, asymptomatic individuals. Zanamivir should not be used to treat the common cold. Effectively review for problem-based courses with the help of text boxes that help you clearly see the clinical relevance of the material. Saint Paul, Minnesota • 651-647-9009 • • • Item #P3072a (7/21) continued on the next page Vaccine Contraindications 1 Precautions 1 Hepatitis B (HepB) • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component • Hypersensitivity to yeast • Moderate or severe acute illness with or without fever • Infant weighing less than 2000 grams (4 lbs, 6 . 3-5 months: 20 mg PO q12hr x5 days. It acts as a transition-state analogue inhibitor of influenza neuraminidase, preventing progeny virions from emerging from infected cells. • Zanamivir: Zanamivir is an inhaled neuraminidase inhibitor that is approved for both treatment and prevention of influenza in those 7 years of age and older. Route & Dosage Contraindications Any antiviral flu drug is contraindicated if you have previously had a serious reaction to the drug or any of its components. 252 terms. All trademarks used are the properties of their respective owners. Found inside – Page 1777... 256f, 257t, 260f, 266 triad, 235, 898 vaccinations for patients with, 266 zanamivir contraindications and, 1440 Asthma action plan, 259 Astrocytoma, 1023t, 1632t Astroviruses, diarrhea/gastroenteritis caused by, 603t ASXL1 mutation, ... Patients should also be advised to avoid use of these antivirals for 14 days after vaccination, if feasible. The usual length of time you will take zanamivir is 10 days if there is a sick household member or 28 days if there is a flu outbreak in the community, or as directed by your doctor.Remove the cover on the disk inhaler. Serious allergic reactions have included anaphylaxis, angioedema, urticaria, and erythema multiforme. Nasal symptoms, headache, dizziness, GI disturbances, cough, infection, rash, bronchitis. Zanamivir is a neuraminidase inhibitor used to treat influenza A and B. Pharmacodynamics. Controlled studies in pregnant women show no evidence of fetal risk. Respiratory problems following inhalation, dysfunction of ventilators due to blockade of the filters by the lactose carrier, . This website also contains material copyrighted by 3rd parties. Consult your pharmacist or local waste disposal company. According to the footnote, quadrivalent LAIV should not be administered to patients who have taken oseltamivir or zanamivir within the previous 48 hours . Contraindications and Precautions. Do not use the missed dose if it is within 2 hours of your next dose. -After the first day, doses should be about 12 . Found inside – Page 1624The serum half-life of zanamivir following administration by oral inhalation ranges from 2.5 to 5.1 hours. ... Contraindications: • Do not use in patients with history of allergic reaction to any ingredient of zanamivir including milk ... (48 hours for oseltamivir and zanamivir, 5 days for peramivir, and 17 days for baloxavir) The CDC also cautions against using the nasal flu vaccine for people with the following health conditions . In that case, skip the missed dose. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. (1.1) Prophylaxis of influenza in patients aged . Zanamivir. R. x. only . However, if your doctor decides you should use zanamivir, have a quick-relief inhaled bronchodilator (such as albuterol inhaler) readily available.The flu itself or zanamivir may rarely cause serious mental/mood changes. Cautious Use. Written by the foremost authority in the field, this volume is a comprehensive review of the multifaceted phenomenon of hepatotoxicity. Contact the applicable plan WillieEspinosa92 PLUS. If you log out, you will be required to enter your username and password the next time you visit. Pregnancy and lactation. Use this drug at evenly spaced intervals at the same time(s) every day.Continue to use this medication for the full time prescribed, even if symptoms improve. Found inside – Page 1409Neuraminidase inhibitor 1409 zanamivir • Give patient Patient's Instructions for Use, review all points before using delivery ... dyspnea GI: Nausea, vomiting, diarrhea SYST: Angioedema CONTRAINDICATIONS: Hypersensitivity to product, ... Zanamivir c. Oseltamivir d. - Answered by a verified Doctor Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Household setting, >5 years: 10 mg inhaled once daily for 10 days; initiate within 48 hours of exposure. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Tell your doctor if you have received flu vaccine in the nose in the past 2 weeks. Found inside – Page 30... lamiVUDine maraviroc oseltamivir penciclovir rapivab simeprevir sofosbuvir sofosbuvir/velpatasvir valacyclovir valganciclovir zanamivir CONTRAINDICATIONS: Hypersensitive reactions may occur, and allergies should be identified before ... Do not drive, use machinery, or do anything that needs alertness until you can do it safely. TAMIFLU (oseltamivir phosphate . Keep the disk inhaler level so that the medication will not spill out. Unknown dialysability. 