Influenza Vaccine Contraindications

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Generic name: Zanamivir
Brand name: Relenza

DRUGS Class and Mechanism: Zanamivir is an inhaled medicine used to treat and prevent influenza or flu. Zanamivir removes and reduces the spread of influenza A and B, the virus that causes influenza. It does this by blocking the action of neuraminidase, an enzyme produced by the virus that allows the virus to spread from infected cells to healthy cells. By preventing the spread of virus from cell to cell, the symptoms and duration of influenza infection are reduced. On average, zanamivir reduced the duration of symptoms by one day if treatment is started within forty-eight hours after the onset of symptoms. The FDA has approved zanamivir in July 1999.

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Generic Available: No

PRESCRIPTION: Yes

PREPARATIONS: Powder for inhalation 5 mg

STORAGE: Zanamivir should be stored at room temperature, 15-30 C (59-86 F)

Hint: Zanamivir is used for the treatment of infection by influenza viruses, including H1N1, in individuals seven years or older with symptoms of more than two days. It is also used to prevent influenza in adults and children five and older.

Dosage: Zanamivir is administered by oral inhalation. The recommended dose is two inhalations (5mg per inhalation) twice daily (approximately 12 hours apart) for five days. Two doses (separated by at least two hours) should be administered on the first day of treatment. For best results, treatment should begin as soon as symptoms develop. The recommended dose for the prevention of influenza in a domestic setting is 10 mg once daily for 10 days. The recommended dose for preventing influenza in the community is 10 mg once daily for 28 days.

INTERACTIONS: Zanamivir may potentially interfere with the action of injections of live attenuated vaccine against the flu because zanamivir prevents viral replication. Therefore, live attenuated vaccine against influenza should not be administered within 2 weeks before or 48 hours after administration of zanamivir.

PREGNANCY: The Centers for Disease Control (CDC) indicates that pregnancy is not a cons-indication for the use of zanamivir in pregnant women because the benefits outweigh the risks.

Lactation: It is not known whether zanamivir is excreted in breast milk. However, the CDC recommends that women who develop the flu after childbirth should be treated with antiviral drugs.

SIDE EFFECTS: The most common side effects are headache, diarrhea, nausea, cough, vomiting and dizziness. Sinusitis, ear, nose and throat infections can occur. Skin reactions, allergic reactions, bronchospasm, and behavioral disorders have been reported.

Patients with respiratory diseases respiratory problems can when treated with zanamivir due to irritation of the respiratory tract by particles from the inhaler. If breathing problems occur, zanamivir should be discontinued. Patients with asthma or other respiratory problems that make them susceptible to inhaled particles should have a rapid-acting inhaled bronchodilator to treat breathing problems that can occur when zanamivir is used.

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