Antiviral Drugs for Seasonal Influenza: Additional Links and Resources
The information on this page should be considered current for the 2014-2015 influenza season for clinical practice regarding the use of influenza antiviral medications. Also see the current summary of recommendations available at Influenza Antiviral Medications: Summary for Clinicians and a list of related references at Antiviral Guide References.
This page contains excerpts from Antiviral Agents for the Treatment and Chemoprophylaxis of Influenza - Recommendations of the Advisory Committee on Immunization Practices (ACIP). PDF Version [1 MB, 28 pages]
Previously, the neuraminidase inhibitors oseltamivir and zanamivir were the only recommended influenza antiviral drugs. On December 19, 2014 the U.S. Food and Drug Administration approved Rapivab® (peramivir) to treat influenza infection in adults. The antiviral content on the CDC website is in the process of being updated to reflect that change.
Antiviral Treatment Recommendations are available.
The majority of currently circulating influenza viruses are susceptible to the neuraminidase inhibitor antiviral medications—oseltamivir, zanamivir and peramivir; however, sporadic cases of oseltamivir and peramivir-resistant influenza viruses have been detected worldwide in recent years. Antiviral treatment with a neuraminidase inhibitor is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at greater risk for influenza-related complications.
- Oseltamivir (brand name Tamiflu® [656 KB, 28 pages]) is FDA-approved for treatment of influenza in persons aged two weeks and older, and for chemoprophylaxis to prevent influenza in people one year of age and older. Although not part of the FDA-approved indications, use of oral oseltamivir for treatment of influenza in infants younger than 14 days old, and for chemoprophylaxis in infants 3 months to 1 year of age, is recommended by the CDC and the American Academy of Pediatrics. If a child is younger than 3 months old, use of oseltamivir for chemoprophylaxis is not recommended unless the situation is judged critical due to limited data in this age group.
- Zanamivir (brand name Relenza® [501 KB, 30 pages]) is FDA-approved to treat flu in people 7 years and older and to prevent influenza in people 5 years and older.
- Peramivir (brand name Rapivab® [196 KB, 12 pages]) is FDA-approved to treat flu in adults 18 years and older.
In recent years, widespread adamantane resistance among influenza A (H3N2) virus strains has made this class of medications less useful clinically. In addition, circulating 2009 H1N1 virus strains are resistant to adamantanes. Therefore, amantadine and rimantadine are not recommended for antiviral treatment or chemoprophylaxis of currently circulating influenza A virus strains. (These medications are active against influenza A viruses but not influenza B viruses.)
- Amantadine (generic) is approved to treat and prevent only influenza A viruses in people older than 1 year.
- Rimantadine (Flumadine® [69 KB, 10 pages], generic) is approved to prevent only influenza A virus infection among people older than 1 year. It is approved to treat only influenza A virus infections in people 17 and older.
The CDC’s weekly FluView provides the latest information on antiviral drug resistant isolates collected via routine surveillance in the United States.
Find labels and label updates for approved drug products at Drugs@FDA.
- Page last reviewed: January 9, 2015
- Page last updated: January 9, 2015
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