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Drug overview for RAPIVAB (PF) (peramivir/pf):
Generic name: peramivir/PF (per-AM-i-vir)
Drug class: Antiviral - Influenza A
Therapeutic class: Anti-Infective Agents
Peramivir is a neuraminidase inhibitor antiviral active against influenza A and B viruses.
No enhanced Uses information available for this drug.
Generic name: peramivir/PF (per-AM-i-vir)
Drug class: Antiviral - Influenza A
Therapeutic class: Anti-Infective Agents
Peramivir is a neuraminidase inhibitor antiviral active against influenza A and B viruses.
No enhanced Uses information available for this drug.
DRUG IMAGES
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The following indications for RAPIVAB (PF) (peramivir/pf) have been approved by the FDA:
Indications:
Influenza due to influenza virus type A
Professional Synonyms:
None.
Indications:
Influenza due to influenza virus type A
Professional Synonyms:
None.
The following dosing information is available for RAPIVAB (PF) (peramivir/pf):
No enhanced Dosing information available for this drug.
Peramivir is administered by IV infusion.
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| RAPIVAB 200 MG/20 ML VIAL | Maintenance | Adults infuse 600 mg over 15-30 minute(s) by intravenous route once |
No generic dosing information available.
The following drug interaction information is available for RAPIVAB (PF) (peramivir/pf):
There are 1 contraindications.
These drug combinations generally should not be dispensed or administered to the same patient. A manufacturer label warning that indicates the contraindication warrants inclusion of a drug combination in this category, regardless of clinical evidence or lack of clinical evidence to support the contraindication.
| Drug Interaction | Drug Names |
|---|---|
| Influenza Virus Vaccine Live/Selected Antiviral Agents SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: Amantadine,(1) oseltamivir,(2) rimantadine,(3) zanamivir,(4) and baloxavir,(5) may inactivate the intranasal live influenza virus vaccine, preventing the body from developing an immune response. CLINICAL EFFECTS: Administration of amantadine,(1) oseltamivir,(2) rimantadine,(3) zanamivir,(4) and baloxavir,(5) may render the intranasal live influenza virus vaccine ineffective. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturers of amantadine,(1) oseltamivir,(2) rimantadine,(3) zanamivir(4), baloxavir(5), and the intranasal live influenza virus vaccine(6) state that these agents should not be initiated within 2 weeks of the administration of the intranasal live influenza virus vaccine and that the vaccine should not be administered within 48 hours of the discontinuation of these agents. Inactivated influenza vaccine may be used at any time.(1) DISCUSSION: Because antiviral drugs such as amantadine,(1) oseltamivir,(2) rimantadine,(3) zanamivir,(4) and baloxavir (5) inhibit the replication of live viruses, these agents may interfere with the efficacy of the intranasal live influenza virus vaccine. |
FLUMIST TRIVALENT 2024-2025 |
There are 1 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Sodium Iodide I 131/Myelosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Sodium iodide I 131 can cause depression of the hematopoetic system. Myelosuppressives and immunomodulators also suppress the immune system.(1) CLINICAL EFFECTS: Concurrent use of sodium iodide I 131 with agents that cause bone marrow depression, including myelosuppressives or immunomodulators, may result in an enhanced risk of hematologic disorders, including anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia. Bone marrow depression may increase the risk of serious infections and bleeding.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of sodium iodide I 131 states that concurrent use with bone marrow depressants may enhance the depression of the hematopoetic system caused by large doses of sodium iodide I 131.(1) Sodium iodide I 131 causes a dose-dependent bone marrow suppression, including neutropenia or thrombocytopenia, in the 3 to 5 weeks following administration. Patients may be at increased risk of infections or bleeding during this time. Monitor complete blood counts within one month of therapy. If results indicate leukopenia or thrombocytopenia, dosimetry should be used to determine a safe sodium iodide I 131 activity.(1) DISCUSSION: Hematologic disorders including death have been reported with sodium iodide I 131. The most common hematologic disorders reported include anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia.(1) |
HICON, SODIUM IODIDE I-131 |
There are 0 moderate interactions.
