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Influenza

Updated : September 17, 2022





Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

oseltamivir 

75

mg

Capsule

Orally 

once a day

10

days



baloxavir marboxil 

tablet
• 20 to <80kg: 40mg orally as a single dose
• ≥80kg: 80mg orally as a single dose

Oral suspension
• 20 to <80kg: 40mg orally as a single dose
• ≥80kg: 80mg orally as a single dose



Dose Adjustments

Coadministration with products that contain polyvalent cations
The medication should not be taken simultaneously as dairy products, calcium-rich beverages, laxatives, or antacids containing multiple cations or oral supplements containing calcium, iron, magnesium, selenium, or zinc. Taking these substances together may interfere with the absorption and effectiveness of the medication

Renal impairment
CrCl>50ml/min: The medication did not significantly impact patients with a creatinine clearance (CrCl) of 50 mL/min or greater

amantadine 

Indicated for Prophylaxis of Influenza A :


Immediate release tablets
200mg orally in a single dose
may divide the daily dose into one 100 mg dose every 12 hours



rimantadine 

Indicated for Influenza A Virus:


Treatment
100mg orally twice a day, typically within 48 hours of the onset of influenza symptoms. a disease

Prophylaxis
100mg orally twice a day



rimantadine 

Indicated for Influenza A Virus:


Treatment
100mg orally twice a day, typically within 48 hours of the onset of influenza symptoms. a disease

Prophylaxis
100mg orally twice a day



rimantadine 

Indicated for Influenza A Virus:


Treatment
100mg orally twice a day, typically within 48 hours of the onset of influenza symptoms. a disease

Prophylaxis
100mg orally twice a day



rimantadine 

Indicated for Influenza A Virus:


Treatment
100mg orally twice a day, typically within 48 hours of the onset of influenza symptoms. a disease

Prophylaxis
100mg orally twice a day



rimantadine 

Indicated for Influenza A Virus:


Treatment
100mg orally twice a day, typically within 48 hours of the onset of influenza symptoms. a disease

Prophylaxis
100mg orally twice a day



influenza virus vaccine quadrivalent 

prophylaxis:

Everyone who is 6 months of age and older are recommended by the CDC's ACIP to have an annual influenza vaccination
0.5 mL given intramuscularly as single dose/season



 

oseltamivir 

75

mg

Capsule

Orally 

once a day

10

days



baloxavir marboxil 

tablet
• 20 to <80kg: 40mg orally as a single dose
• ≥80kg: 80mg orally as a single dose

Oral suspension
• <20kg: 2mg orally as a single dose
• 20 to <80kg: 40mg orally as a single dose
• ≥80kg: 80mg orally as a single dose



Dose Adjustments

Coadministration with products that contain polyvalent cations
The medication should not be taken simultaneously as dairy products, calcium-rich beverages, laxatives, or antacids containing multiple cations or oral supplements containing calcium, iron, magnesium, selenium, or zinc. Taking these substances together may interfere with the absorption and effectiveness of the medication

Renal impairment
CrCl>50ml/min: The medication did not significantly impact patients with a creatinine clearance (CrCl) of 50 mL/min or greater

amantadine 

Indicated for Prophylaxis of Influenza A :


1–9 years: 200 mg orally daily or divided in to 2 times a day
9 to 12 years: 100 mg taken orally every twelve hours



rimantadine 

Indicated for Influenza A Virus:


Children 1-10 years and Children >10 years but <40 kg: 5 mg/kg orally every day or twice a day; not to exceed 150mg/day
Children over the age of 10 years weighing more than 40 kg: 100mg orally twice a day



influenza virus vaccine quadrivalent 

Everyone who is 6 months of age and older are recommended by the CDC's ACIP to have an annual influenza vaccination.
Safety & efficacy were not established
Fluarix Quadrivalent, FluLaval Quadrivalent, Fluzone Quadrivalent, Afluria Quadrivalent: below 6 months
6 months to above 9 years
Fluarix Quadrivalent
Not vaccinated: 0.5 mL given intramuscularly in 2 doses
Previously vaccinated: 0.5 mL given intramuscularly in 1-2 doses
Afluria Quadrivalent, FluLaval Quadrivalent, or Fluzone Quadrivalent
6 to below 36 months and not vaccinated: 0.25 mL or 0.5 mL given intramuscularly in 2 doses
6 to below 36 months and previously vaccinated: 0.5 mL given intramuscularly in 1-2 doses
Above 36 months to below 9 years and not vaccinated: 0.5 mL given intramuscularly in 2 doses
Above 36 months to below 9 years and previously vaccinated: 0.5 mL given intramuscularly in 1-2 doses
Flucelvax Quadrivalent
Above 4 to below 9 years: 0.5 mL given intramuscularly in 1-2 doses
Above 9 years
For all the formulations
0.5 mL given intramuscularly as single dose



influenza virus vaccine quadrivalent 

prophylaxis:

