peramivir

Peramivir is an antiviral medication used to treat influenza A and B infections. It is a neuraminidase inhibitor that prevents release of newly formed virions from infected cells, reducing viral spread within the respiratory tract.

It is administered by intravenous infusion. In adults, a typical regimen is a single 600 mg IV dose; pediatric dosing is weight-based and adjusted for age and renal function. Peramivir dosing must be modified in renal impairment due to renal clearance.

Pharmacokinetics: after IV administration, peramivir achieves therapeutic plasma concentrations and is primarily eliminated unchanged by the kidneys. It has minimal hepatic metabolism.

Clinical use: In the United States, peramivir was approved by the FDA in 2014 for the treatment of acute uncomplicated influenza in adults and pediatric patients aged 2 years and older who have been symptomatic for no more than 2 days. It is often used for patients who cannot take oral oseltamivir or inhaled zanamivir, or in hospitalized or high-risk patients. It serves as an IV option when rapid systemic therapy is preferred.

Resistance and safety: Influenza strains with reduced susceptibility to neuraminidase inhibitors have been reported, but resistance to peramivir remains uncommon. Peramivir should be used in accordance with current guidelines and in the context of local resistance patterns. Common adverse events observed in trials include diarrhea, nausea, and rash; severe adverse events are rare.

Regulatory status: Peramivir was developed by BioCryst Pharmaceuticals and approved in the United States and other countries; it is used as an intravenous option within influenza treatment protocols.