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Treat Influenza and Avian Bird Flu
 ZANAMIVIR
- ORAL INHALER
(zuh-NAM-uh-veer)
COMMON BRAND NAME(S):
Relenza
USES:
This medication is used to treat illness (symptoms) caused by the flu
virus (influenza).
OTHER USES:
Zanamivir may also be used to prevent the flu (e.g., in household
members exposed to a flu sufferer)
 HOW
TO USE:
Inhale the medication through the mouth, generally 2 inhalations twice
daily (approximately 12 hours apart) for 5 days, or as directed by your
doctor. When possible, take two doses (each dose is 2 inhalations) on
the first day of treatment, waiting at least two hours between doses.
Learn all usage instructions in the product package and ask your doctor
or pharmacist for advice if you are unclear about any of the
information.
Check the mouthpiece to be sure it is free of foreign objects before
use. Load the medication disk into the diskhaler. Puncture one
medication blister. Keep diskhaler level so that medication will not
spill. Breathe out through the mouth, put the mouthpiece into your mouth
and breathe in deeply. Hold your breath for a few seconds so that the
medication will stay in your lungs. If you have been directed to inhale
a second time, advance to the next medication blister and repeat the
process. Once you have inhaled the number of times prescribed, replace
the cover of the diskhaler.
This medication works best when the amount of medicine in your body is
kept at a constant level. Take the drug at evenly spaced intervals
(e.g., every 12 hours).
 Continue
to take this medication until the full prescribed amount is finished,
even if symptoms improve. Stopping the medication too early may allow
the virus to continue to grow, resulting in a relapse of the infection.
It is recommended that this medication be used within 48 hours of the
start of flu symptoms.
If you have breathing problems (asthma or COPD) and are scheduled to use
inhaled bronchodilators (e.g., albuterol) at the same time as zanamivir,
use the asthma medication before using zanamivir. Ask your doctor or
pharmacist for more details.
SIDE EFFECTS:
Nausea, diarrhea or headache may occur. If any of these effects persist
or worsen, notify your doctor promptly.
Tell your doctor immediately if you have any of these unlikely but
serious side effects: cough, runny nose, sore throat, fever, fatigue,
muscle or joint pain, ear pain.
An allergic reaction to this drug is unlikely, but seek immediate
medical attention if it occurs. Symptoms of an allergic reaction
include: rash, itching, swelling, dizziness, trouble breathing.
If you notice other effects not listed above, contact your doctor or
pharmacist.
 PRECAUTIONS:
Tell your doctor your medical history, including: allergies, lung or
breathing problems (e.g., asthma, COPD), kidney problems.
Limit alcohol intake, as it may intensify certain side effects of this
medication (e.g., dizziness). Use caution when performing tasks
requiring alertness (e.g., driving).
This medication is not generally recommended for treatment of flu if you
have lung problems (e.g., asthma, emphysema/COPD).
This medication can cause breathing problems (e.g., bronchospasm), which
in rare cases can be fatal. If you have lung/breathing problems and are
using this medication, have a fast-acting inhaled bronchodilator (e.g.,
albuterol inhaler) readily available. If you experience breathing
problems, stop using zanamivir and contact your doctor immediately. Ask
your doctor or pharmacist for details.
This medication should be used only when clearly needed during
pregnancy. Discuss the risks and benefits with your doctor.
It is not known whether this drug is passed into breast milk. Consult
your doctor before breast-feeding.
DRUG INTERACTIONS:
Tell your doctor of all prescription and nonprescription medication you
may use, especially: inhaled medications such as albuterol.
Do not start or stop any medicine without doctor or pharmacist approval.
OVERDOSE:
If overdose is suspected, contact your local poison control center or
emergency room immediately.
NOTES:
Do not share this medication with others.
Consult your doctor about the risks and important benefits of receiving
a yearly flu shot (vaccination) to prevent infection.
MISSED DOSE:
If you miss a dose, use it as soon as you remember. If it is near the
time of the next dose, skip the missed dose and resume your usual dosing
schedule. Do not double the dose to catch up.
STORAGE:
Store at room temperature between 59 and 86 degrees F (15 to 30 degrees
C) away from light and moisture.
 Relenza Can Fight the Asian Avian Bird Flu
A second influenza drug, GlaxoSmithKline’s Relenza, should be stockpiled
in readiness for a feared global pandemic of avian flu, researchers said
Thursday.
The drug, known generically as zanamivir, is inhaled and some doctors
have worried that patients may not be able to use it correctly, but the
team of Asian doctors said it will be important to have as many
antivirals on hand as possible.
The H5N1 bird flu virus has killed 62 people since late 2003 and is
affecting flocks from Vietnam to Kazakhstan. Although it is not yet
easily transmitted from birds to people or from person to person,
experts fear it will acquire this ability and cause a worldwide
disaster.
Relenza and Tamiflu Treat Influenza and Asian Bird Flu
With Tamiflu, also known as oseltamivir, in short supply, some attention
is turning toward Relenza, which is also known as zanamivir. Approved
the same year as Tamiflu, Relenza has been a distant also-ran.
Unlike Tamiflu, which is taken orally, Relenza requires an inhaler.
Within months of Relenza's approval, there were instances of respiratory
problems and fatalities in users who had asthma or other pulmonary
diseases. But some experts say that the inconvenience of an inhaler and
the risk of side effects were minor considerations compared with the
dangers from flu on a wide scale.
The U.S. government recently purchased 84,300 treatment courses of
Relenza for $2.8 million. Germany recently ordered 1.7 million units.
The German order alone exceeds the total amount of Relenza sold
worldwide in the past four years, said Peter Molloy, chief executive of
Biota, the company that invented Relenza and licensed it to Glaxo.
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US Bird Flu Plan - Treat Bird Flu with Tamiflu and
Relenza
The H5N1 avian flu has infected 122 people and killed 62 in four
countries -- Indonesia, Vietnam, Thailand and Cambodia. It has become
entrenched in poultry flocks across much of Asia and into Europe.
The fear is that H5N1 will mutate into a form that can easily infect and
pass among people, causing a pandemic.
An experimental vaccine will help only a little and drugs that can help
control it are in scarce supply.
U.S. Health and Human Services Secretary Michael Leavitt said Roche AG,
maker of Tamiflu, and GlaxoSmithKline, which makes Relenza, would be
able to produce more of the drugs.
"We have vendor representations that they can deliver, as part of our
stockpiling effort, 20 million courses by the fourth quarter of 2006 and
up to 81 million courses by the summer of 2007," Leavitt told reporters
in a telephone briefing.
The 81 million would represent roughly a quarter of the population -- a
figure the World Health Organization has suggested as a target for
countries to use in preparing for an influenza pandemic.
The federal government would pay for about 50 million treatment courses
and states would pay for the other 31 million.
Leavitt said another key goal was to build the capacity to produce 300
million courses of flu vaccine in six months.
Some members of Congress, who must vote for the funds to pay for the
plan, criticized the government for moving too slowly.
At a hearing of the Senate Appropriations Committee's Labor, Health and
Human Services subcommittee, Iowa Democratic Sen. Tom Harkin complained
the plan required states to pay for 31 million treatment courses of
Tamiflu and Relenza.
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