Influenza

NB: It is essential to check resistance patterns of the current season’s influenza strains.

  • Amantadine is active against susceptible Influenza A (not active against Influenza B).

  • Oseltamivir and zanamivir are active against susceptible Influenza A and B.

  • Antiviral prophylaxis indicated:

    • for control of Influenza outbreaks among high risk residents of institutions

    • as an adjunct to late vaccination of people at high risk

    • as sole agent for prophylaxis during an influenza outbreak in high risk individuals where vaccination cannot be given

    • as a supplement to vaccination in high risk individuals with impaired immune response to the vaccine

    • for unvaccinated persons who provide hands on patient care for high risk individuals during an outbreak.

  • Duration of antiviral prophylaxis is 10 days, or duration of outbreak, whichever is longer.

NB: Antiviral prophylaxis should NOT replace annual influenza vaccination.

Oseltamivir

Age Weight/Creatinine Clearance Dosage
1-12 years ≤ 15kg 30mg PO daily
> 15-23kg 45 mg PO daily
> 23-40kg 60mg PO daily
> 40kg 75mg PO daily
≥ 13 years > 60 mL/min 75mg PO daily
> 30-60mL/min 30mg PO daily
10-30 mL/min 30mg PO q2days

Zanamivir

Age Dosage
≥ 7 years 10mg inhaled by mouth daily

Amantadine

No Renal Impairment

Age Dosage
1-9 years 5mg/kg divided once or twice daily (max daily dose 150mg)
10-64 years 200mg divided once or twice daily
≥ 65 years 100mg once daily

 

Renal Impairment

Creatinine clearance (mL/min/1.73m²) Dosage with capsules Daily dosage with solution (10mg/mL)
10-64 years old > 65 years old > 65 years old

≥ 80

100mg twice daily

100mg once daily

100mg (10mL)

60-79

Alternating daily doses of 200mg and 100mg

Alternating daily doses of 100mg and 50mg

75mg (7.5mL)

40-59

100mg once daily

100mg every 2 days

50mg (5mL)

30-39

200mg twice weekly

100mg twice weekly

25mg (2.5mL)

20-29

100mg three times/week

50mg three times/week

25mg (2.5mL)

10-19

Alternating weekly doses of 200mg and 100mg

Alternating weekly doses of 100mg and 50mg

No daily dose