China
Africa
Explore chapters and articles related to this topic
Respiratory Diseases
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Aref T. Senno, Ryan K. Brannon
The neuraminidase inhibitors, oseltamivir and zanamivir, are modestly effective against both influenza A (including H1N1) and influenza B. Although the manufacturer has conducted no studies to assess safety of these medications for pregnant women, available risk-benefit data suggest that pregnant women with suspected or confirmed influenza should receive prompt antiviral therapy. Information about peramivir in pregnancy is limited to a handful of cases treated under the FDA's Emergency Use Authorization, and no recommendation can be made about this drug.
Antiviral therapeutics for viral infections of the central nervous system
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Peramivir shares the same basic mechanism of action as zanamivir and oseltamivir. Peramivir has a strong affinity for influenza neuraminidase as well as a slow off rate; this feature and its pharmacokinetic properties enable one-time dosing in uncomplicated infections [86].
Peramivir
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
On the other hand, treatment of adults infected with influenza A (H3N2) viruses susceptible to both drugs yielded a valid comparison of peramivir and standard treatment with oseltamivir. Of 328 study subjects with laboratory-confirmed A (H3N2) infection due to peramivir-susceptible viruses, median IC50 values of NA were 0.82 nM (range: 0.45–2.13) and for oseltamivir 0.62 nM (range: 0.27–1.84). A total of 112 subjects had been randomized to receive a single intravenous dose of peramivir 300 mg, 108 subjects were given 600 mg, and 108 subjects were given oseltamivir for 5 days. The median times to alleviation of symptoms were not different among the three treatment groups: 69.9 hours (95% CI: 54.4–97.1), 70.6 hours (95% CI: 47.7–91.9), and 75.1 hours (63.4–92.6), respectively. The therapeutic effect appeared to have been mediated by an antiviral effect in the 300 mg peramivir group because the time-weighted change in baseline titer was significantly reduced from day 1 to day 2 (p = 0.04) and from day 1 to day 3 (p = 0.02) but not from day 1 to day 8 (p = 0.06). Both in recipients of 600 mg peramivir and oseltamivir, no significant reductions were observed in titer at day 2, 3, or 8 compared to baseline. This study demonstrated no difference among the three treatment groups; an antiviral effect was observed in the 300 mg peramivir treatment group.
The protective effect of 999 XiaoErGanMao granules on the lungs and intestines of influenza A virus-infected mice
Published in Pharmaceutical Biology, 2023
Yuan-zhen Hao, Li-feng Cen, Ting Wang, Tong Yi, Xun-long Shi, Hui-juan Duan, Zhi Dai, Hai-yan Zhu, Jian-guo Tang
Although several anti-influenza virus drugs have been discovered and applied, drug resistance continues to emerge as the influenza virus continues to change abnormally, which reduces the effectiveness of the drugs. In addition, these anti-influenza drugs have various gastrointestinal adverse reactions. For example, the most common adverse reactions of oseltamivir are nausea and vomiting; zanamivir may cause bronchospasm; peramivir may cause diarrhea. The results of a genetic meta-analysis (Dobson et al. 2015) suggested that oseltamivir in adults with influenza accelerates time to clinical remission and reduces the risk of lower respiratory tract complications and hospital admissions, but increases the incidence of nausea and vomiting. Researchers are also concerned about whether the adverse reactions of these drugs outweigh their therapeutic effects. Therefore, TCM with milder efficacy is deemed a preferable treatment option for influenza infection in China.
The use of antiviral drugs in children
Published in Journal of Chemotherapy, 2022
Marco Antonio Motisi, Agnese Tamborino, Sara Parigi, Luisa Galli, Maurizio de Martino, Elena Chiappini
Neuraminidase promotes the release of the virion from the infected host cell. Neuraminidase inhibitors are active against influenza type A and B viruses. Zanamivir is approved by the EMA for inhalation by children over the age of five. The dose is similar to that indicated for adults: two 5 mg inhalations twice daily for five days. Oseltamivir is approved by the EMA from birth age, administered twice daily for five days. Both drugs are also approved for post-exposure prevention. A systematic review involving 74 studies carried out in 2012 showed a reduction in the duration of influenza symptoms, complication rates and mortality with zanamivir and oseltamivir [10]. This success and the presence of viral strains with neuraminidase mutations that may affect their binding to oseltamivir led to the subsequent development of two more drugs in this class: peramivir, which can be administered intravenously in a single dose and is approved by the EMA for treatment in children over the age of two but not for post-exposure prophylaxis, and laninamavir, which has been approved in Japan for use in adults and children since 2010 and can be administered by inhalation in a single dose. Laninamivir has also proven effective against oseltamivir-resistant virus strains in adults [11]. It is used by inhalation as a single dose (40 mg over the age of ten and 20 mg under the age of ten), and is also approved in Japan for post-exposure prophylaxis.
Pediatric drug safety signal detection of non-chemotherapy drug-induced neutropenia and agranulocytosis using electronic healthcare records
Published in Expert Opinion on Drug Safety, 2019
Ran Wei, Lu-Lu Jia, Yun-Cui Yu, Xiao-Lu Nie, Zi-Yang Song, Duan-Fang Fan, Yue-Feng Xie, Xiao-Xia Peng, Zhi-Gang Zhao, Xiao-Ling Wang
The association between oseltamivir and neutropenia was identified as a potential new signal. To the best of our knowledge, this was not mentioned in the SPCs and had not been reported in the published literature regardless of the age of the patients. Oseltamivir phosphate is a neuraminidase inhibitor [16] which can inhibit neuraminidase activity by binding to the active site of several influenza virus A and B strains. It is the only antiviral treatment recommended for influenza in young children over the age of 1 year. Although it has been used worldwide [17], there is still some controversy regarding its safety in children for lack of evidence. However, the signal of DIN has been detected for another neuraminidase inhibitor as peramivir. Peramivir has the similar antiviral mechanism as oseltamivir, which is recommended for treatment of influenza in young children over the age of 2 years. The clue of the association between oseltamivir and neutropenia present in this study needs further study.