Relenza

Relenza is a prescription-only antiviral agent used to:

• Treat viral flu (influenza A and influenza B)
• Prevent and treat swine flu
• Control flu symptoms such as a headache, fever, cough, congest or runny, and sore throat
• Keep you from acquiring influenza post exposure to the affected person.

The treatment should begin within 2 days after flu symptoms appear. Remember that if you are carrying the flu virus, taking zanamivir won’t prevent you from transmitting the virus to other persons who come in close contact to you.

Using zanamivir during severe illness or occurrence of breathing problems such as asthma or chronic obstructive pulmonary disease (COPD) is not recommended. Zanamivir should not be used to replace annual flu jab. It is available as Disk form.

Before using Relenza, you must know all about the risks and complications associated with it. Together with your doctor, you can decide whether the medication will do you more goods than the harms.

Here are some factors to be considered before deciding to use this medicine:

Allergies: Inform your doctor about the allergies you have, such as to this medication, other medications, or to foods, dyes, or preservatives.

Pediatric: Safety and efficacy of zanamivir to treat influenza in children below 7 years and prevent influenza in children below 5 years have not been well documented.

Geriatric: Use cautiously in elderly as they are more likely to develop undesirable effects.

Pregnancy: It falls under pregnancy category C for all trimesters, meaning that due to lack of sufficient studies, it’s not clear if this medication is safe for use in pregnancy.

Breastfeeding: Use only after assessing the risks and benefits.

Drug Interactions: Taking two medicines together can be harmful due to possible interactions. In other cases, even if there is a possible interaction between two medicines your doctor may advise you to take them together after adjusting the dose or issuing precautions.

Inform you doctor about your intake of any other prescription or nonprescription medicine.

Other Interactions: Taking your medicine together with certain foods or items such as alcohol or tobacco may cause undesirable interactions. Talk to your doctor to know if using this medicine with food, alcohol, or tobacco is safe.

Inform your doctor if you have any other medical conditions, including:

• Allergy to lactose or milk proteins: Should not be used in patients with this condition.
• Brain conditions such as encephalopathy
• Mental disorders
• Current or past seizures: Use with caution.
• Heart problems: It’s not clear if using this medicine in patients with heart problems is safe.
• Lung disease or breathing difficulties such as asthma, chronic obstructive pulmonary disease (COPD): Do not use zanamivir.

To use Relenza properly, you must follow all instructions given by your doctor. Here are some points to consider:

Read the patient information leaflet carefully and follow accordingly. Use the inhaler only as recommended. If you have any query, consult your doctor.

Ask your doctor if you can still get a flu jab, in case you have not been vaccinated yet.

For this medicine to show its optimum effect, it must be used right after getting exposed to the affected person.

In case you are already affected by the flu, do not discontinue the medicine. Rather complete its course (for 5 days) even when your symptoms improve after few doses.

Stopping the medicine half way can cause the symptoms to reappear.

Use a separate inhaler for zanamivir.

Loading the inhaler

• Remove the blue cover and see if the mouthpiece is clear of any of foreign particles.
• Extend the tray by pulling the white mouthpiece.
• Once you see the raised ridges on each side of the tray, press them inward and pull the entire tray out of the inhaler body.
• Place one medicine disk on the wheel and then push the tray back into the inhaler.

When replacing the used disk with a new one, apply the same guidelines.

Using the inhaler

• Hold the inhaler in your hand keeping it flat.
• Elevate the flap to its utmost level to pick the medicine blister. Elevate only when the cartridge is inside the inhaler.
• Once the blister is punctured, bring the flap back into its place.
• Exhale completely before keeping the mouthpiece into your mouth.
• Maintain the inhaler in a flat position and put the mouthpiece into your mouth.
• Tighten your lips over the round surface of the mouthpiece while keeping your head tilted slightly back.
• Make sure not to bite the mouthpiece or obstruct it with your teeth or tongue.
• Make sure not to block the air holes on either side of the mouthpiece.
• Inhale completely and steadily through your mouth.
• Hold your breath for up to 10 seconds before taking out the mouthpiece. This allows enough time for the medicine to stay in your airways and lungs.
• Exhale completely.
• If the new cartridge is ready for another inhalation, pull the mouthpiece to extend the tray and then push it in until you notice a “click”.
• The next dose is ready.
• Puncture the blister just when you are ready to inhale.
• For the next inhalation, repeat the same steps mentioned above.
• Clean the mouthpiece after each use and keep it covered. In case you are also using another inhaled medicine, take it before zanamivir.

