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Pharmacologic class: Neuraminidase inhibitor
Therapeutic class: Antiviral
Pregnancy risk category C
Inhibits influenza virus neuraminidase, an enzyme essential for viral replication
Powder for inhalation: 5 mg/blister
Indications and dosages
➣ Prevention of influenza
Adults and children ages 5 and older: Prophylaxis in the household setting, 2 inhalations (10 mg) once daily for 10 days. Prophylaxis during community outbreaks, 2 inhalations (10 mg) once daily for 28 days.
➣ Influenza virus A or B
Adults and children ages 7 and older: Two oral inhalations (5 mg/inhalation) b.i.d. for 5 days
• History of allergic reaction to components of drug, including lactose milk proteins
Use cautiously in:
• chronic obstructive pulmonary disease, asthma, lactose intolerance
• concurrent use of live attenuated intranasal influenza vaccine (Don't administer until 48 hours after cessation of zanamivir and don't administer zanamivir until 2 weeks after administration of live attenuated influenza vaccine, unless medically indicated.)
• pregnant or breastfeeding patients
• children younger than age 7 (safety not established).
• Give two doses on day 1, spaced at least 2 hours apart. On subsequent days, space doses 12 hours apart, and give at approximately same time each day.
CNS: headache, dizziness
EENT: sinusitis, EENT infections
GI: nausea, vomiting, diarrhea
Respiratory: bronchitis, cough
Other: allergic reaction
• Assess respiratory status. Watch closely for signs and symptoms of declining respiratory function.
• Explain therapy to patient. Demonstrate how to use Diskhaler device.
• Tell patient to take drug exactly as prescribed for as long as directed, even if symptoms improve.
• If patient is also taking an inhaled bronchodilator, advise him to take bronchodilator before zanamivir.
• Emphasize that drug doesn't prevent spread of influenza to others.
• Instruct patient to immediately report worsening respiratory symptoms.
• As appropriate, review other significant adverse reactions.