Table 1.

Agents used to prevent and treat influenza

Class	Drug	Usual Adult Dosagea		Dose Adjustment State	Suggested Dosage
		Prophylaxis	Treatment
M2 Inhibitor	Amantadine	100 mg q 12 h	100 mg q 12 h	Age 1–9 y	5 mg/kg to maximum of 150 mg in 2 divided doses
				CrCl 30–50 mL/min	100 mg q 24 h
				CrCl 15–30 mL/min	100 mg q 24 h
				CrCl 10–15 mL/min	100 mg q week
				CrCl 10 mL/min	100 mg q week
				Age ≥ 65 y	100 mg q 24 h
	Rimantadine	100 mg q 12 h	100 mg q 12 h	Age 1–9 y	5 mg/kg to maximum of 150 mg in 2 divided doses
				CrCl <10 mL/min	100 mg q 24 h
				Severe hepatic dysfunction	100 mg q 24 h
				Age ≥ 65 y	100 mg q 24 h
Neuraminidase Inhibitor	Laninamivir	20 mg QD × 2 d	40 mg × 1	Age <10 y	20 mg × 1
	Oseltamivirb	75 mg q 24 h	75 mg q 12 h	CrCl <30 mL/mind	Treatment: 75 mg q 24 h Prophylaxis: 75 mg every other day
				≤15 kge	30 mg q 12 h (5 mLc)
				15–23 kge	45 mg q 12 h (7.5 mLc)
				23–40 kge	60 mg q 12 h (10 mLc)
				>40 kge	75 mg q 12 h (12.5 mLc)
				Any weight, 2 wk to <1 y	3mg/kg q 12 h (0.5 mL/kgc)
	Peramivir	NA	300 mg once	For patients with severe infection	600 mg QD as a single-dose or multidose regimen
				Children 6–17 y	10 mg/kg QD for 5 d (maximum of 600 mg QD)
				Children 181 d to 5 y	12 mg/kg QD
				CrCl 31–49 mL/mine	Adult: 150 mg QD Age 6–17 y: 2.5 mg/kg QDe Age 180 d to 5 y: 3 mg/kg QD
				CrCl 10–30 mL/mine	Adult: 100 mg QD Age 6–17 y: 1.6 mg/kg QDe Age 180 d to 5 y: 1.9 mg/kg QD
				CrCl <10 mL/min	Adult: 100 mg on day 1 then 15 mg QD Age 6–17 y: 1.6 mg/kg on day 1 then 0.25 mg/kg QD Age 180 d to 5 y: 1.9 mg/kg on day 1 then 0.3 mg/kg
				Intermittent HD (Dose on HD days only)	≥18 y: 100 mg on day 1 then 100 mg 2 h after HD Age 6–17 y: 1.6 mg/kg on day 1 then 1.6 mg/kg 2 h after HD Age 181 d to 6 y: 1.9 mg/kg on day 1 then 1.9 mg/kg 2 h after HD
	Inhaled Zanamivirf	2 puffs	2 puffs	No dose adjustment needed	—

Recommendations based on those provided by the Advisory Committee on Immunization Practices.⁴

Abbreviations: CrCl, creatinine clearance; HD, hemodialysis; NA, not available; q, every; QD, every day.

^aDuration of treatment is usually 5 days. Duration of prophylaxis depends on clinical setting.

^bOseltamivir is indicated for prophylaxis in children 1 year old and older and for treatment in children in greater than or equal to 2 weeks of age.

^cVolume of suspension.

^dNo treatment or prophylaxis dosing recommendations are available for patients undergoing renal dialysis.

^eInitial loading dose of 600 mg or age-adjusted equivalent; maximum dosage 600 mg per day.

^fZanamivir is indicated for prophylaxis in children greater than or equal to 5 years old and for treatment in children greater than or equal to 7 years old.

Data from Fiore AE, Fry A, Shay D, et al. Antiviral agents for the treatment and chemoprophylaxis of influenza — recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2011;60:1–24.