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Overview
General Treatment
- Non-aspirin antipyretics/pain relievers for fever, myalgia and headaches
- Increased fluid intake
- Rest
- Antiviral therapy
Antiviral Agents
Neuraminidase inhibitors
Zanamivir (RelenzaŽ, a trademark of GlaxoWellcome) and oseltamivir (TamifluŽ, a trademark of Roche) are two recently approved antiviral neuraminidase inhibitors for the treatment of influenza A and B in adults and adolescents age 12 or older.
Zanamivir side effects
Side effects of zanamivir are comparable to placebo, although the safety of this drug has not been established in patients with chronic pulmonary disease.
Amantadine and Rimantadine
Amantadine (Symmetrel) and rimantadine (Flumadine) can be used to treat and prevent influenza A.
Side Effects of Amantadine and Rimantadine
Serious side effects are rare, although less serious side effects may include headache, dizziness, insomnia, irritability, trouble concentrating, and anxiety.
General Treatment:
- Give ONLY non-aspirin medicines such as acetaminophen (Tylenol) to children for fever, muscle aches and headaches.
- Ibuprofen-containing pain relievers (e.g., Advil) can be used for fever and pain in older adolescents and adults.
- The patient should drink plenty of fluids to prevent secretions from getting thick and increasing breathing problems.
- Rest is recommended to help the body fight the infection.
- Antiviral medicines can be used. See below.
- Antibiotics are of absolutely no use for influenza and are used only for bacterial complications after the acute phase is over. Read more about antibiotic resistance.
Antiviral Agents:
Neuraminidase Inhibitors
- Viral neuraminidase inhibitors help stop influenza virus replication and are active against influenza types A and B.
- Zanamivir (RelenzaŽ, a trademark of GlaxoWellcome) is the first neuraminidase inhibitor approved by the FDA for the treatment of flu A and B.
- Oseltamivir (TamifluŽ, a trademark of Roche), which is also a neuraminidase inhibitor, was approved by the FDA in the fall of 1999.
- Zanamivir and oseltamivir have been shown to shorten the duration of flu symptoms if given within 48 hours of symptom onset.
- Zanamivir, which is administered by the patient with a special inhaler, is approved for use in those 12 years of age and older.
- The normal dosage regimen for Relenza (zanamivir for inhalation) is two inhalations (2 x 5 mg) twice daily - approximately 12 hours apart - for 5 days.
- Oseltamivir is administered orally in pill form. For more information about the availability and dosage regimen of this drug, please contact your Roche representative.
Zanamivir Side Effects
- Side effects of zanamivir are comparable to placebo.
- The most common side effects are diarrhea, nausea and sinusitis.
- Safety and efficacy have not been established in patients with high-risk underlying medical conditions, such as chronic obstructive pulmonary disease (COPD) or asthma.
- Patients with asthma or COPD may experience bronchospasm with zanamivir, and should have a fast-acting inhaled bronchodilator available.
Amantadine and Rimantadine
- Amantadine (Symmetrel) and rimantadine (Flumadine) interfere with the reproduction cycle of influenza type A viruses. They are only effective against type A viruses and are not effective against type B.
- Amantadine and rimantadine can reduce the severity and shorten the duration of influenza A illness when administered within 48 hours of the onset of symptoms.
- Amantadine can be used to treat children 1 year old or older. Insufficient studies have been done to determine the efficacy of rimantadine treatment in children who are under 13 years of age. It is currently approved only for prophylaxis in children - not treatment.
- Persons with influenza-like illness should avoid contact with uninfected persons.
- Duration of treatment is usually 3-5 days during the course of the illness, or for 24-48 hours after the disappearance of signs and symptoms.
Amantadine and Rimantadine Side Effects:
- Amantadine and rimantadine may cause adverse (but not severe) reactions in some persons. Side effects may include headache, dizziness, insomnia, irritability, trouble concentrating, and anxiety. These symptoms go away quickly when medication is stopped.
- Rare but serious side effects may include marked behavioral changes, delirium, hallucinations, or seizures. These side effects have been associated with high plasma drug concentrations and are most often observed in elderly persons on prolonged treatment.
- Some persons with renal insufficiency, seizure disorders or certain psychiatric disorders who take more than the normal dosage of 200 mg of amantadine per day for over 5 days may also experience severe side effects. Clinical observations and studies provide evidence that lowering the dosage of amantadine in these persons will reduce the incidence and severity of such side effects.
- Modifications in dosage of amantadine or rimantadine may also be required for persons with impaired renal or hepatic function, the elderly, children, and persons with a history of seizures.
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