Download Recommended Antiviral Medications for Prevention and Treatment

Recommended Antiviral Medications for Prevention and Treatment of Influenza (September 2008)
Prescription Coveragec
a
5 mg blisters of
oral powder for
inhalation via
Diskhaler
Prophylaxis of
influenza A and B
in patients aged
≥5 years;
treatment of
influenza A and B
in patients aged
≥7 years
All
30mg QD
30mg BID
45mg QD
45mg BID
60mg QD
60mg BID
75mg QD
75mg BID
10mg QD
10mg BID
Veteran Affairs
Prophylaxis and
≤ 15 kg
treatment of
15-23 kg
influenza A and B
23-40 kg
in patients aged
> 40 kg
≥1 year
Midwest Health Plan
30, 45, and
75mg oral
capsules;
12mg/mL oral
powder for
suspension
Prevention
Treatment
(≥ 10 Days) (5-Day Course)
$101 for 10 2QL
• Prophylaxis in children aged 1-12 years is
capsules;
recommended for 10 days • Prophylaxis in
$51 for 25mL
patients aged ≥13 years is recommended for at
least 10 days (up to 6 weeks for community
outbreaks) • Most effective if started within 48
hours of onset of illness or exposure • Reduce
dose by half for patients with CrCl between 10 and
30 mL/min • Pregnancy category C • Most
common side effects are nausea and vomiting
2
2
2QL PA
NF
2
• Prophylaxis is recommended for 10 days for
household settings and 28 days for community
outbreaks • Most effective if started within 48
hours of onset of illness or exposure • If
scheduled at the same time, patients should use
their inhaled bronchodilator first before taking
zanamivir • Patients should be instructed about
the correct use of the inhalation device • Not
recommended for treatment in patients with
underlying airway disease due to limited data •
Contains lactose • Pregnancy category C • Most
common side effects are cough, diarrhea and
nasal symptoms
2
2
2QL PA
NF
NF
Comments
Cost
b
3QL
$67 for 1
inhaler
(20 blisters)
BlueCaid
Weight
MI Medicaid
Zanamivir
®
(Relenza )
Indicationsa
BCN
Oseltamivir
(Tamiflu®)
Strength(s)
UM Employees
Antiviral
Agent
BCBSM
Dosage
Antiviral therapy should be considered during periods of increased influenza activity in the community as:
• Prophylaxis for people at high risk during the 2 weeks after influenza vaccination (after the second dose for children aged <9 years who have not previously been vaccinated);
• Prophylaxis for people at high risk for whom influenza vaccine is contraindicated (e.g., persons allergic to eggs or other components of the vaccine);
• Prophylaxis for people with immune deficiencies or those who might not respond to vaccination (e.g., persons infected with HIV or receiving immunosuppressive medications);
• Prophylaxis for people who are unvaccinated and are living with and/or caring for high risk people or infants aged <6 months (e.g, health care workers, household members);
• Treatment for people with influenza who live with or care for high risk people;
• Treatment for people with influenza who are at higher risk for influenza complications; and
• Treatment for people presenting with influenza symptoms within 48 hours who want to decrease the duration or severity of their symptoms and transmission of influenza to others at higher risk for complications.
b
Cost is based on the average wholesale price as listed on the Amerisouce Price Lookup.
c
Coverage levels are obtained from the respective prescription drug plan formularies. Code definitions are: 1 = generic; 2 = preferred brand; 3 = nonpreferred brand; NF = non-formulary; QL = quatity limits apply; PA = prior authorization required.
Questions and/or comments about this information may be directed to Annie Sy, PharmD ([email protected]).
References:
1. Fiore AE, Shay DK, Broder K, et al. Prevention and control of influenza. August 8, 2008. Centers for Disease Control and Prevention. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5707a1.htm. Accessed September 10, 2008.
2. Oseltamivir. Drug Facts and Comparisons . Drug Facts and Comparisons 4.0 [online]. 2008. Available from Wolters Kluwer Health, Inc. Accessed September 10, 2008.
3. Zanamivir. Drug Facts and Comparisons . Drug Facts and Comparisons 4.0 [online]. 2008. Available from Wolters Kluwer Health, Inc. Accessed September 10, 2008.