Rapivab (peramivir) is an antiviral medication that's used to treat the flu in people 6 months and older. It's given as a one-time intravenous (IV) infusion by a trained healthcare professional, typically in a hospital setting. It should only be used within 2 days of when symptoms started. Diarrhea is the most common side effect of this medication.
Flu treatment in people 6 months and older
Rapivab (peramivir) is a neuraminidase inhibitor. It's an antiviral medication that stops a protein in the influenza (flu) virus called neuraminidase. When this protein is blocked, the virus can't spread throughout your body.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Single dose
Can shorten the amount of time you have flu symptoms by 1 day
Possible option for people with kidney problems
Infused intravenously over 15 to 30 minutes
Can't prevent the flu, unlike some other neuraminidase inhibitors, such as Tamiflu (oseltamivir)
Needs to be taken within 2 days of flu symptoms
If you choose to get the live intranasal vaccine after a course of Rapivab (peramivir), wait at least 2 days after the end of your infusion.
You need to receive Rapivab (peramivir) within 48 hours of having flu symptoms. Otherwise, it might not work as well.
A Rapivab (peramivir) infusion takes about 15 to 30 minutes, so you might want to bring something to listen to or read to pass the time.
If you're on hemodialysis, make sure your prescriber knows your dialysis schedule. Rapivab (peramivir) should be given after dialysis.
Rapivab (peramivir) is only approved to treat the flu. To protect yourself from catching the flu, it's important to get a flu shot every year.
Rapivab (peramivir) might cause the live intranasal vaccine (FluMist) to not work well if it has been less than 2 weeks since your vaccination. If you've received the live flu vaccine, let your healthcare team know before your Rapivab (peramivir) infusion.
Rapivab (peramivir) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Prior severe allergic reaction to Rapivab (peramivir)
It's rare, but some people have had serious allergic and skin reactions to Rapivab (peramivir). Symptoms of such reactions can include hives, painful rash and blisters all over the body, difficulty breathing, and swelling of the face, lips, mouth, or throat. If this happens to you, the infusion will be stopped, and your care team will treat your reaction depending on the symptoms. This allergy should be added to your medication allergy list, and you shouldn't receive Rapivab (peramivir) again in the future. Get medical help if you notice any of the symptoms listed above once you get home, since allergic reactions can sometimes happen later.
Risk factors: Children
There have been reports of people (mostly children) having unusual thoughts and behaviors that can lead to harm to self or others after starting Rapivab (peramivir). The flu itself can also cause people to have unusual behaviors and hallucinations. It's difficult to know if these symptoms are caused by the medication or the flu. Look out for signs of unusual thoughts or behaviors and tell your prescriber if this happens to you.
Rapivab (peramivir) only treats influenza viruses. It won't prevent or treat bacterial infections. Sometimes, a person with a bacterial infection might have flu-like symptoms. In some cases, a person might have both the flu and an underlying bacterial infection. Your prescriber should examine you thoroughly and treat you with antibiotics if you have a bacterial infection.
Rapivab (peramivir) is given as an infusion through the veins in a hospital setting by a healthcare professional.
Adults and children age 13 or older: The typical dose is 600 mg infused over 15 to 30 minutes as a single dose.
Children age 6 months to 12 years old: Your child's pediatrician will determine the dose based on your child's body weight. The typical dose is 12 mg/kg (maximum of 600 mg) infused over 15 to 30 minutes as a single dose.
Your dose might be different if you have kidney problems.
Flu treatment in people 6 months and older
Flu treatment (flu types A and B) in people 2 weeks of age and older
Flu prevention (flu types A and B) in people 1 year of age and older
Flu treatment (flu types A and B) - age 7 years and older
Flu prevention (flu types A and B) - age 5 years and older
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BioCryst Pharmaceuticals, Inc. (2024). Rapivab- peramivir solution [package insert]. DailyMed.
Centers for Disease Control and Prevention. (2023). Influenza antiviral medications: Summary for clinicians.
Naem, S. (2001). The role of neuraminidase inhibitors in the treatment and prevention of influenza. Journal of Biomedicine & Biotechnology.
National Institute of Diabetes and Digestive and Kidney Disease. (2018). Hemodialysis.
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