Everyone who is 6 months of age and older are recommended by the CDC's ACIP to have an annual influenza vaccination.
Safety & efficacy were not established
Fluarix Quadrivalent, FluLaval Quadrivalent, Fluzone Quadrivalent, Afluria Quadrivalent: below 6 months
6 months to above 9 years
Fluarix Quadrivalent
Not vaccinated: 0.5 mL given intramuscularly in 2 doses
Previously vaccinated: 0.5 mL given intramuscularly in 1-2 doses
Afluria Quadrivalent, FluLaval Quadrivalent, or Fluzone Quadrivalent
6 to below 36 months and not vaccinated: 0.25 mL or 0.5 mL given intramuscularly in 2 doses
6 to below 36 months and previously vaccinated: 0.5 mL given intramuscularly in 1-2 doses
Above 36 months to below 9 years and not vaccinated: 0.5 mL given intramuscularly in 2 doses
Above 36 months to below 9 years and previously vaccinated: 0.5 mL given intramuscularly in 1-2 doses
Flucelvax Quadrivalent
Above 4 to below 9 years: 0.5 mL given intramuscularly in 1-2 doses
Above 9 years
For all the formulations
0.5 mL given intramuscularly as single dose



 

amantadine 

Influenza A Prevention or Treatment 65 years and older: a single dosage of 100 mg orally



influenza virus vaccine quadrivalent 

prophylaxis:

Everyone who is 6 months of age and older are recommended by the CDC's ACIP to have an annual influenza vaccination
0.5 mL given intramuscularly as single dose/season
Fluzone High Dose Quadrivalent
Indicated in patients above 65 years
0.5 mL given intramuscularly as single dose/season



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References

Influenza

Updated : September 17, 2022




oseltamivir 

75

mg

Capsule

Orally 

once a day

10

days



baloxavir marboxil 

tablet
• 20 to <80kg: 40mg orally as a single dose
• ≥80kg: 80mg orally as a single dose

Oral suspension
• 20 to <80kg: 40mg orally as a single dose
• ≥80kg: 80mg orally as a single dose



Dose Adjustments

Coadministration with products that contain polyvalent cations
The medication should not be taken simultaneously as dairy products, calcium-rich beverages, laxatives, or antacids containing multiple cations or oral supplements containing calcium, iron, magnesium, selenium, or zinc. Taking these substances together may interfere with the absorption and effectiveness of the medication

Renal impairment
CrCl>50ml/min: The medication did not significantly impact patients with a creatinine clearance (CrCl) of 50 mL/min or greater

amantadine 

Indicated for Prophylaxis of Influenza A :


Immediate release tablets
200mg orally in a single dose
may divide the daily dose into one 100 mg dose every 12 hours



rimantadine 

Indicated for Influenza A Virus:


Treatment
100mg orally twice a day, typically within 48 hours of the onset of influenza symptoms. a disease

Prophylaxis
100mg orally twice a day



rimantadine 

Indicated for Influenza A Virus:


Treatment
100mg orally twice a day, typically within 48 hours of the onset of influenza symptoms. a disease

Prophylaxis
100mg orally twice a day



rimantadine 

Indicated for Influenza A Virus:


Treatment
100mg orally twice a day, typically within 48 hours of the onset of influenza symptoms. a disease

Prophylaxis
100mg orally twice a day



rimantadine 

Indicated for Influenza A Virus:


Treatment
100mg orally twice a day, typically within 48 hours of the onset of influenza symptoms. a disease

Prophylaxis
100mg orally twice a day



rimantadine 

Indicated for Influenza A Virus:


Treatment
100mg orally twice a day, typically within 48 hours of the onset of influenza symptoms. a disease

Prophylaxis
100mg orally twice a day



influenza virus vaccine quadrivalent 

prophylaxis:

