Zanamavir Intravenous Infusion for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

  • Zanamivir  is indicated for the treatment of complicated and potentially life-threatening influenza A or B virus infection  when:

    • The patient's influenza virus is known or suspected to be resistant to anti-influenza medicinal products other than zanamivir (ref 1) OR
    • Other anti-viral medicinal products for treatment of influenza, are not suitable for the individual patient.  (ref 1,3) AND the patient has multi-organ involvement, or requires intensive care (ref 2)
    • Use should be supervised by a consultant clinical microbiologist/virologist or infectious diseases consultant and a consultant in intensive care medicine (ref 3) 
  • Treatment should commence as soon as possible and usually within 6 days of the onset of symptoms (ref 2)
  • See under 'Dose' for adjustments required in renal impairment

Available preparations

Dectova 200mg per 20ml (10mg/mL) vial

Reconstitution

Already in solution

Infusion fluids

Sodium Chloride 0.9% ONLY

Methods of intravenous administration

Intermittent intravenous infusion (using an electronically controlled infusion device)

  • Add the required dose to infusion fluid to make a final volume of 100ml or 250ml

    • Withdraw and discard a volume (equal to the volume of drug solution) from the infusion bag
  • The infusion bag should be gently manipulated by hand to ensure it is mixed thoroughly
  • Administer over 30 minutes (ref 1,3)
  • See also under Further information- re administration undiluted

Dose in adults

Usual dose

  • Give 600mg every 12 hours for 5 to 10 days (ref 2)

Renal impairment

  • See Table 1 below
Table 1: Doses in renal impairment
CrCl (mL/min) Initial dose Maintenance dose Maintenance dose schedule
50 to < 80 600mg 400mg every 12 hours Begin Maintenance dose 12 hours AFTER initial dose
30 to < 50 600mg 250mg every 12 hours
15 to < 30 600mg 150mg every 12 hours Begin Maintenance dose 24 hours AFTER initial dose
< 15 600mg 60mg (SIXTY) every 12 hours Begin Maintenance dose 48 hours AFTER initial dose

Hepatic impairment

  • No dose modification is required

Elderly

  • No dose modification is required

Monitoring

  • Monitor temperature, blood pressure, heart rate, respiratory rate, O2 saturation, behavioural changes, and injection site reaction (ref 3)
  • Can increase ALT and AST and cause hepatocellular injury (1%)
  • Common side effects are rash, ALT/AST increase and diarrhoea (ref 1,3)

Further information

  • Can give undiluted over 30 minutes via electronically controlled device
  • No dose adjustment is required for elderly patients

Storage

Store below 250C

References

SPC - Dectova  01/10/2019
1. Zanamivir - BNF, accessed online via medicines complete  17/01/2024
2. Guidance on the use of antiviral agents for the treatment and prophylaxis of Influenza, HSE, December 2023
3. Injectable medicines guide NHS Medusa Injectable Medicines Guide, downloaded 17/01/2024

Therapeutic classification

Direct Acting Antivirals - Neuraminidase inhibitors - J05AH