Drug reference
peramivir
Neuraminidase inhibitor · Antiviral (Anti-influenza)
Neuraminidase inhibitorAntiviral (Anti-influenza)ATC J05AH03
CDSCO approvedATC J05AH03
EXCRETION
—
not curated
INTERACTIONS
—
none in our sources
PREGNANCY
—
not curated
Mechanism
Peramivir has a mechanism of action similar to other neuraminidase inhibitors, causing a conformational change within the enzyme’s active site and inhibiting its activity. This leads to viral aggregation at the cell surface and reduced virus spread.
Indications
treatment of acute uncomplicated influenza in patients 18 years and older who have been symptomatic for no more than 2 daysacute, uncomplicated influenza for individuals who cannot take oral or inhaled medicationsTreatment of influenza A and B virusesComplicated influenza infections in hospitalized patientsTreatment for high-risk groups (children <2 years, adults >65 years, patients with chronic conditions, immunosuppressed individuals, pregnant women, women who have delivered infants ≤2 weeks previously, patients <19 years old receiving long-term aspirin treatment, Native Americans/Alaska Natives, morbidly obese individuals, and residents of nursing homes or chronic-care facilities)Considered for patients who cannot tolerate or absorb oral or enterically administered oseltamivir
Dosing
- Adult
- Single 600 mg dose via intravenous infusion over 15 to 30 min
- Pediatric
- Licensed for individuals ≥2 years of age
- Renal adjustment
- 200 mg for Clcr between 30 and 49 mL/min; 100 mg for Clcr of 10 to 29 mL/min
Pharmacokinetics
Half-life
20 h
Protein binding
<30%
Metabolism
Not significantly metabolized in humans (not a substrate for CYPs, nor a substrate or inhibitor of P-glycoprotein)
Excretion
Largely (90%) via renal excretion of the unchanged compound
Side effects
Common
diarrhea (>2%)decreased neutrophil counts (10.4%)
Serious
- hypersensitivity reactions (e.g., Stevens-Johnson syndrome and erythema multiforme)
- neuropsychiatric events (e.g., hallucinations, delirium, and abnormal behavior)
Related guidelines
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Sources: Goodman & Gilman 14e, Harrison 22e·Verified: 2026-05-10 · House clinical team