| Drug/available formulations | Dosage | FDA-approved indications | FDA pregnancy category and contraindications | Possible adverse effects | ||
|---|---|---|---|---|---|---|
| Oseltamivir (Tamiflu) | Children 1 to 12 years Prophylaxis | Influenza prophylaxis in patients 1 year and older Treatment of uncomplicated acute influenza in patients 1 year and older who have been symptomatic for no more than 2 days | Category C (preferred treatment in pregnancy) Contraindicated in patients with known serious hypersensitivity to oseltamivir or any component of the product | Nausea, vomiting, allergic reactions (rash, facial swelling) Rarely, serious skin reactions (toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme) and transient neuropsychiatric events(self-injury or delirium; causal relationship has not been established) | ||
| Capsules (30, 45, and 75 mg) Intravenous form (in clinical trials) Powder for oral suspension | ≤ 33 lb (≤ 15 kg): 30 mg once daily for 10 days* > 33 to 51 lb (> 15 to 23 kg): 45 mg once daily for 10 days* > 51 to 88 lb (> 23 to 40 kg): 60 mg once daily for 10 days* > 88 lb (> 40 kg): adult dosage | |||||
| Treatment | ||||||
| ≤ 33 lb (= 15 kg): 30 mg twice daily for 5 days | ||||||
| > 33 to 51 lb (> 15 to 23 kg): 45 mg twice daily for 5 days | ||||||
| > 51 to 88 lb (> 23 to 40 kg): 60 mg twice daily for 5 days | ||||||
| > 88 lb (> 40 kg): adult dosage | ||||||
| Adults and children 13 years and older | ||||||
| Prophylaxis | ||||||
| 75 mg once daily for at least 10 days* | ||||||
| Patients with impaired renal function: 75 mg every other day for at least 10 days* | ||||||
| Treatment | ||||||
| 75 mg twice daily for 5 days | ||||||
| Patients with impaired renal function: 75 mg once daily for5 days | ||||||
| Zanamivir (Relenza) | Children | Influenza prophylaxis in patients 5 years and older Treatment of influenza in patients 7 years and older who have been symptomatic for no more than 2 days | Category C Contraindicated in patients with milk allergy or history of allergic reaction to zanamivir or any component of the product Not recommended in patients with underlying reactive airways disease (e.g., asthma, chronic obstructive pulmonary disease); may worsen pulmonary status in these patients | Cough, nasal and throat discomfort, bronchospasm, worsening of pulmonary status, allergic reactions(including anaphylaxis) | ||
| Intravenous form (not FDA approved) Powder for inhalation, supplied in blister packs of 10 5-mg doses and packaged with a Diskhaler (should not be used with any other inhalation device) | Prophylaxis | |||||
| 5 years and older: adult dosage | ||||||
| Treatment | ||||||
| 7 years and older: adult dosage | ||||||
| Adults | ||||||
| Prophylaxis | ||||||
| 10 mg (2 5-mg inhalations) once daily for 10 days | ||||||
| Treatment | ||||||
| 10 mg (2 5-mg inhalations) twice daily for 5 days | ||||||
| Peramivir‡ | NA | NA | NA | Diarrhea, nausea, vomiting, neutropenia | ||
| Intravenous form (single-use vials) | ||||||
| Amantadine | Children | Prophylaxis and treatment of influenza A virus infection in patients 1 year and older Treatment of parkinsonism and drug-induced extrapyramidal reactions | Category C Contraindicated in patients with known hypersensitivity to amantadine or rimantadine | Central nervous system effects (e.g., insomnia, lightheadedness, difficulty concentrating, delirium, seizures, hallucinations) Suicidal ideation has been reported (more common in patients taking other agents with central nervous system effects) | ||
| Capsules and tablets (100 mg) Oral solution | Prophylaxis | |||||
| 1 to 9 years of age: 5 mg per kg per day (up to 150 mg per day) in 2 divided doses for at least 10 days after exposure§ | ||||||
| 10 years and older (≥ 88 lb [≥ 40 kg]): adult dosage | ||||||
| Treatment | ||||||
| 1 to 9 years of age: 5 mg per kg per day (up to 150 mg per day) in 2 divided doses for 5 days | ||||||
| 10 years and older (≥ 88 lb [≥ 40 kg]): adult dosage | ||||||
| Adults | ||||||
| Prophylaxis | ||||||
| 100 mg twice daily for at least 10 days after exposure§ | ||||||
| Creatinine clearance less than 50 mL per minute: 100 mg once daily for 10 days after exposure | ||||||
| Treatment | ||||||
| 100 mg twice daily for 5 days | ||||||
| 65 years and older: 100 mg once daily for 5 days | ||||||
| Creatinine clearance less than 50 mL per minute: 100 mg once daily for 5 days | ||||||
| Rimantadine (Flumadine) Tablets (100 mg) | Children | Influenza A virus prophylaxis in children 1 to 16 years of age Prophylaxis and treatment of influenza A virus infection in adults and adolescents 17 years and older | Category C Contraindicated in patients with known hypersensitivity to amantadine or rimantadine | Similar to amantadine, but less common | ||
| Prophylaxis∥ | ||||||
| 1 to 9 years of age: 5 mg per kg per day (up to 150 mg per day) in 2 divided doses for 5 to 7 days after exposure | ||||||
| 10 years and older: adult dosage | ||||||
| Adults | ||||||
| Prophylaxis∥ | ||||||
| 100 mg twice daily for 5 to 7 days after exposure | ||||||
| 65 years and older: 100 mg once daily for 5 to 7 days after exposure | ||||||
| Treatment | ||||||
| 100 mg twice daily for 5 days | ||||||
| 65 years and older: 100 mg once daily for 5 days | ||||||
| Ribavirin | As specified in an approved research protocol | Approved for use only in patients with respiratory syncytial virus infection and in those with hepatitis C (in combination with other agents), but has been used in hospitalized immunocompromised patients with influenza Should be used only in critical patients and on a case-by-case basis as part of an approved research protocol | Category X See package insert for contraindications and FDA boxed warnings | Cardiovascular events, arrhythmias, hematologic derangements, seizures, asthenia, worsening of pulmonary status | ||
| Intravenous form (available through the FDA as part of an approved research protocol) | ||||||
| Powder for nebulizer solution (Virazole) | ||||||
| Capsules and tablets (for treatment of hepatitis C) | ||||||