The following contraindication information is available for RAPIVAB (PF) (peramivir/pf):
Drug contraindication overview.
*Known serious hypersensitivity (e.g., anaphylaxis, erythema multiforme, Stevens-Johnson syndrome) to peramivir or any ingredient in the formulation.
*Known serious hypersensitivity (e.g., anaphylaxis, erythema multiforme, Stevens-Johnson syndrome) to peramivir or any ingredient in the formulation.
There are 0 contraindications.
There are 5 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Chronic kidney disease stage 3A (moderate) GFR 45-59 ml/min |
| Chronic kidney disease stage 3B (moderate) GFR 30-44 ml/min |
| Chronic kidney disease stage 4 (severe) GFR 15-29 ml/min |
| Chronic kidney disease stage 5 (failure) GFr<15 ml/min |
| Hemodialysis with high-flux membrane |
There are 5 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Acute cognitive impairment |
| Delirium |
| Neutropenic disorder |
| Proteinuria |
| Suicidal ideation |
The following adverse reaction information is available for RAPIVAB (PF) (peramivir/pf):
Adverse reaction overview.
Adverse effects occurring in 2% or more of adults or pediatric patients receiving peramivir include diarrhea, vomiting, constipation, insomnia, and hypertension.
Adverse effects occurring in 2% or more of adults or pediatric patients receiving peramivir include diarrhea, vomiting, constipation, insomnia, and hypertension.
There are 6 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. |
Abnormal hepatic function tests Neutropenic disorder |
| Rare/Very Rare |
|---|
|
Anaphylaxis Erythema multiforme Exfoliative dermatitis Stevens-johnson syndrome |
There are 10 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Diarrhea |
Delirium Insomnia Vomiting |
| Rare/Very Rare |
|---|
|
Behavioral disorders Constipation Hallucinations Hyperglycemia Hypertension Skin rash |
The following precautions are available for RAPIVAB (PF) (peramivir/pf):
Safety and efficacy of peramivir have not been established in pediatric patients younger than 6 months of age. Safety and efficacy of peramivir for the treatment of acute, uncomplicated influenza in pediatric patients 6 months to 17 years of age have been established and are supported by evidence from adequate and well-controlled trials of the drug in adults and additional data from a randomized, open-label, active-controlled trial in pediatric patients in this age group (86 patients 6 months to 12 years of age and 21 patients 13-17 years of age received peramivir). Data from the open-label pediatric study indicated that the safety profile of the drug in pediatric patients 6 months to 17 years of age generally is similar to that reported in adults. The only adverse effects reported in 2% or more of pediatric patients treated with peramivir and not reported in adults were vomiting and proteinuria.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
Data regarding use of peramivir in pregnant women are insufficient to determine whether the drug is associated with a risk of adverse developmental outcomes. In animal reproduction studies, no adverse embryofetal effects were observed in pregnant rats when peramivir was administered by IV injection once daily at the maximum feasible dosage, resulting in systemic drug exposures approximately 8 times those in humans at the recommended dosage. However, when peramivir was administered to pregnant rats by continuous IV infusion, fetal abnormalities (reduced renal papilla, dilated ureters) were observed.
In rabbits, peramivir administered by IV injection once daily during organogenesis at exposures 8 times those in humans at the recommended dosage resulted in developmental toxicity (abortion or premature delivery) at maternally toxic doses. Pregnant women are at increased risk for severe complications from influenza, which may lead to adverse pregnancy and/or fetal outcomes including maternal death, stillbirths, birth defects, preterm delivery, low birthweight, and small size for gestational age. CDC states that only limited data are available regarding use of peramivir for the treatment of influenza in pregnant women. Oseltamivir is the preferred antiviral for the treatment of suspected or confirmed influenza in women who are pregnant or up to 2 weeks postpartum.
