Survey of the proper use of instructions and compliance for laninamivir octanoate dry powder inhalation in community pharmacies for treatment of influenza

Abstract

Objective：Laninamivir Octanoate（LO）is a novel anti-influenza drug administered by inhalation only once administration, and with a very simple dosage adjustment regimen. Conversely, inhalation might be expected to fail in some groups of patients, particularly the very young and very elderly because of poor inhalation technique. Therefore, we undertook a study to investigate the success and failure rates of the dry powder inhalation formulation of LO.Methods：We observed 159 patients who were prescribed LO. Pharmacists observed the administration technique after explaining how to inhale the drug. Success was defined as patients who could inhale the drug without a problem. Failure was defined as those patients who were judged to have inhaled less than 75％ of the drug. We also examined the success rate between pharmacies and the success and failure rates according to age.Results：A 4-years-old patient was the youngest to fail LO therapy whereas a 5-years-old patient was the youngest to succeeded with the therapy. The success rate did not differ significantly between pharmacies. The success rate was 88.9％ in patients under the age of 9 years, but which was significantly lower compared with 97.9％ in the group of patients over 10 years of age.Conclusion：This survey revealed that many cases of inhalation failure of LO anti-influenza therapy occur below the age of 9 year.

Incomplete Inhalation of Laninamivir Octanoate in Children with Influenza

“…In a study of 55 children, the rate of residual LO was found to be inversely correlated with patient age, and the body temperature at 24 hours after the treatment was significantly higher in 32 patients whose residual volumes were above 20 %, although the difference was not significant [4]. Patients under 10 years of age inhaled significantly less LO than patients over 10 years of age [5]. Inhalation of LO was found group, but the sample size was too small to show a significant difference.…”

“…However, with only a single LO use per day, the amount of LO that reaches the trachea and lungs might not be sufficient in patients who do not inhale well. There is no article on correlation between inhalation rates of LO, patient's age and the time to fever resolution although some previous papers written in Japanese have been examined inhalation rates of LO in children [3][4][5][6]. In this study, we measured the amount of residual LO after inhalation in children with influenza and determined whether it had any relation with the time to fever resolution as reported by the parents.…”

A Comparison of the Frequency of Prescription and Pharmacy Revisits between Baloxavir Marboxil and Neuraminidase Inhibitors in Influenza-Infected Pediatric Patients during the 2019–2020 Influenza Season

“…6) When neuraminidase inhibitors are administrated to pediatric patients with influenza, it has been reported that the administration of oseltamivir or zanamivir resulted in a decrease in the number of times that an antipyretic analgesic was needed, shortening hospitalization time and the period of viral shedding. [7][8][9] However, because these drugs need to be taken twice a day for 5 d, non-compliance in dosing may be a problem. Whereas the dosing form of laninamivir is a dry powdered formulation that is inhaled and the patient receives a single dose only.…”

Impact of the number of repeated inhalations and patient characteristics on the residual amount of inhaled laninamivir octanoate hydrate dry powder in pediatric patients with influenza

“…However, if laninamivir DPIs are not operated correctly, a sufficient therapeutic effect cannot be obtained [ 3 ]. Therefore, pharmacists are required to instruct patients about the proper inhalation technique and provide information on the appropriate use of the inhalers [ 4 ].…”