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(trade name)


Therapeutic: antivirals
Pharmacologic: neuraminidase inhibitors
Pregnancy Category: C


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


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

Therapeutic effects

Reduced duration or prevention of flu-related symptoms.


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)

IVrapidend of infusionunknown


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


  • hypertension


  • constipation


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


Drug-Drug interaction

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


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


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)


  • 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 ?
3M of RAPIVAB product sales to commercial partners in 2016 that did not recur in 2017 and approximately a $2.
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.
Stonehouse said, BioCryst built up supplies of Rapivab in anticipation of the FDA approval and will start shipping immediately.
M2 EQUITYBITES-June 19, 2015-BioCryst Pharmaceuticals licenses global rights to commercialise Rapivab to CSL
United States-based BioCryst Pharmaceuticals has licensed global rights to commercialise influenza treatment, Rapivab, to CSL, an Australia-based biopharmaceutical company, it was reported on Thursday.
M2 PHARMA-June 19, 2015-BioCryst Pharmaceuticals licenses global rights to commercialise Rapivab to CSL
The FDA gave approval on December 23, 2014, for Rapivab (peramivir) to treat flu in adults who have been symptomatic for only over two days, suggesting that regulatory compliance problems at the contract manufacturer for the drug - which resulted in an FDA warning letter - have been resolved.
M2 EQUITYBITES-December 23, 2014-BioCryst Pharmaceuticals' RAPIVAB receives approval from US FDA
The United States Food and Drug Administration has granted approval to United States-based BioCryst Pharmaceuticals' RAPIVAB (peramivir injection) for the treatment of acute uncomplicated influenza in patients 18 years and older who have been symptomatic for no more than two days, it was reported yesterday.
M2 PHARMA-December 23, 2014-BioCryst Pharmaceuticals' RAPIVAB receives approval from US FDA
M2 EQUITYBITES-December 22, 2014-BioCryst wins US FDA's approval for RAPIVAB for treating acute uncomplicated influenza
Pharmaceutical company BioCryst Pharmaceuticals (NasdaqGS:BCRX) disclosed on Monday the receipt of approval from the US Food and Drug Administration (FDA) for RAPIVAB for the treatment of acute uncomplicated influenza.