Zanamivir (Relenza)
Zanamivir is a neuraminidase inhibitor approved for the treatment of seasonal influenza in patients greater than 7 years of age and for the prevention of seasonal influenza in patients greater than 5 years of age. Zanamivir is an orally inhaled powder administered by mouth via a special device and can be used as a single agent when Oseltamivir (Tamiflu) resistant influenza A (H1N1) virus is suspected.
Influenza Treatment and Chemoprophylaxis Dosing
| Antiviral Agent | Age Group (Years) | |||||
|---|---|---|---|---|---|---|
| 1-6 | 7-9 | 10-12 | 13-64 | ≥65 | ||
| Zanamivir | Treatment, Influenza A and B |
N/A | 10 mg (2 inhalations) twice daily | 10 mg (2 inhalations) twice daily | 10 mg (2 inhalations) twice daily | 10 mg (2 inhalations) twice daily |
| Prophylaxis, Influenza A and B |
Ages 1-4 N/A | Ages 5-9 10 mg (2 inhalations) once daily | 10 mg (2 inhalations) once daily | 10 mg (2 inhalations) once daily | 10 mg (2 inhalations) once daily | |
| Oseltamivir | Treatment, Influenza A and B |
Dose varies by child's weight | Dose varies by child's weight | Dose varies by child's weight | 75 mg twice daily | 75 mg twice daily |
| Prophylaxis, Influenza A and B |
Dose varies by child's weight | Dose varies by child's weight | Dose varies by child's weight | 75 mg once daily | 75 mg once daily | |
| Amantadine | Treatment, Influenza A |
5 mg/kg body weight/day up to 150 mg in 2 divided doses | 5 mg/kg body weight/day up to 150 mg in 2 divided doses | 100 mg twice daily | 100 mg twice daily | Up to 100 mg once daily |
| Prophylaxis, Influenza A |
5 mg/kg body weight/day up to 150 mg in 2 divided doses | 5 mg/kg body weight/day up to 150 mg in 2 divided doses | 100 mg twice daily | 100 mg twice daily | Up to 100 mg once daily | |
| Rimantadine | Treatment, Influenza A |
N/A | N/A | N/A | 100 mg twice daily | 100 mg once daily |
| Prophylaxis, Influenza A |
5 mg/kg body weight/day up to 150 mg in 2 divided doses | 5 mg/kg body weight/day up to 150 mg in 2 divided doses | 100 mg twice daily | 100 mg twice daily | 100 mg once daily | |
Moxifloxacin (Avelox) Report
Moxifloxacin is contraindicated in the following patients:
- Impaited liver function (Child Pugh C)
- Transaminase increase greater than 5 times the upper limit of normal
Echinocandins
Micafungin (Mycamine) has been added to the formulary and will be automatically substituted when other echinocandins are ordered (e.g. caspofungin and anidulafungin).
The dosing for micafungin is as follows:
| Indication | Recommended Daily Dose |
|---|---|
| Treatment of Candidemia, Acute Disseminated Candidiasis, Candida Peritonitis and Abscesses | 100 mg daily for approximately 10-15 days |
| Treatment of Esophageal Candidiasis | 150 mg daily for approximately 10-15 days |
| Prophylaxis of Candidal Infections in HSCT Recipients | 50 mg |