Trade Name(s)

  • Rapivab

Ther. Class.

Pharm. Class.
neuraminidase inhibitors


Treatment of acute uncomplicated influenza in patients who have had symptoms for 2 days or less.


Inhibits the enzyme neuraminidase, which may alter virus particle aggregation and release.

Therapeutic Effect(s):

Reduced duration or prevention of flu-related symptoms.


Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism and Excretion: Mostly eliminated unchanged by kidneys (> 90%).

Half-life: 20.8 hr.

TIME/ACTION PROFILE (blood levels)

IVrapidend of infusionunknown


Contraindicated in:

  • Hypersensitivity.

Use Cautiously in:

  • Renal impairment (dose ↓ required for CCr <50 mL/min)
  • Geri:  Consider age-related ↓ in hepatic, renal, cardiac function, concurrent diseases and drug therapy;
  • OB:  Use only if clearly needed
  • Lactation: Consider benefits of breastfeeding, need for peramivir, and potential for adverse effects;
  • Pedi:  Safety and effectiveness not established.

Adverse Reactions/Side Effects

CNS: insomnia, neuropsychiatric events

CV: hypertension

GI: constipation



* CAPITALS indicate life-threatening.
Underline indicate most frequent.



Avoid use of  live attenuated influenza vaccine  within 2 wk prior and 48 hr after peramivir; interference may occur.


IV (Adults and Children ≥13 yr): 600 mg x 1 dose.

IV (Children 2–12 yr): 12 mg/kg (max = 600 mg) x 1 dose.

Renal Impairment 
IV (Adults and Children ≥13 yr):  CCr 30–49 mL/min– 200 mg x 1 dose;  CCr 10–29 mL/min– 100 mg x 1 dose.

Renal Impairment 
IV (Children 2–12 yr):  CCr 30–49 mL/min– 4 mg/kg (max = 600 mg) x 1 dose;  CCr 10–29 mL/min– 2 mg/kg (max = 600 mg) x 1 dose.


Solution for injection: 10 mg/mL


  • Assess for signs and symptoms of influenza (fever, dyspnea, tachypnea, tachycardia, hypotension) prior to and at least daily during therapy. Patient must be symptomatic for no more than 2 days to receive peramivir.
  • Monitor for signs of neuropsychiatric symptoms (hallucinations, delirium, abnormal behavior) during therapy.
  • Assess patient for skin rash during therapy. Monitor closely and treat symptomatically.

Lab Test Considerations:

May cause ↑ serum ALT, AST, glucose, creatine kinase, and ↓ neutrophils.

Potential Diagnoses


IV Administration

  • Intermittent Infusion:   Diluent:   0.9% NaCl or 0.45% NaCl, D5, or LR to a maximum volume of 100 mL. Solution is clear and colorless; do not administer solution that is discolored or contains a precipitate. Upon dilution, administer immediately or refrigerate up to 24 hrs; discard after 24 hrs. Allow to reach room temperature prior to administration. Discard unused portion of single use vial.
  • Rate: Infuse over 15 to 30 min.
  • Y-Site Incompatibility: Do not administer simultaneously with any other medication.

Patient/Family Teaching

  • Explain purpose of peramivir to patient.
  • Advise patient to notify health care professional if signs and symptoms of anaphylaxis or rash, or neuropsychiatric symptoms occur.
  • Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

Resolution of sign and symptoms of influenza.

peramivir is a sample topic from the Davis's Drug Guide.

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Anesthesia Central is an all-in-one web and mobile solution for treating patients before, during, and after surgery. This collection of drug, procedures and test information is derived from Davis’s Drug, MGH Clinical Anesthesia Procedures, Pocket Guide to Diagnostic Tests, and MEDLINE Journals. .