Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Zanamivir may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
for
Relenza contains zanamivir, which belongs to a group of medicines called antivirals. Relenza is used to treat flu (influenza virus infection). It reduces the symptoms of flu, and helps you recover more quickly. Relenza is also used to help prevent you from getting flu, during a flu outbreak. Adults and children aged 5 years or more can be treated with Relenza. Relenza needs to be inhaled (breathed in) into the lungs, because it is poorly absorbed into the body if it is swallowed. The flu virus infects the lungs, and when you inhale Relenza it works directly on the virus inside your lungs. Relenza is not a substitute for flu vaccination. You still need to talk to your doctor about whether you need to be vaccinated against flu. 2
e Relenza
Do not use Relenza •
•
if you are allergic to zanamivir or any of the other ingredients of this medicine (listed in section 6). if you have a milk protein allergy (see 'Relenza contains lactose and milk protein' and section 6)
Do not give Relenza to children under 5 years old.
Take special care with Relenza If you feel tightness in your throat or chest when you use Relenza In very rare cases, Relenza can cause a reaction including:
Other medicines and Relenza Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription. If you use inhaled medication for asthma or other breathing problems, make sure you have read the advice above. If you have been advised to have a flu vaccination You can be vaccinated at any time, even if you are using Relenza to help prevent you from getting flu. Pregnancy, breast-feeding and fertility If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask → your doctor for advice before taking this medicine. There is only limited information about the safety of Relenza for pregnant women. Although there is no evidence so far that Relenza harms unborn babies, you should not use it during pregnancy unless your doctor has advised you to.
The active ingredient (zanamivir) could get into breast milk, therefore you should not breast-feed while taking Relenza. You should discuss with your doctor whether you should stop or abstain from taking Relenza or stop breast-feeding, depending on what is best for you and your baby. Driving and using machines Relenza should not affect your ability to drive or use machines. Relenza contains lactose and milk protein Relenza contains a sugar called lactose, and contains milk protein. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.
3
Relenza
Always use this medicine exactly as your doctor or pharmacist has told you to. Check with your doctor or pharmacist if you are not sure. Relenza is a powdered medicine, which you inhale into your lungs through your mouth, using the Diskhaler device. The powder is contained in blisters on a Rotadisk
If there is a flu outbreak in your local community:
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. Conditions you need to look out for: Severe allergic reactions These are rare and affect less than 1 in 1,000 people using Relenza. Signs include: Raised and itchy rash (hives). Swelling, sometimes of the face, mouth or throat, causing difficulty in breathing. Collapse. If you get any of these symptoms: • Contact your doctor immediately. Serious skin reactions These side effects are rare and may affect less than 1 in 1,000 people using Relenza: Skin rash, which may blister, and looks like small targets (central dark spots surrounded by a paler area, with a dark ring around the edge – erythema multiforme), a widespread rash with blisters and peeling skin, particularly around the mouth, nose, eyes and genitals (Stevens-Johnson Syndrome),
extensive peeling of the skin on much of the body surface – (toxic epidermal necrolysis). If you notice any of these symptoms contact a doctor immediately. Stop using Relenza. Other common side effects These affect less than 1 in 10 people using Relenza: Skin rash Other uncommon side effects These affect less than 1 in 100 people using Relenza: Tightness of the throat or chest, feeling short of breath, or sudden difficulty in breathing. If you have lung disease (such as asthma or COPD), you may need to be monitored while you are using Relenza in case you get this side effect. Swelling of the face, mouth or throat Hives (itchy bumps on your skin). Fainting and feeling lightheaded If you are feeling unwell when you take Relenza you may faint or become lightheaded after inhaling Relenza. You must sit down in a relaxed position before inhaling the dose of Relenza, and you must only hold your breath for as long as is comfortable after inhaling the dose. If you are feeling unwell, you are advised to have someone with you while you are inhaling the dose of Relenza. If you get any of these effects: → Stop using Relenza and get medical help immediately. Contact your doctor or the nearest hospital emergency department. Sudden changes in behaviour, hallucinations and fits During treatment with Relenza, changes in behaviour such as confusion and unresponsiveness have occurred. Some people may also have hallucinations (seeing, hearing, or feeling things not there) or fits (seizures) which can lead to loss of consciousness. Parents should be especially careful to watch out for these symptoms if their child or teenager has flu. These symptoms have been seen in people with flu who were not taking Relenza. Therefore it is not known if Relenza played a part in causing them. If you get any of these symptoms: → Contact your doctor immediately. Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any
not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
5
Relenza
Keep this medicine out of the sight and reach of children. Do not use Relenza or the Diskhaler after the expiry date (EXP) which is stated on the pack. Do not store Relenza above 30°C. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment. Ask your pharmacist how to throw away the Diskhaler you no longer use. These measures will help protect the environment. 6
What Relenza contains The active substance is zanamivir (5mg per dose). The other ingredient is lactose monohydrate (which contains milk protein). What Relenza looks like and contents of the pack Relenza powder is contained in the four blisters on the silver-coloured aluminium foil disk, called a Rotadisk. Each blister contains 5mg of zanamivir. The medicine is inhaled through the mouth from the Rotadisk using a plastic device called a Diskhaler. Relenza is supplied in two types of pack:
Please be ready to give the following information: Product name: Reference number:
Relenza 5 mg 10949/0327
This is a service provided by the Royal National Institute of Blind People. This leaflet was last revised in: October 2023
Trade marks are owned by or licensed to the GSK group of companies. © 2023 GSK group of companies or its licensor
——————————————————————————————————-The Diskhaler has three parts: Do not take it apart until you have looked at the step-by-step guide.
