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Rapivab

peramivir
Used for Flu
Used for Flu

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.

Reviewed by:
reviewer
Kristianne Hannemann, PharmD
reviewer
Allison Gourley, PharmD
Last reviewed on December 9, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageCostAlternativesLatest newsReferencesPricesMedicare
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What is Rapivab (peramivir)?

What is Rapivab (peramivir) used for?

How Rapivab (peramivir) works

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.

Drug Facts

Common BrandsRapivab
Drug ClassAntiviral
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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What are the side effects of Rapivab (peramivir)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Diarrhea (8%)

Other Side Effects

  • Constipation
  • Difficulty falling asleep

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Serious allergic reactions: rash, hives, difficulty breathing, swelling of the face, lips, mouth, or throat
  • Serious skin reactions: painful rash, blisters, peeling skin
  • Abnormal thoughts and behaviors: hallucinations, feeling confused and disoriented

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
  • Redness, blistering, peeling, or loosening of the skin, including inside the mouth

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Rapivab (peramivir)

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Pros

Single dose

Can shorten the amount of time you have flu symptoms by 1 day

Possible option for people with kidney problems

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Cons

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

pharmacist-tips

Pharmacist tips for Rapivab (peramivir)

pharmacist

  • 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.

              faqs

              Frequently asked questions about Rapivab (peramivir)

              Can Rapivab (peramivir) be injected intramuscularly?
              No, Rapivab (peramivir) is given as an intravenous (IV) infusion. It must be given by a trained healthcare professional.
              Does Rapivab (peramivir) prevent flu?
              Unlike some other neuraminidase inhibitors, such as Tamiflu (oseltamivir), Rapivab (peramivir) is only FDA-approved to treat the flu. It's prescribed to help people recover faster by stopping the flu virus from spreading in the body. This medication is given as a one-time IV infusion and works best if started within 2 days of symptoms. If you want to prevent the flu, some ways to protect yourself include getting a flu shot, washing your hands often, and if possible, avoiding close contact with those who are sick with the flu. Talk with your healthcare team if you have more questions about flu prevention.
              Does Rapivab (peramivir) cause constipation?
              It can. Some people reported constipation as a side effect during clinical studies. To minimize this side effect, drink enough fluids to stay hydrated and eat foods high in fiber to prevent constipation. If you become constipated, ask your healthcare professional about appropriate treatment options.
              Does Rapivab (peramivir) cause skin rash?
              Although not common, Rapivab (peramivir) can cause a skin rash as a side effect. In rare cases, it might trigger serious skin reactions like Stevens-Johnson syndrome (SJS), which can cause fever, chills, muscle aches, rash that spreads, and blistering and peeling skin. If you have SJS, you need treatment right away because this condition can become life-threatening. Tell your prescriber if you notice a rash after taking this medication and they can let you know about next steps.
              Can Rapivab (peramivir) be used in pregnancy?
              More research is needed to understand whether Rapivab (peramivir) is safe to receive during pregnancy. If you catch the flu while pregnant, let your healthcare team know right away and they can talk with you about the risks and benefits of different treatment options. If you need an antiviral medication and are able to take medications by mouth, your care team might recommend Tamiflu (oseltamivir) instead because it's the first-choice antiviral medication to treat flu during pregnancy.
              Is Rapivab (peramivir) an antibiotic?
              No, Rapivab (peramivir) is an antiviral and only works against the influenza virus. Antibiotics are used to fight bacterial infections.
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              What are the risks and warnings for Rapivab (peramivir)?

              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-warning

              Allergic and serious skin reactions

              • 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-warning

                Unusual thoughts and behaviors

                • 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.

                  risk-warning

                  Not for treating bacterial infections

                  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.

                  dosage

                  Rapivab (peramivir) dosage forms

                  Typical dosing for Rapivab (peramivir)

                  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.

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                  alternatives

                  What are alternatives to Rapivab (peramivir)?

                  There are a number of medications that your doctor can prescribe in place of Rapivab (peramivir). Compare a few possible alternatives below.
                  Rapivab (peramivir)
                  Used for:
                  $959.80 Lowest GoodRx priceView Prices
                  Tamiflu (oseltamivir)
                  Used for:

                  • 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

                  $24.72 Lowest GoodRx priceView Prices
                  Relenza (zanamivir)
                  Used for:

                  • Flu treatment (flu types A and B) - age 7 years and older

                  • Flu prevention (flu types A and B) - age 5 years and older

                  $66.64 Lowest GoodRx priceView Prices

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                  References

                  Best studies we found

                  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.

                  View All References (1)

                  National Institute of Diabetes and Digestive and Kidney Disease. (2018). Hemodialysis.

                  GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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