Side effects of Peramivir

Peramivir (trade name Rapivab) is an antiviral drug developed by BioCryst Pharmaceuticals for the treatment of influenza. It also known as BCX-1812 or RWJ-270201, belongs to the class of neuraminidase inhibitors (which includes zanamavir and oseltamavir). Its chemical name is (1S,2S,3R,4R)-3-[(1S)-1-(acetylamino)- 2-ethylbutyl]-4-[(aminoiminomethyl)amino]-2-hydroxy-cyclopentanecarboxylic acid (trihydrate) and its molecular formula is C15H34N4O7 (trihydrate).

Uses

Peramivir is currently an investigational agent which is being developed by Biocryst Phamaceuticals (Birmingham, AL, USA). It has recently been reviewed, with other influenza antiviral drugs.

Mechanism of action

Peramivir was designed to be structurally different from the currently approved NAI drugs, oseltamivir and zanamivir. It was developed by a rational structure-based approach that was predicated on the observation that inhibition of viral neuraminidase depended on the relative positions of sialic acid and the interacting constituents of the inhibitory compound rather than the absolute position of the central ring. Accordingly, a five-membered ring structure was utilized as a novel starting scaffold for substituents that would interact with the four binding pockets of the NA active site at least as avidly as oseltamivir and zanamivir. The result of the development process, peramivir, is a potent, selective inhibitor of influenza NA. However, it is not highly orally bioavailable, as was anticipated by the elimination of the polar glycerol side chain.

Peramivir selectivity for influenza NA is evident from the requirement for concentrations of 0.9–11nM to inhibit influenza NA, but more than 300,000nM to inhibit sialadases of a mammalian cell (rat hepatocyte), bacteria (Vibrio cholerae, Clostridium perfringens), or paramyxoviruses (parainfluenza and Newcastle disease virus).

Side effects

Peramivir injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

constipation;

difficulty falling asleep or staying asleep;

Some side effects can be serious. If you experience any of these symptoms or those mentioned in the SPECIAL PRECAUTIONS section, call your doctor immediately:

rash, hives, or blisters on the skin;

itching;

swelling of the face or tongue;

difficulty breathing or swallowing;

wheezing;

hoarseness.