Zanamivir Inhalation (patient information)

# Why is this medication prescribed
Zanamivir is used in adults and children to treat some types of influenza ('flu') in people who have had symptoms of the flu for less than 2 days. This medication is also used to prevent some types of flu in adults and children when they have spent time with someone who has the flu or when there is a flu outbreak. Zanamivir is in a class of medications called neuraminidase inhibitors. It works by stopping the growth and spread of the flu virus in your body.Zanamivir helps shorten the time you have flu symptoms such as nasal congestion, sore throat, cough, muscle aches, tiredness, weakness, headache, fever, and chills.

# How should this medicine be used
Zanamivir comes as a powder to inhale (breathe in) by mouth. To treat influenza, two inhalations of zanamivir are used twice daily for 5 days. You should inhale the doses about 12 hours apart and at the same time each day., However, on the first day of treatment, your doctor may tell you to inhale the doses closer together. To help prevent the spread of influenza in people living in the same household, two inhalations of zanamivir are used once a day for 10 days. To help prevent the spread of influenza in a community, two inhalations of zanamivir are used once a day for 28 days. When using zanamivir to prevent influenza it should be inhaled at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use zanamivir exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Zanamivir comes with a plastic inhaler called a Diskhaler (device for inhaling powder) and five Rotadisks (circular foil blister packs containing four doses of medication). Do not put a hole in or open any medication blister pack until inhaling a dose with the Diskhaler. Carefully read the manufacturer's instructions that describe how to prepare and inhale a dose of zanamivir using the Diskhaler Be sure to ask your pharmacist or doctor if you have any questions about how to prepare or inhale this medication.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part that you do not understand. Use zanamivir exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
The use of the inhaler for a child should be supervised by an adult who understands how to use zanamivir and has been instructed in its use by a healthcare provider.
Continue to take zanamivir even if you start to feel better. Do not stop taking zanamivir without talking to your doctor.
If you feel worse or develop new symptoms during or after treatment, or if your flu symptoms do not start to get better, call your doctor.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# What special precautions should I follow
Before using zanamivir
- tell your doctor and pharmacist if you are allergic to zanamivir, any other medications, any food products, or lactose (milk proteins).
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had asthma or other breathing problems ,bronchitis (swelling of the air passages that lead to the lungs),emphysema (damage to air sacs in the lungs);or heart,kidney, liver, or other lung disease.
- if you use an inhaled medication to treat asthma, emphysema, or other breathing problems and you are scheduled to take that medication at the same time as zanamivir, you should take your regular medication before taking zanamivir.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking zanamivir, call your doctor.
- you should know that zanamivir may cause serious or life-threatening breathing problems, more commonly in patients with asthma or emphysema. If you have trouble breathing or have wheezing after your dose of zanamivir, stop using zanamivir and get medical attention. If you have difficulty breathing, and have been prescribed a rescue medication, use your rescue medication immediately and then call for medical attention. Do not take any more zanamivir without first talking to your doctor.

# What special dietary instructions should I follow
Unless your doctor tells you otherwise, continue your normal diet.

# What should I do if I forget a dose
If you forget to inhale a dose, inhale it as soon as you remember it. If it is 2 hours or less until the next dose, skip the missed dose and continue your regular dosing schedule. Do not inhale a double dose to make up for a missed one.

# Side Effects

## Mild side effects
Zanamivir may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- headache
- dizziness
- nausea
- vomiting
- diarrhea
- cough
- irritation of the nose
- infection of the ear, nose, sinuses, throat, or bronchi (breathing tubes of the lung)

## Severe side effects
If you experience any of the following symptoms, call your doctor immediately:
- difficulty breathing
- wheezing
- shortness of breath
- hives
- rash
- itching
- difficulty swallowing
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- hoarseness
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# What storage conditions are needed for this medicine
Keep this medication in the container it came in and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# What other information should I know
You should maintain proper hygiene, wash your hands frequently, and avoid situations such as sharing cups and utensils that can spread the influenza virus to others.
Ask your doctor if you should receive a flu vaccination each year. Zanamivir does not take the place of a yearly flu vaccine.
The Diskhaler should only be used for zanamivir. Do not use the Diskhaler to take other medications that you inhale.
Do not let anyone else use your medication.Your prescription is probably not refillable.

# Brand names
- Relenza