Cover Sliding tray
Mouthpiece (with a small airhole on each side)
Main body
Wheel – The Rotadisk fits onto this. Finger grip Piercing needle – This pierces the blisters on the Rotadisk, to make the medicine ready to inhale.
Hinged lid
Refer to the stepby-step guide
The Rotadisk fits into the Diskhaler
The Rotadisk fits onto the wheel of the Diskhaler. The Rotadisk contains four blisters. Each blister contains 5 mg of zanamivir. A dose is normally two blisters (10 mg).
Important: Do not pierce any of the blisters on the Rotadisk before you load it onto the Diskhaler. You can keep a Rotadisk on the Diskhaler between doses, but do not pierce a blister until just before you inhale your dose.
Keep the Diskhaler clean. Wipe the mouthpiece with a tissue after you use it, and replace the blue cover between uses. Tell your doctor or pharmacist of any malfunction or problems with the Diskhaler and Rotadisk.
Step-by-step guide to using your Relenza Diskhaler To load a Rotadisk into the Diskhaler: 1
Remove the blue cover.
Check that the mouthpiece is clean, inside and outside.
2
Hold the white sliding tray as shown and pull it out until it stops.
3
Gently squeeze the finger grips on the sides of the white tray. Remove the tray from the main body.
The white tray should come out easily.
4
Place a new Relenza Rotadisk on the wheel.
Make sure the printed side is up, with the blisters facing downwards. The blisters fit into the holes in the wheel.
5
Push the white tray back into the main body.
If you are not ready to inhale a dose of Relenza straight away, replace the blue cover.
To get your dose ready to inhale: Do not do this until just before you inhale a dose. 6
Hold the Diskhaler horizontally.
Keep the Diskhaler horizontal Flip the lid up as far as it will go. The lid must be fully vertical, to make sure that the blister is pierced at both the top and bottom. Push the lid back down. Your Diskhaler is now ready for use. Keep it horizontal until you have inhaled your dose.
If you use other inhaled medication, make sure you read 'Using Relenza with inhaled medication for breathing problems' in Section 2 of this leaflet.
To inhale the medication: 7
Do not put the Diskhaler into your mouth yet.
Breathe out as far as is comfortable, keeping the Diskhaler away from your mouth. Do not blow into the Diskhaler. If you do, you will blow the powder out of the Rotadisk.
Keep the Diskhaler horizontal Place the mouthpiece between your teeth. Close your lips firmly around the mouthpiece. Do not bite the mouthpiece. Do not block the airholes on the side of the mouthpiece. Take one quick, deep breath in through the mouthpiece. Hold this breath for a few seconds. Remove the Diskhaler from your mouth.
Carry on holding your breath for a few more seconds or as long as is comfortable.
To prepare the next blister (the second part of your dose):
8
Pull the white tray out as far as it will go (do not remove it completely), then push it back in again.
This will turn the wheel so the next blister will appear. Repeat if necessary until a full blister is positioned under the piercing needle. Repeat steps 6 and 7 to inhale the medicine.
9
After you have inhaled the full dose (normally two blisters): Wipe the mouthpiece with a tissue and replace the blue cover. It is important to keep the Diskhaler clean.
