BNF for Children 2011-2012

BNFC 2011–2012 5.3.5 Respiratory syncytial virus 327Breast-feeding amount probably too small to beharmful; use only if potential benefit outweighs risk;(e.g. during a pandemic); see also p. 326Side-effects nausea, vomiting, abdominal pain, diarrhoea;headache; conjunctivitis; less commonly eczema;also reported hepatitis, gastro-intestinal bleeding,arrhythmias, neuropsychiatric disorders,thrombocytopenia, visual disturbances, Stevens-Johnson syndrome, and toxic epidermal necrolysisLicensed use not licensed for use in children under 1year unless there is a pandemicIndication and dosePrevention of influenza. By mouthChild under 1 month (see notes above) 2 mg/kgonce daily for 10 days for post-exposure prophylaxisChild 1–3 months (see notes above) 2.5 mg/kgonce daily for 10 days for post-exposure prophylaxisChild 3 months–1 year (see notes above) 3 mg/kg once daily for 10 days for post-exposureprophylaxisChild 1–13 yearsBody-weight under 15 kg 30 mg once daily for10 days for post-exposure prophylaxis; for up to 6weeks during an epidemicBody-weight 15–23 kg 45 mg once daily for 10days for post-exposure prophylaxis; for up to 6weeks during an epidemicBody-weight 23–40 kg 60 mg once daily for 10days for post-exposure prophylaxis; for up to 6weeks during an epidemicBody-weight over 40 kg 75 mg once daily for 10days for post-exposure prophylaxis; for up to 6weeks during an epidemicChild 13–18 years 75 mg once daily for 10 daysfor post-exposure prophylaxis; for up to 6 weeksduring an epidemicTreatment of influenza. By mouthChild under 1 month (see notes above) 2 mg/kgtwice daily for 5 daysChild 1–3 months (see notes above) 2.5 mg/kgtwice daily for 5 daysChild 3 months–1 year (see notes above) 3 mg/kg twice daily for 5 daysChild 1–13 yearsBody-weight under 15 kg 30 mg twice daily for 5daysBody-weight 15–23 kg 45 mg twice daily for 5daysBody-weight 23–40 kg 60 mg twice daily for 5daysBody-weight over 40 kg 75 mg twice daily for 5daysChild 13–18 years 75 mg twice daily for 5 daysAdministration if suspension not available, capsulescan be opened and the contents mixed with a smallamount of sweetened food, such as sugar water orchocolate syrup, just before administration1Tamiflu c (Roche) ACapsules, oseltamivir (as phosphate) 30 mg (yellow),net price 10-cap pack = £7.71; 45 mg (grey), 10-cappack = £15.41; 75 mg (grey-yellow), 10-cap pack =£15.41. Label: 9Oral suspension, sugar-free, tutti-frutti-flavoured,oseltamivir (as phosphate) for reconstitution withwater, 60 mg/5 mL, net price 75 mL = £15.41. Label: 9Excipients include sorbitol 1.7 g/5 mLNote Solutions prepared by ‘Special Order’ manufacturersmay be a different concentration1. D except for the treatment and prophylaxis of influenza asindicated in the notes above and NICE guidance; endorseprescription ‘SLS’ZANAMIVIRCautions asthma and chronic pulmonary disease (riskof bronchospasm—short-acting bronchodilatorshould be available; avoid in severe asthma unlessclose monitoring possible and appropriate facilitiesavailable to treat bronchospasm); uncontrolledchronic illness; other inhaled drugs should be administeredbefore zanamivirPregnancy use only if potential benefit outweighs risk(e.g. during a pandemic); see also p. 326Breast-feeding amount probably too small to beharmful; use only if potential benefit outweighs risk(e.g. during a pandemic); see also p. 326Side-effects very rarely bronchospasm, respiratoryimpairment, angioedema, urticaria, and rash; alsoreported neuropsychiatric disorders, Stevens-Johnsonsyndrome, toxic epidermal necrolysisIndication and dosePost-exposure prophylaxis of influenza. By inhalation of powderChild 5–18 years 10 mg once daily for 10 daysPrevention of influenza during an epidemic. By inhalation of powderChild 5–18 years 10 mg once daily for up to 28daysTreatment of influenza. By inhalation of powderChild 5–18 years 10 mg twice daily for 5 days (forup to 10 days if resistance to oseltamivir suspected)1Relenza c (GSK) ADry powder for inhalation disks containing 4 blistersof zanamivir 5 mg/blister, net price 5 disks with Diskhalerc device = £16.361. D except for the treatment and prophylaxis of influenza asindicated in the notes above and NICE guidance; endorseprescription ‘SLS’5.3.5 Respiratory syncytialvirusRibavirin inhibits a wide range of DNA and RNAviruses. It is licensed for administration by inhalationfor the treatment of severe bronchiolitis caused by the5 Infections