3 4 5 COOC O 2H5 HN NH. This information does not assure that this product is safe, effective, or appropriate for you. They include bronchospasm and allergic phenomena. The current influenza A H3N2 and pandemic A(H1N1)pdm09 viruses are already resistant to the M2 inhibitors as are many H5N1 viruses. Oseltamivir can be combined with rimantidine or amantidine for those in whom zanamivir is contraindicated. Manage and view all your plans together – even plans in different states. . 1.2 Prophylaxis of Influenza. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This drug may be less effective for young children. They include bronchospasm and allergic phenomena. The reproductive performance of the F1 generation born to female rats given zanamivir was not affected. This drug is available at the lowest co-pay. AND FOR ORAL SUSPENSION . Started within 2 days of symptom onset; administer 2 doses on day 1, at least 2 hours apart. Contraindications Oseltamivir • Oseltamivir is contraindicated in persons with known hypersensitivity to oseltamivir or any components The above information is provided for general This is commonly called the flu, but many different illnesses cause flu-like symptoms such as fever, chills, aches and pains, cough . . Any IIV4 or It helps lessen symptoms (such as stuffy nose, cough, sore throat, fever/chills, headache, body aches, tiredness) and shortens the recovery time by about 1 to 2 days.Zanamivir may also be used to prevent the flu if you have been exposed to someone who already has the flu (such as a sick household member) or if there is a flu outbreak in the community. Found inside – Page 1704ZALEPLON ZANAMIVIR Patient & Family Education CAUTIOUS USE Concurrent use of * Exercise caution when walking ; inhaled medication with ... CONTRAINDICATIONS Hypersensi- Do not breast feed while taking tivity to zanamivir . this drug . and formulary information changes. Usual Pediatric Dose for Influenza. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. WebMD provides common contraindications for zanamivir inhalation. Do not store in the bathroom. Zanamivir(Relenza) generic is an antiviral agent and neuraminidase inhibitor, prescribed for the prevention and treatment of flu. Inhibits viral neuraminidases; stops release of virus from cells & prevents virus from crossing mucous lining of respiratory tract, Excretion: Urine (as unchanged drug); feces (unabsorbed drug). Most Zanamivir, however, is contraindicated in subjects with asthma and COPD because of its potential to cause bronchospasm. It suppresses the activity of the neuraminidase enzyme, which is . By clicking send, you acknowledge that you have permission to email the recipient with this information. Found inside – Page 1292PRECAUTIONS Contraindications: Hypersensitivity to zanamivir. Cautions: Not recommended in respiratory disease (e.g., COPD, asthma), renal/hepatic impairment. ACTION Inhibits influenza virus enzyme neuraminidase, essential for viral ... <3 months: 12 mg PO q12hr x5 days. Insufficient data available on use of LAIV4 in setting of antiviral use Based on half-lives and assuming normal clearance, reasonable to assume interference possible if antivirals are administered within these intervals: Antiviral Interval Oseltamivir and Zanamivir 48 hours before to 2 weeks after LAIV4 <15 kg: 30 mg PO q12hr x5 days. 2 . If given too closely together, zanamivir may interfere with the protection from flu vaccine given in the nose. 117 0 obj <>stream In 2006, it was approved for prevention of influenza A and B. Zanamivir was the first . 23-40 kg: 60 mg PO qDay x10 days. Contraindications or cautions are to be exercised when administering urinary anti-infectives in which patients? Community outbreak, 12-16 years: 10 mg inhaled once daily for 28 days; initiate within 5 days of outbreak. Limit alcoholic beverages. 5. Daniel MJ, Barnett JM, Pearson BA. To view formulary information first create a list of plans. If possible, on the first day of treatment, take two doses (2 inhalations each), waiting at least 2 hours between doses.For flu prevention: inhale this medication through your mouth as directed by your doctor, usually 2 inhalations (1 blister per inhalation) once a day. Zanamivir is a medication used to treat and prevent influenza caused by influenza A and B viruses.It is a neuraminidase inhibitor and was developed by the Australian biotech firm Biota Holdings. Copyright © 2001 - 2021 Pediatric Oncall All Rights Reserved. • Zanamivir (trade name Relenza®) is approved for treatment of flu in children 7 years and older. Clin Pharmacokinet 1999;36 Suppl 1:41-50. Child: In patients with complicated and potentially life-threatening infection, resistant and/or unsuitable to other treatments: As zanamivir hydrate: 6 . Zanamivir is administered by inhalation using a proprietary "Diskhaler" device distributed together with the medication. Compare formulary status to other drugs in the same class. Talk to your doctor for more details.This medication works by stopping the flu virus from growing. INDICATIONS Treatment Of Influenza. RELENZA (zanamivir) inhalation powder is indicated for treatment of uncomplicated acute illness due to influenza A and B virus in adults and pediatric patients aged 7 years and older who have been symptomatic for no more than 2 days. Cross-resistance between oseltamivir and zanamivir has been observed in neuraminidase biochemical assays. Puncture one medication blister. A leader in pharmacology and rehabilitation, Charles Ciccone, PT, PhD offers a