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Drug overview for RELENZA (zanamivir):
Generic name: ZANAMIVIR (za-NAM-i-vir)
Drug class: Antiviral - Influenza A
Therapeutic class: Anti-Infective Agents
Zanamivir, a sialic acid derivative, is a neuraminidase inhibitor antiviral that is pharmacologically related to oseltamivir and active against influenza A and B viruses.
No enhanced Uses information available for this drug.
Generic name: ZANAMIVIR (za-NAM-i-vir)
Drug class: Antiviral - Influenza A
Therapeutic class: Anti-Infective Agents
Zanamivir, a sialic acid derivative, is a neuraminidase inhibitor antiviral that is pharmacologically related to oseltamivir and active against influenza A and B viruses.
No enhanced Uses information available for this drug.
DRUG IMAGES
RELENZA 5 MG DISKHALER
The following indications for RELENZA (zanamivir) have been approved by the FDA:
Indications:
Influenza prevention
Influenza
Professional Synonyms:
Flu
Grip
Influenza prophylaxis
Indications:
Influenza prevention
Influenza
Professional Synonyms:
Flu
Grip
Influenza prophylaxis
The following dosing information is available for RELENZA (zanamivir):
No enhanced Dosing information available for this drug.
Zanamivir powder for inhalation is administered only by oral inhalation using the inhaler (Diskhaler(R)) provided by the manufacturer. Zanamivir has been administered IV+, but a parenteral dosage form of the drug is not available in the US. Zanamivir powder for inhalation mustnotbe used to prepare an extemporaneous solution and mustnotbe administered using a nebulizer or mechanical ventilator. (See Administration Precautions under Cautions.)
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| RELENZA 5 MG DISKHALER | Maintenance | Adults inhale 2 puffs (10 mg) by inhalation route once daily |
No generic dosing information available.
The following drug interaction information is available for RELENZA (zanamivir):
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 0 severe interactions.
There are 0 moderate interactions.
The following contraindication information is available for RELENZA (zanamivir):
Drug contraindication overview.
*History of hypersensitivity reaction to zanamivir or any ingredient in the formulation (e.g., milk protein contained in the lactose vehicle).
*History of hypersensitivity reaction to zanamivir or any ingredient in the formulation (e.g., milk protein contained in the lactose vehicle).
There are 2 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Exacerbation of chronic obstructive pulmonary disease |
| Severe persistent asthma |
There are 1 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Chronic obstructive pulmonary disease |
There are 4 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 |
| Hallucinations |
| Seizure disorder |
The following adverse reaction information is available for RELENZA (zanamivir):
Adverse reaction overview.
Adverse effects occurring in 1-3% or more of adults and children 12 years of age or older include diarrhea; nausea; vomiting; nasal signs and symptoms; bronchitis; sinusitis; cough; ear, nose, and throat infections; headache; and dizziness. Adverse effects occurring in up to 5% of children 5-12 years of age include ear, nose, and throat infections; vomiting; nausea; and diarrhea. Bronchospasm and allergic-like reactions, including oropharyngeal edema and serious rash, have been reported. Some adverse effects may be related to the lactose vehicle (contains milk proteins) used in the powder for oral inhalation formulation.
Adverse effects occurring in 1-3% or more of adults and children 12 years of age or older include diarrhea; nausea; vomiting; nasal signs and symptoms; bronchitis; sinusitis; cough; ear, nose, and throat infections; headache; and dizziness. Adverse effects occurring in up to 5% of children 5-12 years of age include ear, nose, and throat infections; vomiting; nausea; and diarrhea. Bronchospasm and allergic-like reactions, including oropharyngeal edema and serious rash, have been reported. Some adverse effects may be related to the lactose vehicle (contains milk proteins) used in the powder for oral inhalation formulation.
There are 15 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. |
Arthralgia Sore throat |
| Rare/Very Rare |
|---|
|
Anaphylaxis Bronchospastic pulmonary disease Cardiac arrhythmia Delirium Dyspnea Erythema multiforme Pharyngeal edema Seizure disorder Skin rash Stevens-johnson syndrome Syncope Toxic epidermal necrolysis Urticaria |
There are 17 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Cough Dizziness Nasal congestion Sinusitis |
Chills Fever Nausea |
| Rare/Very Rare |
|---|
|
Acute abdominal pain Agitation Behavioral disorders Facial edema Fatigue Hallucinations Malaise Myalgia Nightmares Symptoms of anxiety |
The following precautions are available for RELENZA (zanamivir):
Safety and efficacy for treatment of influenza have not been established in children younger than 7 years of age. Some clinical studies evaluating zanamivir have included children 5-6 years of age+; however, there is some evidence that the drug is not as effective in these children as in older children and adults. Safety and efficacy for prophylaxis of influenza have not been established in children younger than 5 years of age.
Safety and efficacy in adolescents and children 5 years of age or older for prophylaxis of influenza are similar to adults. Some young children may have suboptimal inspiratory flow rates through the drug delivery system (Diskhaler(R)). When considering use of zanamivir in pediatric patients, clinicians should carefully evaluate the ability of the child to use the inhaler.
Children should receive zanamivir only under adult supervision and with close attention to proper use of the inhaler. The supervising adult should be instructed on proper use of the inhaler.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Safety and efficacy in adolescents and children 5 years of age or older for prophylaxis of influenza are similar to adults. Some young children may have suboptimal inspiratory flow rates through the drug delivery system (Diskhaler(R)). When considering use of zanamivir in pediatric patients, clinicians should carefully evaluate the ability of the child to use the inhaler.
Children should receive zanamivir only under adult supervision and with close attention to proper use of the inhaler. The supervising adult should be instructed on proper use of the inhaler.
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
Available data from published studies suggest that the use of zanamivir during pregnancy is not associated with an increased risk of birth defects or adverse maternal or fetal outcomes; however, these studies had several limitations (e.g., lack of specific analyses for zanamivir, possible exposure and outcome misclassifications, small sample sizes) which preclude a definitive assessment of the risk. In animal reproduction studies, no adverse maternal or embryofetal effects were observed in rats or rabbits treated with IV zanamivir at dosages that resulted in systemic exposures approximately 300 times those in humans receiving 10 mg of the drug twice daily by oral inhalation. 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. Oseltamivir is the preferred antiviral for the treatment of suspected or confirmed influenza or prevention of influenza in women who are pregnant or up to 2 weeks postpartum.
It is not known whether zanamivir is distributed into human milk, affects milk production, or has any effects on breast-fed infants. Zanamivir is distributed into milk in rats. The benefits of breast-feeding and the importance of zanamivir 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.
Safety and efficacy for treatment of influenza in geriatric adults 65 years of age or older is similar to that reported in younger adults. Safety and efficacy for prophylaxis of influenza in geriatric adults 65 years of age or older in household or community settings are similar to that reported in younger adults. Efficacy has not been established for prophylaxis of influenza in geriatric individuals in nursing home settings.
The possibility exists of greater sensitivity to the drug in some older individuals. Some geriatric patients may need assistance with the drug delivery system (Diskhaler(R)).
The possibility exists of greater sensitivity to the drug in some older individuals. Some geriatric patients may need assistance with the drug delivery system (Diskhaler(R)).
The following prioritized warning is available for RELENZA (zanamivir):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for RELENZA (zanamivir)'s list of indications:
| Influenza | |
| 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 |
| Influenza prevention | |
| Z20.828 | Contact with and (suspected) exposure to other viral communicable diseases |
Formulary Reference Tool