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Antiviral (neuraminidase inhibitor)

Zanamivir: uses, side effects & precautions

Also known as Relenza, Zanamivir.

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What it is used for

  • Treatment of influenza (flu)
  • Prevention of influenza after exposure
  • Useful when oral antivirals are unsuitable

How it works

Zanamivir blocks an enzyme (neuraminidase) the influenza virus needs to spread between cells, limiting how far the infection spreads and easing symptoms when started early. It works against influenza viruses only, not colds or other respiratory infections.

How it is taken

Most commonly used as an inhaled powder breathed in through a special device (a hospital injectable form also exists for severe cases). For treatment it works best when started within the first day or two of symptoms and can also be used preventively after close contact with flu. Use the inhaler exactly as your doctor, pharmacist, or label directs.

No doses here on purpose. The right strength and schedule depend on you — only a doctor or pharmacist should set them. Always follow your prescription and the label.

Common side effects

  • Headache
  • Cough or throat irritation
  • Stuffy or runny nose
  • Diarrhoea
  • Nausea

Serious effects — get help

  • Wheezing or sudden breathing difficulty, especially in people with asthma or lung disease
  • Severe allergic or skin reaction
  • Sudden confusion or abnormal behaviour (reported mainly in young people)

If a reaction is severe — for example trouble breathing, swelling of the face or throat, or collapse — go to the nearest emergency room now or call your local emergency number. Do not wait for an online consultation.

Interactions to watch

  • Live attenuated (nasal spray) flu vaccine may be less effective if given close to zanamivir
  • Few other significant interactions
  • Tell your clinician about your medicines and recent vaccinations

Who should take care

  • Use with caution if you have asthma or chronic lung disease, as it can trigger wheezing; keep a reliever inhaler to hand
  • Do not put the powder in a nebuliser or ventilator unless specifically instructed
  • Use in pregnancy or breastfeeding on clinical advice
  • It does not replace the yearly flu vaccine

Frequently asked questions

How is zanamivir different from oseltamivir?
Both treat flu, but zanamivir is usually inhaled while oseltamivir is taken as capsules or liquid. Your clinician chooses based on your situation, such as lung conditions or ability to swallow capsules.
Can I use it if I have asthma?
It can sometimes trigger wheezing, so it is used with caution in asthma or lung disease, with a reliever inhaler nearby. Discuss the safest option with your doctor.
When should I start it?
It works best within the first 48 hours of flu symptoms. Contact your clinician promptly if you think you have the flu.
Does it work against colds or COVID-19?
No. It only works against influenza viruses, not cold viruses or coronaviruses.
Is Zanamivir safe to take?
For most people it is safe when taken exactly as a doctor or pharmacist advises and as printed on the label. Tell your clinician about your other medicines and health conditions, and seek urgent care for any serious reaction.

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