Everyone who is 6 months of age and older are recommended by the CDC's ACIP to have an annual influenza vaccination
0.5 mL given intramuscularly as single dose/season



oseltamivir 

75

mg

Capsule

Orally 

once a day

10

days



baloxavir marboxil 

tablet
• 20 to <80kg: 40mg orally as a single dose
• ≥80kg: 80mg orally as a single dose

Oral suspension
• <20kg: 2mg orally as a single dose
• 20 to <80kg: 40mg orally as a single dose
• ≥80kg: 80mg orally as a single dose



Dose Adjustments

Coadministration with products that contain polyvalent cations
The medication should not be taken simultaneously as dairy products, calcium-rich beverages, laxatives, or antacids containing multiple cations or oral supplements containing calcium, iron, magnesium, selenium, or zinc. Taking these substances together may interfere with the absorption and effectiveness of the medication

Renal impairment
CrCl>50ml/min: The medication did not significantly impact patients with a creatinine clearance (CrCl) of 50 mL/min or greater

amantadine 

Indicated for Prophylaxis of Influenza A :


1–9 years: 200 mg orally daily or divided in to 2 times a day
9 to 12 years: 100 mg taken orally every twelve hours



rimantadine 

Indicated for Influenza A Virus:


Children 1-10 years and Children >10 years but <40 kg: 5 mg/kg orally every day or twice a day; not to exceed 150mg/day
Children over the age of 10 years weighing more than 40 kg: 100mg orally twice a day



influenza virus vaccine quadrivalent 

Everyone who is 6 months of age and older are recommended by the CDC's ACIP to have an annual influenza vaccination.
Safety & efficacy were not established
Fluarix Quadrivalent, FluLaval Quadrivalent, Fluzone Quadrivalent, Afluria Quadrivalent: below 6 months
6 months to above 9 years
Fluarix Quadrivalent
Not vaccinated: 0.5 mL given intramuscularly in 2 doses
Previously vaccinated: 0.5 mL given intramuscularly in 1-2 doses
Afluria Quadrivalent, FluLaval Quadrivalent, or Fluzone Quadrivalent
6 to below 36 months and not vaccinated: 0.25 mL or 0.5 mL given intramuscularly in 2 doses
6 to below 36 months and previously vaccinated: 0.5 mL given intramuscularly in 1-2 doses
Above 36 months to below 9 years and not vaccinated: 0.5 mL given intramuscularly in 2 doses
Above 36 months to below 9 years and previously vaccinated: 0.5 mL given intramuscularly in 1-2 doses
Flucelvax Quadrivalent
Above 4 to below 9 years: 0.5 mL given intramuscularly in 1-2 doses
Above 9 years
For all the formulations
0.5 mL given intramuscularly as single dose



influenza virus vaccine quadrivalent 

prophylaxis:

Everyone who is 6 months of age and older are recommended by the CDC's ACIP to have an annual influenza vaccination.
Safety & efficacy were not established
Fluarix Quadrivalent, FluLaval Quadrivalent, Fluzone Quadrivalent, Afluria Quadrivalent: below 6 months
6 months to above 9 years
Fluarix Quadrivalent
Not vaccinated: 0.5 mL given intramuscularly in 2 doses
Previously vaccinated: 0.5 mL given intramuscularly in 1-2 doses
Afluria Quadrivalent, FluLaval Quadrivalent, or Fluzone Quadrivalent
6 to below 36 months and not vaccinated: 0.25 mL or 0.5 mL given intramuscularly in 2 doses
6 to below 36 months and previously vaccinated: 0.5 mL given intramuscularly in 1-2 doses
Above 36 months to below 9 years and not vaccinated: 0.5 mL given intramuscularly in 2 doses
Above 36 months to below 9 years and previously vaccinated: 0.5 mL given intramuscularly in 1-2 doses
Flucelvax Quadrivalent
Above 4 to below 9 years: 0.5 mL given intramuscularly in 1-2 doses
Above 9 years
For all the formulations
0.5 mL given intramuscularly as single dose



amantadine 

Influenza A Prevention or Treatment 65 years and older: a single dosage of 100 mg orally



influenza virus vaccine quadrivalent 

prophylaxis:

Everyone who is 6 months of age and older are recommended by the CDC's ACIP to have an annual influenza vaccination
0.5 mL given intramuscularly as single dose/season
Fluzone High Dose Quadrivalent
Indicated in patients above 65 years
0.5 mL given intramuscularly as single dose/season