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Peramivir injection in the treatment of acute influenza: a review of the literature

Authors Wester A, Shetty AK

Received 19 January 2016

Accepted for publication 3 May 2016

Published 22 August 2016 Volume 2016:9 Pages 201—214

DOI https://doi.org/10.2147/IDR.S86460

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Varun Dwivedi

Peer reviewer comments 2

Editor who approved publication: Professor Suresh Antony

Ashley Wester,1 Avinash K Shetty2

1Department of Pharmacy, 2Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA

Abstract: Influenza virus infection is a major cause of morbidity and mortality in children and adults globally. Seasonal epidemics are common due to the rapid virus evolution, whereas the frequent emergence of antigenic variants can result in pandemics and sporadic/endemic avian influenza virus infections. Although annual vaccination is the mainstay for influenza prevention and control, the use of antiviral agents must be considered for treatment and prophylaxis against influenza. Currently available antiviral drugs include neuraminidase inhibitors (NAIs), adamantanes, and a novel polymerase inhibitor (favipiravir). Peramivir is a recently US Food and Drug Administration-approved NAI for the treatment of acute uncomplicated influenza in adults. The chemical structure of peramivir allows it to bind to the influenza neuraminidase with much higher affinity than oseltamivir. Peramivir is effective against a variety of influenza A and B subtypes and has a lower half-maximal inhibitory concentration compared to other NAIs in in vitro studies. Peramivir can be administered intravenously, a route that is favorable for hospitalized, critically ill patients with influenza. The long half-life of peramivir allows for once-daily dosing. The drug is eliminated primarily by the kidneys, warranting dose adjustments in patients with renal dysfunction. Studies have assessed the clinical efficacy of peramivir for treatment of pandemic influenza A (H1N1). Although anecdotal evidence supports the use of peramivir in pediatric patients, pregnant women, and hospitalized patients with severe influenza receiving continuous renal replacement therapy and extracorporeal membrane oxygenation, well-designed, controlled clinical trials should be conducted in order to assess its clinical efficacy in these patient populations.

Keywords: peramavir, influenza, pharmacokinetics, safety, efficacy, review

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