Dosing: For best results, follow your doctor to know what amount of medicine you should take in a single dose. The doses of a medicine can differ according to the conditions for which it is being prescribed, your age and your overall health status.

Remember your doses can differ. Consult your doctor if you have anything to ask.

The doses of inhalation (powder) are:

To prevent flu from household exposure

• Adults, teenagers, and children 5 years and older: Take two inhalations once daily for 10 days not more than 36 hours after the signs and symptoms of the flu start occurring. Use the doses at scheduled time every day.
• Children below 5 years: Your doctor will decide the use and dose.

To prevent flu during community outbreaks

• Adults, teenagers, and children 5 years and older: Take two inhalations once daily for 28 days not more than 5 days after an outbreak in your community was determined. Use the doses at scheduled time every day.
• Children below 5 years: Your doctor will decide the use and dose.

To treat the flu

• Adults, teenagers, and children 7 years and older: Take two inhalations every 12 hours for 5 days and not later than 48 hours after the signs and symptoms start occurring. Use the doses at scheduled time every day. If possible, take double doses at the beginning of the treatment maintaining a gap of at least 2 hours.
• Children below 7 years: Your doctor will decide the use and dose.

Missed Dose: Take your missed dose once you remember but avoid it if it’s time to take your next dose, and follow your normal dosing schedule. Avoid taking double doses to make up for the missed dose.

Storage:

• Remove the medicine from the foil pouch just before taking it.
• Store in a closed container at room temperature.
• Keep away from heat, moisture, and direct light.
• Do not freeze.
• Keep away from children.
• Discard any unused or expired medicines.

Before using Relenza, there are some precautions you must take. Your progress should be regularly monitored to determine if you are responding to the treatment or have some undesirable effects.

If you are carrying the flu virus, taking zanamivir won’t prevent you from transmitting the virus to other persons who come in close contact to you.

Relenza should not be used to replace annual flu jab. Relenza is not effective against bacterial infections that have flu-like symptoms.

Using Relenza during severe illness or occurrence of breathing problems such as asthma or chronic obstructive pulmonary disease (COPD) is not recommended. Discontinue this medicine and call your doctor immediately if you have breathing problems such as shortness of breath, or wheezing.

If you already have some breathing problems, carry a fast-acting bronchodilator inhaler with you during the treatment.

Discontinue the medicine and call your doctor IMMEDIATELY if you have signs of a life-threatening allergic reaction, anaphylaxis, such as, a cough, welts, dizziness, swallowing or breathing problems, a rapid heartbeat, fainting, chest discomfort, swollen face, hands, tongue, or throat after you take the medicine.

Call your doctor immediately if you have severe agitation, irritation, or other unusual behaviors.

Do not take live nasal flu vaccine 14 days before or 2 days after taking zanamivir. Consult your doctor if your condition does not get better after a full course of this medicine.

Make sure you meet with your doctor in using Relenza to avoid unwanted potential side effects.

Consult your doctor immediately if you have any of the following rare but serious side effects:

• Abnormal heart rhythm
• Breathing difficulties
• Chest discomfort
• Dizziness and tendency to faint
• Increased sensitivity to sunlight
• Itchy, painful, red, swollen, or watery eye or eyelid
• Joint pain
• Puffed face
• Seizures
• Skin flushing
• Swelling of the glands
• Welts
• Wheezing

Non-serious side effects usually go away on their own without requiring medical intervention. You may also ask your doctor to learn more about how you may prevent or reduce the side effects.

Talk to your doctor if the side effects persist or worry you, including:

Less common:

• Diarrhea
• Dizziness
• Facial pain
• Fever or chills
• Headache
• Impaired hearing
• Infections of the ear, nose and throat
• Nausea and vomiting
• Pain in ear or discharge from the ear
• Productive cough
• Rapid, shallow breathing

The side effects of the medicine are not limited to the ones listed above. Call your doctor immediately if you experience any side effects that are uncommon or worry you. To report side effects to the FDA, contact at 1-800-FDA-1088.