peramivir

(redirected from Rapivab)

peramivir

(per-am-a-veer),

Rapivab

(trade name)

Classification

Therapeutic: antivirals
Pharmacologic: neuraminidase inhibitors
Pregnancy Category: C

Indications

Treatment of acute uncomplicated influenza in patients ≥18 yr who have had symptoms for two days or less.

Action

Inhibits the enzyme neuraminidase, which may alter virus particle aggregation and release.

Therapeutic effects

Reduced duration or prevention of flu-related symptoms.

Pharmacokinetics

Absorption: IV administration results in complete bioavailaility.
Distribution: Unknown.
Metabolism and Excretion: Mostly eliminated unchanged by kidneys (> 90%).
Half-life: 20.8 hr.

Time/action profile (blood levels)

ROUTEONSETPEAKDURATION
IVrapidend of infusionunknown

Contraindications/Precautions

Contraindicated in: None noted.
Use Cautiously in: Renal impairment (dose reduction required for CCr <50 mL/min); Geriatric: Consider age-related decrease in hepatic, renal, cardiac function, concurrent diseases and drug therapy; Obstetric: Use only if clearly needed; Lactation: Consider benefits of breastfeeding, need for peramivir and potential for adverse effects; Pediatric: Safety and effectiveness in children <18 yr has not been established.

Adverse Reactions/Side Effects

Central nervous system

  • insomnia
  • neuropsychiatric events

Cardiovascular

  • hypertension

Gastrointestinal

  • constipation

Dermatologic

  • skin reactions including stevens-johnson syndrome (life-threatening)

Interactions

Drug-Drug interaction

Avoid use of live attenuated influenza vaccine within 2 wk prior and 48 hr after peramivir; interference may occur.

Route/Dosage

Intravenous (Adults and Children ≥18 yr (CCr ≥50 mL/min) 600 mg.

Renal Impairment

Intravenous (Adults and Children ≥18 yr) CCr 30–49 mL/min—200 mg, CCr 10–29 mL/min—100 mg

Availability

Solution for IV use: 200 mg/ 20 mL vial

Nursing implications

Nursing assessment

  • Assess for signs and symptoms of influenza (fever, dyspnea, tachypnea, tachycardia, hypotension) prior to and at least daily during therapy. Patient must be symptomatic for no more than 2 days to receive peramivir.
  • Monitor for signs of neuropsychiatric symptoms (hallucinations, delirium, abnormal behavior) during therapy.
  • Assess patient for skin rash during therapy. Monitor closely and treat symptomatically.
  • Lab Test Considerations: May cause ↑ serum ALT, AST, glucose, creatine phosphokinase, and ↓ neutrophils.

Potential Nursing Diagnoses

Risk for infection (Indications)

Implementation

  • Intravenous Administration
  • Intermittent Infusion: Diluent: 0.9% NaCl or 0.45% NaCl, D5, or LR to a maximum volume of 100 mL. Solution is clear and colorless; do not administer solution that is discolored or contains a precipitate. Upon dilution, administer immediately or refrigerate up to 24 hrs; discard after 24 hrs. Allow to reach room temperature prior to administration.. Discard unused portion of single use vial.
  • Rate: Infuse over 15 to 30 min.
  • Y-Site Incompatibility: Do not administer simultaneously with any other medication.

Patient/Family Teaching

  • Explain purpose of peramivir to patient.
  • Advise patient to notify health care professional if signs and symptoms of anaphylaxis or rash, or neuropsychiatric symptoms occur.
  • Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

  • Resolution of sign and symptoms of influenza.
References in periodicals archive ?
RAPIVAB (peramivir injection), a viral neuraminidase inhibitor for the treatment of influenza, is BioCryst's first approved product and has received regulatory approval in the U.S., Canada, Australia, Japan, Taiwan, Korea and the European Union.
Antiviral agents such as oseltamivir (Tamiflu), zanamivir (Relenza), and peramivir (Rapivab) are now also increasingly being used for flu, especially for people who are at high risk for complications.
Treatment for flu includes common antiviral drugs like oseltamivir (available as a generic version or under the trade name Tamiflu), zanamivir (trade name Relenza), and peramivir (trade name Rapivab).
(14) Oseltamivir (Tamiflu) and zanamivir (Relenza) are the recommended prophylactic agents; a related intravenous medication, peramivir (Rapivab), is recommend for treatment only (see table 3 (14)).
The US Centers for Disease Control and Prevention has granted a USD34.7m contract to US-based BioCryst Pharmaceuticals for the supply of up to 50,000 doses over five years of its antiviral influenza therapy, RAPIVAB, it was reported on Monday.
Decrease in revenue compared to prior year was primarily due to the recognition of $2.3M of RAPIVAB product sales to commercial partners in 2016 that did not recur in 2017 and approximately a $2.5M decline in collaborative revenue in 2017, associated with a decrease in development activity under U.S.
Three neuraminidase inhibitor antiviral medications are approved and recommended for use in the United States during the 2017-18 influenza season: oral oseltamivir (available as a generic or under the trade name Tamiflu [Genentech, South San Francisco, California]), inhaled zanamivir (Relenza [GlaxoSmithKline, London, England]) and intravenous peramivir (Rapivab [Seqirus, Summit, New Jersey]).
Approved by the FDA in December of 2014, peramivir (Rapivab) is the only antiviral agent for influenza treatment to come to market in nearly 20 years.
The seven new anti-infectives and their indications are dalbavancin (Dalvance) for treatment of skin infections caused by gram-positive organisms; efinaconazole (Jublia), for treatment of fungal infections of the toenails; miltefosine (Impavido) for treatment of visceral, cutaneous, and mucosal infections by various Leishmania species; oritavancin (Orbactiv) for skin infections caused by gram-positive bacteria; peramivir (Rapivab), for acute uncomplicated influenza; tavaborole (Kerydin) for treatment of fungal infections of the toenails; and tedizolid (Sivextro) for treatment of bacterial skin infections.
Revenues of USD25.8m were collected for the three months ended 30 June 2015, up from revenues of USD1.5m in the second quarter of 2014, due to the partial recognition of the upfront payment from the licensing of RAPIVAB as well as a significant increase in collaboration revenue associated with BCX4430 development.
The seven new anti-infectives and their indications are dalbavancin (Dalvance) for treatment of skin infections caused by gram-positive organisms; efinaconazole (Jublia) for treatment of fungal infections of the toenails; miltefosine (Impavido) for treatment of visceral, cutaneous, and mucosal infections by various Leishmania species; oritavancin (Orbactiv) for skin infections caused by gram-positive bacteria; peramivir (Rapivab) for acute uncomplicated influenza; tavaborole (Kerydin) for treatment of fungal infections of the toenails; and tedizolid (Sivextro) for treatment of bacterial skin infections.