To replace the Rotadisk: 10
When all four blisters are empty, remove the Rotadisk from the Diskhaler and insert a new one, using steps 1 to 5.
Relenza 5mg/dose inhalation powder comes as inhaler containing 5mg. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
The active substance in Relenza 5mg/dose inhalation powder is zanamivir.
This leaflet reproduces the patient information leaflet approved for Relenza 5mg/dose inhalation powder, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
Treatment of influenza
Relenza is indicated for treatment of both influenza A and B in adults and children (≥ 5 years) who present with symptoms typical of influenza when influenza is circulating in the community.
Prevention of influenza
Relenza is indicated for post-exposure prophylaxis of influenza A and B in adults and children (≥ 5 years) following contact with a clinically diagnosed case in a household (see section 5.1 for children aged 5-11 years). In exceptional circumstances, Relenza may be considered for seasonal prophylaxis of influenza A and B during a community outbreak (e.g. in case of a mismatch between circulating and vaccine strains and a pandemic situation).
Relenza is not a substitute for influenza vaccination. The appropriate use of Relenza for prevention of influenza should be determined on a case-by-case basis depending on the circumstances and the population requiring protection.
The use of antivirals for the treatment and prevention of influenza should take into consideration official recommendations, the variability of epidemiology, and the impact of the disease in different geographical areas and patient populations.
Inhaled drugs, e.g. asthma medication, should be administered prior to administration of Relenza (see section 4.4).
Treatment of influenza
Treatment should begin as soon as possible, within 48 hours after onset of symptoms for adults, and within 36 hours after onset of symptoms for children.
Relenza is for administration to the respiratory tract by oral inhalation only, using the Diskhaler device provided (See section 'Step-by-step guide to using your Relenza Diskhaler' in the leaflet for the directions for proper use, including cleaning of the device). One blister should be utilised for each inhalation.
The recommended dose of Relenza for treatment of influenza in adults and children from the age of 5 years is two inhalations (2 x 5 mg) twice daily for five days, providing a total daily inhaled dose of 20 mg.
Prevention of influenza
Post-exposure prophylaxis
The recommended dose of Relenza for prevention of influenza, following close contact with an individual, is two inhalations (2 x 5 mg) once daily for 10 days. Therapy should begin as soon as possible and within 36 hours of exposure to an infected person.
Seasonal prophylaxis
The recommended dose of Relenza for prevention of influenza during a community outbreak is 2 inhalations (2 x 5 mg) once daily for up to 28 days.
Impaired Renal or Hepatic Function: No dose modification is required. (See section 5.2).
Elderly patients: No dose modification is required. (See section 5.2).
Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.
Contraindicated in patients with milk protein allergy.
Due to the limited number of patients with severe asthma or with other chronic respiratory disease, patients with unstable chronic illnesses or immunocompromised patients (see Section 5.1) who have been treated, it has not been possible to demonstrate the efficacy and safety of Relenza in these groups. Due to limited and inconclusive data, the efficacy of Relenza in the prevention of influenza in the nursing home setting has not been demonstrated. The efficacy of zanamivir for the treatment of elderly patients ≥ 65 years has also not been established (see section 5.1).
There have been very rare reports of patients being treated with Relenza who have experienced bronchospasm and/or decline in respiratory function which may be acute and/or serious. Some of these patients did not have any previous history of respiratory disease. Any patients experiencing such reactions should discontinue Relenza and seek medical evaluation immediately.
Due to the limited experience, patients with severe asthma require a careful consideration of the risk in relation to the expected benefit, and Relenza should not be administered unless close medical monitoring and appropriate clinical facilities are available in case of bronchoconstriction. In patients with persistent asthma or severe COPD, management of the underlying disease should be optimised during therapy with Relenza.
Should zanamivir be considered appropriate for patients with asthma or chronic obstructive pulmonary disease, the patient should be informed of the potential risk of bronchospasm with Relenza and should have a fast acting bronchodilator available. Patients on maintenance inhaled bronchodilating therapy should be advised to use their bronchodilators before taking Relenza (see section 4.2).
Zanamivir inhalation powder must not be made into an extemporaneous solution for administration by nebulisation or mechanical ventilation. There have been reports of hospitalised patients with influenza who received a solution made with zanamivir inhalation powder administered by nebulisation or mechanical ventilation, including a fatal case where it was reported that the lactose in this formulation obstructed the proper functioning of the equipment. Zanamivir inhalation powder must only be administered using the device provided (see section 4.2).
