Contents

Search

neuraminidase inhibitor

Indications: - treatment of influenza a) zanamivir (Relenza) b) oseltamivir (Tamiflu) Benefit/risk: - no benefit for preventing influenza-like illness - number needed to harm - 7 for nausea; 37 for vomiting Adverse effects: - nausea, vomiting - reports of neuropsychiatric effects - no neonatal consequences from neuraminidase inhibitors during pregnancy [6] Mechanism of action: - inhibition of neuraminidase - effective against influenza if administered early [2] - marginal benefit in prevention & treatment of influenza [4] Notes: - oseltamivir & zanamivir are modestly effective for symptoms of influenza in otherwise healthy adults - when used prophylactically, they have no effect against in preventing influenza-like illness or asymptomatic influenza - the drugs reduce influenza's symptoms by about a day - benefit for very ill people in hospital is without supporting data [1]

Interactions

drug interactions drug adverse effects of neuraminidase inhibitor(s)

Related

neuraminidase

Specific

oseltamivir (Tamiflu) zanamivir (Relenza)

General

antiviral agent enzyme inhibitor

References

  1. Jefferson T et al Neuraminidase inhibitors for preventing and treating influenza in healthy adults: systematic review and meta-analysis BMJ 2009;339:b5106 PMID: 19995812 http://www.bmj.com/cgi/content/full/339/dec07_2/b5106 http://dx.doi.org/10.1136/bmj.b5106 - Doshi P. Neuraminidase inhibitors - The story behind the Cochrane review. BMJ 2009 Dec 8; 339:b5164. PMID: 19995813 http://dx.doi.org/10.1136/bmj.b5164
  2. Muthuri SG et al. Impact of neuraminidase inhibitor treatment on outcomes of public health importance during the 2009-2010 influenza A (H1N1) pandemic: A systematic review and metaanalysis in hospitalized patients. J Infect Dis 2013 Feb 15; 207:553. PMID: 23204175 - Aoki FY and Hayden FG. The beneficial effects of neuraminidase inhibitor drug therapy on severe patient outcomes during the 2009-2010 influenza A virus subtype H1N1 pandemic. J Infect Dis 2013 Feb 15; 207:547. PMID: 23204176
  3. Jefferson T, Jones M, Doshi P, Del Mar C, Dooley L, Foxlee R. Neuraminidase inhibitors for preventing and treating influenza in healthy adults. Cochrane Database Syst Rev. 2010 Feb 17;(2):CD001265 PMID: 20166059 - Jefferson T, Jones MA, Doshi P et al Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children. Cochrane Database Syst Rev. 2014 Apr 10;4:CD008965 PMID: 24718923
  4. Krumholz HM and Hines HH Neuraminidase inhibitors for influenza BMJ 2014;348:g2548 PMID: 24811413 http://www.bmj.com/content/348/bmj.g2548
  5. The NNT: Neuraminidase Inhibitors Given for Influenza. http://www.thennt.com/nnt/neuraminidase-inhibitors-for-influenza/
  6. Graner S et al Neuraminidase inhibitors during pregnancy and risk of adverse neonatal outcomes and congenital malformations: population based European register study. BMJ 2017;356:j629 PMID: 28246106 Free full text http://www.bmj.com/content/356/bmj.j629