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<sup>1</sup> <b>oseltamivir renal dosing in adults:</b><br>
• CrCl 61-90 mL/min: 75 mg PO once daily<br>
• CrCl 31-60 mL/min: 30 mg PO once daily<br>
• CrCl 11-30 mL/min: 30 mg PO every other day<br>
• ESRD on hemodialysis only (CrCl ≤10 mL/min): 30 mg PO after alternate HD cycles (can administer initial dose prior to start of dialysis)<br>
• CAPD (CrCl ≤10 mL/min): 30 mg PO once weekly immediately after dialysis exchange
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<sup>2</sup> <b>oseltamivir adverse events:</b> nausea, vomiting, HA. Postmarketing reports of serious skin rxns and sporadic, transient neuropsychiatric events.
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<sup>3</sup> <b>zanamivir renal dosing:</b> no dose adjustment recommended for pts w/ renal impairment.
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<sup>4</sup> <b>Zanamivir not recommended</b> if underlying resp dz (asthma, COPD, etc.) or allergy to lactose or milk protein. <br><br>
<b>zanamivir adverse events:</b> bronchospasm risk, esp. if underlying airways dz; sinusitis, and dizziness. Postmarketing reports of serious skin rxns and sporadic, transient neuropsychiatric events.
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<sup>5</sup> <b>baloxavir marboxil adverse events:</b> none more common than placebo in clinical trials.
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Don’t administer w/ dairy products, calcium-fortified beverages, polyvalent cation-containing laxatives, antacids, or oral supplements (e.g., calcium, iron, magnesium, selenium, or zinc).
<br><br>
One study of baloxavir postexposure prophylaxis (PEP) of flu in household members reported 86% lower risk of lab-confirmed flu among those who received baloxavir PEP vs. placebo.
• CrCl 61-90 mL/min: 75 mg PO once daily<br>
• CrCl 31-60 mL/min: 30 mg PO once daily<br>
• CrCl 11-30 mL/min: 30 mg PO every other day<br>
• ESRD on hemodialysis only (CrCl ≤10 mL/min): 30 mg PO after alternate HD cycles (can administer initial dose prior to start of dialysis)<br>
• CAPD (CrCl ≤10 mL/min): 30 mg PO once weekly immediately after dialysis exchange
<br><br>
<sup>2</sup> <b>oseltamivir adverse events:</b> nausea, vomiting, HA. Postmarketing reports of serious skin rxns and sporadic, transient neuropsychiatric events.
<br><br>
<sup>3</sup> <b>zanamivir renal dosing:</b> no dose adjustment recommended for pts w/ renal impairment.
<br><br>
<sup>4</sup> <b>Zanamivir not recommended</b> if underlying resp dz (asthma, COPD, etc.) or allergy to lactose or milk protein. <br><br>
<b>zanamivir adverse events:</b> bronchospasm risk, esp. if underlying airways dz; sinusitis, and dizziness. Postmarketing reports of serious skin rxns and sporadic, transient neuropsychiatric events.
<br><br>
<sup>5</sup> <b>baloxavir marboxil adverse events:</b> none more common than placebo in clinical trials.
<br><br>
Don’t administer w/ dairy products, calcium-fortified beverages, polyvalent cation-containing laxatives, antacids, or oral supplements (e.g., calcium, iron, magnesium, selenium, or zinc).
<br><br>
One study of baloxavir postexposure prophylaxis (PEP) of flu in household members reported 86% lower risk of lab-confirmed flu among those who received baloxavir PEP vs. placebo.
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Give antiviral chemoprophylaxis (PO oseltamivir or inhaled zanamivir) to all non-ill residents (regardless of vaccination status) during influenza outbreak.