This medicinal product contains lactose. Patients with rare hereditary problems of galactose intolerance, the total lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Relenza is not a substitute for influenza vaccination and the use of Relenza must not affect the evaluation of individuals for annual vaccination. The protection against influenza only lasts as long as Relenza is administered. Relenza should be used for the treatment and prevention of influenza only when reliable epidemiological data indicate that influenza is circulating in the community.
Relenza is effective only against illness caused by influenza viruses. There is no evidence for the efficacy of Relenza in any illness caused by agents other than influenza viruses.
Neuropsychiatric events have been reported during administration of Relenza in patients with influenza, especially in children and adolescents. Therefore, patients should be closely monitored for behavioural changes and the benefits and risks of continuing treatment should be carefully evaluated for each patient (see section 4.8).
Potential for other drugs to affect zanamivir
Zanamivir is eliminated through renal filtration. Clinically significant drug interactions are unlikely.
Potential for zanamivir to affect other drugs
Zanamivir does not inhibit the cytochrome P450 (CYP) enzymes CYP1A1/2, 2A6, 2C9, 2C19, 2D6, 2E1 and 3A4. Zanamivir does also not affect the renal transporters OAT1, 2, 3 and 4, OCT1 and 2, OCT2-A, OCT3 and the urate transporter hURAT1.
Zanamivir, when given for 28 days, did not impair the immune response to influenza vaccine.
Pregnancy
Systemic exposure to zanamivir is low following administration by inhalation; however, there is no information on placental transfer of zanamivir in humans. There is a limited amount of data (less than 300 pregnancy outcomes) from the use of zanamivir in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity (see section 5.3).
As a precautionary measure, it is preferable to avoid the use of Relenza during pregnancy, unless the clinical condition of the woman is such that the potential benefit to the mother significantly outweighs the possible risk to the foetus.
Breastfeeding
Systemic exposure to zanamivir is low following administration by inhalation; however, there is no information on secretion of zanamivir into human breast milk. A risk to the breastfed child cannot be excluded. A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from Relenza therapy, taking into account the benefit of breast feeding for the child and the benefit of therapy for the woman.
Fertility
Animal studies indicate no clinically meaningful effects of zanamivir on male or female fertility (see section 5.3).
Zanamivir has no or negligible influence on ability to drive and use machines.
There have been rare reports of patients with previous history of respiratory disease (asthma, COPD) and very rare reports of patients without previous history of respiratory disease, who have experienced acute bronchospasm and/or serious decline in respiratory function after use of Relenza (see section 4.4).
The adverse events considered at least possibly related to the treatment are listed below by body system, organ class and absolute frequency. Frequencies are defined as very common (≥1/10), common (>1/100, <1/10), uncommon≥ >1/1000, <1/100), rare (≥1/10,000, <1/1000), very rare (<1/10,000), not known (cannot be estimated from the available data).
Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness.
Immune system disorders
Uncommon:
allergic-type reactions including oropharyngeal oedema
Rare:
Anaphylactic/Anaphylactoid reactions, facial oedema
Nervous systems disorders
Uncommon: vasovagal-like reactions have been reported in patients with influenza symptoms, such as fever and dehydration, shortly following inhalation of zanamivir.
Respiratory, thoracic and mediastinal disorders:
Uncommon:
bronchospasm, dyspnoea, throat tightness or constriction
Skin and subcutaneous tissue disorders:
Common:
rash
Uncommon:
urticaria
Rare:
Severe skin reactions including Erythema Multiforme, Stevens-Johnson syndrome and Toxic epidermal necrolysis
Psychiatric and nervous system disorders:
Convulsions and psychiatric events such as depressed level of consciousness, abnormal behaviour, hallucinations and delirium have been reported during Relenza administration in patients with influenza. The symptoms were mainly reported in children and adolescents. Convulsions and psychiatric symptoms have also been reported in patients with influenza not taking Relenza.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
Symptoms
The clinical signs and symptoms reported with overdoses of inhaled zanamivir are similar to those reported with therapeutic doses of inhaled zanamivir and/or the underlying disease.
Management
As zanamivir has a low molecular weight, low protein binding, and small volume of distribution, it is expected to be removed by haemodialysis. Further management should be as clinically indicated or as recommended by the national poisons centre.
Medicines sold in Poland with the same active substance: W Polsce znany jako
Same active substance. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Polish medicines in the UK →
Ask anything about Relenza 5mg/dose inhalation powder. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.
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