Pharmacy Author: Omudhome Ogbru, Pharm.D.
Medical Editor: Jay Marks, M.D.

GENERIC NAME: Influenza nasal vaccine

BRAND NAME: FluMist

DRUG CLASS AND MECHANISM: FluMist is a nasal vaccine to protect against infection with the influenza virus which causes "flu". FluMist contains live influenza virus that has been weakened so that it causes minimal or no symptoms. When FluMist is inhaled, the body responds to the weakened viruses in FluMist by developing antibodies that fight influenza viruses. These antibodies protect against later infections by the naturally-occurring influenza virus. FluMist is effective only against the strains of influenza virus that are included in it, and the strains of virus change from year to year. FluMist has no effect on the flu once infection has begun. FluMist should be given shortly before the flu season begins to allow time for antibodies to be produced and for protection throughout the entire flu season. The FDA approved FluMist in June, 2003.

PRESCRIPTION: Yes.

GENERIC AVAILABLE: No.

PREPARATIONS: Intranasal Spray: prefilled sprayer, 0.5 ml

STORAGE: Store below 15°C (59°F).

PRESCRIBED FOR: FluMist is used for preventing infection with the influenza virus (flu).

DOSING: Children 5-8 years old who have not previously received FluMist should be given 2 doses of 0.5 ml 46-74 days apart. Children 5-8 years old who have previously received FluMist and adults 9-49 years old, should be given 1 dose (0.5 ml) each season. FluMist is administered by inhaling through the nose and is not given by injection. Approximately 0.25 ml, which is half of a single dose, should be inhaled into each nostril while in a standing position.

Since FluMist contains viruses that are likely to cause the flu in the upcoming season FluMist developed for previous seasons will not be effective and should not be used.

DRUG INTERACTIONS: Children 5-17 years of age who are receiving aspirin therapy should not be given FluMist because of the association between aspirin, influenza infection and Reye's syndrome.

Use of FluMist together with antiviral drugs that are active against the influenza virus has not been evaluated; however, since there is a potential for these agents to reduce the effectiveness of FluMist (by preventing infection with the viruses contained in the FluMist), such antiviral agents should not be administered until 2 weeks after FluMist therapy, and FluMist should not be administered until 48 hours after antiviral therapy is discontinued.

PREGNANCY: FluMist should not be given to pregnant women.

NURSING MOTHERS: Use of FluMist during breast feeding has not been adequately evaluated, and it is not known whether FluMist is excreted in breast milk.

SIDE EFFECTS: The most common side effects of FluMist are cough, runny nose, nasal congestion, sore throat , headache , restlessness, muscle aches, tiredness or weakness and fever.

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