In rabbits, peramivir administered by IV injection once daily during organogenesis at exposures 8 times those in humans at the recommended dosage resulted in developmental toxicity (abortion or premature delivery) at maternally toxic doses. Pregnant women are at increased risk for severe complications from influenza, which may lead to adverse pregnancy and/or fetal outcomes including maternal death, stillbirths, birth defects, preterm delivery, low birthweight, and small size for gestational age. CDC states that only limited data are available regarding use of peramivir for the treatment of influenza in pregnant women. Oseltamivir is the preferred antiviral for the treatment of suspected or confirmed influenza in women who are pregnant or up to 2 weeks postpartum.
It is not known whether peramivir is distributed into human milk, affects milk production, or has any effects on breast-fed infants. Peramivir is distributed into milk in rats. (See Distribution under Pharmacokinetics.) The benefits of breast-feeding and the importance of peramivir to the woman should be considered along with potential adverse effects on the breast-fed child from the drug or from the underlying maternal condition.
Clinical studies of peramivir did not include sufficient numbers of patients 65 years of age and older to determine whether geriatric patients respond differently than younger adults. Other reported clinical experience has not identified differences in responses between geriatric and younger adults. Peramivir pharmacokinetics in geriatric adults are similar to the pharmacokinetics of the drug reported in younger adults; therefore, dosage adjustments based solely on age are not necessary in adults 65 years of age and older.
The following prioritized warning is available for RAPIVAB (PF) (peramivir/pf):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for RAPIVAB (PF) (peramivir/pf)'s list of indications:
| Influenza due to influenza virus type A | |
| J09 | Influenza due to certain identified influenza viruses |
| J09.x | Influenza due to identified novel influenza A virus |
| J09.x1 | Influenza due to identified novel influenza A virus with pneumonia |
| J09.x2 | Influenza due to identified novel influenza A virus with other respiratory manifestations |
| J09.x3 | Influenza due to identified novel influenza A virus with gastrointestinal manifestations |
| J09.x9 | Influenza due to identified novel influenza A virus with other manifestations |
| J10 | Influenza due to other identified influenza virus |
| J10.0 | Influenza due to other identified influenza virus with pneumonia |
| J10.00 | Influenza due to other identified influenza virus with unspecified type of pneumonia |
| J10.01 | Influenza due to other identified influenza virus with the same other identified influenza virus pneumonia |
| J10.08 | Influenza due to other identified influenza virus with other specified pneumonia |
| J10.1 | Influenza due to other identified influenza virus with other respiratory manifestations |
| J10.2 | Influenza due to other identified influenza virus with gastrointestinal manifestations |
| J10.8 | Influenza due to other identified influenza virus with other manifestations |
| J10.81 | Influenza due to other identified influenza virus with encephalopathy |
| J10.82 | Influenza due to other identified influenza virus with myocarditis |
| J10.83 | Influenza due to other identified influenza virus with otitis media |
| J10.89 | Influenza due to other identified influenza virus with other manifestations |
| J11 | Influenza due to unidentified influenza virus |
| J11.0 | Influenza due to unidentified influenza virus with pneumonia |
| J11.00 | Influenza due to unidentified influenza virus with unspecified type of pneumonia |
| J11.08 | Influenza due to unidentified influenza virus with specified pneumonia |
| J11.1 | Influenza due to unidentified influenza virus with other respiratory manifestations |
| J11.2 | Influenza due to unidentified influenza virus with gastrointestinal manifestations |
| J11.8 | Influenza due to unidentified influenza virus with other manifestations |
| J11.81 | Influenza due to unidentified influenza virus with encephalopathy |
| J11.82 | Influenza due to unidentified influenza virus with myocarditis |
| J11.83 | Influenza due to unidentified influenza virus with otitis media |
| J11.89 | Influenza due to unidentified influenza virus with other manifestations |
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