concise, easy-to-access resource that delivers the drug information rehabilitation specialists need to know. administration to the respiratory tract by oral inhalation only. Contraindications and precautions to commonly used vaccines; Vaccine Citation Contraindications . Adding plans allows you to compare formulary status to other drugs in the same class. Do not use it later for another infection unless your doctor tells you to.This medication is not a substitute for the flu vaccine. Zanamivir inhalation powder is a mixture of active drug substance and lactose drug carrier. Do not make into an extemporaneous solution for administration by nebulization or mechanical ventilation; fatality reports of hospitalized patients with influenza who received a solution made with Relenza Inhalation Powder administered by nebulization . Rarely, hypersensitivity reactions, arrhythmias, bronchospasm, dyspnoea, facial oedema, seizures and syncope. Medscape Education. Mechanism of Resistance: In vitro resistance to zanamivir occurs from mutations in either the hemagglutinin or neuraminidase genes, or both. The following are contraindications and cautions for the use of agents for respiratory viruses: Renal impairment. Found inside – Page 1769... 252f, 253,256–257t stepwise approach to, 248f, 249t, 252f, 258 triad, 227, 888 vaccinations for patients with, 258 zanamivir contraindications and, 1428, Astrocytoma, 1013t, 1637t Astroviruses, diarrhea/gastroenteritis caused by, ... Found inside – Page 164... or zanamivir (chronic lung disease and asthma are contraindications). Dosing, base on knowledge of susceptability of circulating strains: oseltamivir 75 mg PO twice • daily ́ 5 days; zanamivir 10 mg (2 puffs) twice daily ́ 5 days. Contraindications (4) 12/2011 -----INDICATIONS AND USAGE-----RELENZA, an influenza neuraminidase inhibitor, is indicated for: Treatment of influenza in patients aged 7 years and older who have been symptomatic for no more than 2 days. Zanamivir, an antiviral agent, is a neuraminidase inhibitor indicated for treatment of uncomplicated acute illness due to influenza A and B virus in adults and pediatric patients 7 years and older who have been symptomatic for no more than 2 days. flublok-influenza-virus-vaccine-trivalent-recombinant-999830 Alters metabolism and excretion of drugs, particularly amantadine, zanamivir, and oseltamivir. oseltamivir and zanamivir. Oseltamivir Mechanism : Oseltamivir is a neuraminidase inhibitor. If you experience trouble breathing such as wheezing or shortness of breath, stop using zanamivir and get medical help right away. The H275Y (N1 numbering) or N294S (N2 numbering) oseltamivir resistance-associated . Found inside – Page 1279Zanamivir is only for oral inhalation via DISKHALER; do not attempt via nebulization or mechanical ventilation. ... 0.5–1.5 hr 4hr IV rapid end ofinfu- 4 hr sion Contraindications/Precautions Contraindicated in: Hypersensitivity; ... WARNINGS AND PRECAUTIONS Serious Warnings and Precautions 6-11 months: 25 mg PO q12hr x5 days. Trade Name: . See product monograph for additional details. This will draw the medication into your lungs. CrCl < 30 ml/min, oseltamavir) • Fructose/sorbitol intolerance (oseltamivir) • Patients allergic to milk protein (zanamivir) 8 . Alters metabolism and excretion of drugs, particularly amantadine, zanamivir, and oseltamivir. Contraindications. Found inside – Page 573Oseltamivir (Tamiflu) and zanamivir (Relenza) are neuraminidase inhibitors, effective against both influenza A and ... (Tamiflu) and zanamivir (Relenza) also can be used for chemoprophylaxis by individuals who have contraindications to ... Found inside – Page 606Treatment with oseltamivir and zanamivir should begin within 2 days of influenza symptom onset . Oseltamivir and zanamivir are contraindicated in patients with known hypersensitivity to them . • Assessment Before administering an ... There are four NAIs licensed in some parts of the world, zanamivir, oseltamivir, peramivir, and a long-acting NAI, laninamivir. Zanamivir is a reversible competitive inhibitor of influenza neuraminidase. Hypersensitivity to zanamivir or any of the components. Inhaled zanamivir is Contraindications and Precautions • Know hypersensitivity to oseltamivir, zanamivir or baloxavir • Underlying respiratory disease or asthma (zanamivir) • Severe renal dysfunction (est. Find information on Zanamivir (Relenza) in Davis's Drug Guide including dosage, side effects, interactions, nursing implications, mechanism of action, half life, administration, and more. The nature of the inhaler is that it's more difficult to use, and there are some contraindications, for example, in younger children, in pregnant women, and in . Found inside – Page 1801See also specific disorder in colorectal cancer prevention, 5t, 1690 contraindications to in heat stroke, 1610 COX-1/COX-2 ... 261 zanamivir contraindications and, 1406t Asthma action plan, 256 Astrocytoma, 1033t, 1657t Astroviruses, ... Contraindications XOFLUZA is contraindicated in patients with a history of hypersensitivity to baloxavir marboxil or any of its ingredients. Found inside – Page 257Zanamivir and oseltamivir : Inhibits neuroaminidase on surface of influenza virus , which alters virus particle ... ( interferon and ribavirin combination is 60 % effective ) Contraindications and precautions • Contraindicated in patients ... Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.. Oseltamivir is the first line option for the vast majority of pregnant women with influenza, including during seasons that are dominated by influenza A(H1N1). endstream endobj 47 0 obj <>>> endobj 48 0 obj <. Access your plan list on any device – mobile or desktop. Virion release from infected cells and spread with the respiratory tract are inhibited due to blockade of this enzyme. Preferred for use in pregnancy. Found inside – Page 348Clinical studies seem to indicate that these agents shorten the duration of influenza by only 1 or 2 days, when the virus is not resistant. Oseltamivir and zanamivir are used in the prevention and treatment of either influenza A or B. Contraindications. Zanamivir, an antiviral drug, is prescribed for the treatment of flu symptoms in patients for less than two days. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Contraindications and precautions (a) to commonly used vaccines . Canada residents can call a provincial poison control center. Do not double the dose to catch up. Side Effects: Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. Found inside – Page 551... prophylactic treatment with oseltamivir or zanamivir is a consideration when influenza is circulating in the community, particularly, in the event of nursing home outbreak.35 All residents without contraindications should receive ... STORAGE: Store at room temperature in a dry place. Household setting: 10 mg inhaled qDay for 10 days, Community outbreaks: Begin within 5 days of outbreak; may administer for up to 28 days, Start within 2 days of symptom onset; administer 2 doses on day 1, at least 2 hours apart, 10 mg inhaled q12hr for 5 days; may consider longer treatment for patients severely ill after 5 days, Household setting, >5 years: 10 mg inhaled qDay for 10 days; initiate within 48 hours of exposure, Community outbreak, 12-16 years: 10 mg inhaled qDay for 28 days; initiate within 5 days of outbreak, Household setting, >5 years old: 10 mg inhaled qDay for 10 days; initiate within 48 hours of exposure, Community outbreak, 12-16 years old: 10 mg inhaled qDay for 28 days; initiate within 5 days of outbreak, >7 years old: 10 mg inhaled q12hr for 5 days, Infection (ear, nose, & throat; 2% adults, 5% children), Allergic Reactions: Allergic or allergic-like reaction, including oropharyngeal edema, Psychiatric: Delirium, including symptoms such as altered level of consciousness, confusion, abnormal behavior, delusions, hallucinations, agitation, anxiety, nightmares, Neurologic: Seizures, vasovagal-like episodes shortly after administration, Skin: Facial edema; rash, including serious cutaneous reactions (eg, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis); urticaria, Hypersensitivity to zanamivir or formulation, including milk proteins, Administer only via the Diskhaler inhaler, Do not make into an extemporaneous solution for administration by nebulization or mechanical ventilation; fatality reports of hospitalized patients with influenza who received a solution made with Relenza Inhalation Powder administered by nebulization or mechanical ventilation; lactose in this formulation obstructs proper functioning of the equipment, Most effective when used within 24-48 hr of onset of symptoms, Not recommended for treatment or prophylaxis of influenza in individuals with underlying airway diseases (eg, asthma, COPD); serious cases of bronchospasm, including fatalities, have been reported during treatment, If use is considered for patient with underlying airway disease, carefully monitor respiratory function, closely observe patient, and have supportive therapy (ie, fast-acting bronchodilators) immediately available, Reports of abnormal behavior and delirium, Available data from published studies suggest that use during pregnancy is not associated with an increased risk of birth defects or adverse maternal or fetal outcomes; however, these studies are limited by their small sample sizes, which preclude a definitive assessment of the risk; there are risks to mother and fetus associated with influenza infection in pregnancy; in animal reproduction studies, no adverse developmental effects were observed with intravenous or subcutaneous administration of zanamivir at exposures 300 and 150 times, respectively, the systemic exposure at the maximum recommended human inhalation dose (MRHID) of 10 mg twice daily, Pregnant women are at higher risk of severe complications from influenza, which may lead to adverse pregnancy and/or fetal outcomes, including maternal death, stillbirths, birth defects, preterm delivery, low birth weight,and small for gestational age, There are no data on presence of zanamivir in human milk or effects on milk production; there are data from adults that have shown low oral bioavailability of zanamivir; limited data from postmarketing case reports have not suggested a safety concern in infants exposed to breast milk of mothers receiving therapy; drug was present in milk of lactating rats without effect on nursing pups; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from drug or underlying maternal condition.
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