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What is the swine flu (H1N1 influenza A virus) and what causes it?

The 2009 swine flu virus (otherwise known as H1N1 influenza) is caused by an H1N1 influenza A virus. H1N1 influenza viruses are the normal cause of influenza in humans and may also infect other animals, including pigs. This particular variant is an example of a virus that likely originated in swine and has mutated (changed its biological characteristics) so it is now affecting humans.

What are the symptoms of swine flu (H1N1 influenza A virus)?

Symptoms of swine flu vary widely and are similar to symptoms of seasonal flu. Infected individuals may experience

  • fever,
  • cough,
  • sore throat,
  • body aches,
  • headache,
  • chills, and
  • fatigue.

Vomiting and diarrhea have been reported and severe cases may result in respiratory failure and even death.

How...

Fluarix

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WARNINGS

Included as part of the PRECAUTIONS section.

PRECAUTIONS

Guillain-Barré Syndrome

If Guillain-Barré syndrome has occurred within 6 weeks of receipt of a prior influenza vaccine, the decision to give FLUARIX should be based on careful consideration of the potential benefits and risks.

Latex

The tip caps of the prefilled syringes may contain natural rubber latex which may cause allergic reactions in latex sensitive individuals [see DESCRIPTION].

Altered Immunocompetence

If FLUARIX is administered to immunosuppressed persons, including individuals receiving immunosuppressive therapy, the immune response may be lower than in immunocompetent persons.

Preventing and Managing Allergic Vaccine Reactions

Prior to administration, the healthcare provider should review the immunization history for possible vaccine sensitivity and previous vaccination-related adverse reactions. Appropriate medical treatment and supervision must be available to manage possible anaphylactic reactions following administration of FLUARIX.

Limitations of Vaccine Effectiveness

Vaccination with FLUARIX may not protect all susceptible individuals.

Persons at Risk of Bleeding

As with other intramuscular injections, FLUARIX should be given with caution in individuals with bleeding disorders such as hemophilia or on anticoagulant therapy, to avoid the risk of hematoma following the injection.

Nonclinical Toxicology

Carcinogenesis, Mutagenesis, Impairment of Fertility

FLUARIX has not been evaluated for carcinogenic or mutagenic potential, or for impairment of fertility.

Use In Specific Populations

Pregnancy

Pregnancy Category B

A reproductive and developmental toxicity study has been performed in female rats at a dose approximately 56 times the human dose (on a mg/kg basis) and revealed no evidence of impaired female fertility or harm to the fetus due to FLUARIX. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, FLUARIX should be given to a pregnant woman only if clearly needed.

In a reproductive and developmental toxicity study, the effect of FLUARIX on embryo-fetal and pre-weaning development was evaluated in pregnant rats. Animals were administered FLUARIX by intramuscular injection once prior to gestation, and during the period of organogenesis (gestation days 6, 8, 11, and 15), 0.1 mL/rat/occasion (approximately 56-fold excess relative to the projected human dose on a body weight basis). No adverse effects on mating, female fertility, pregnancy, parturition, lactation parameters, and embryo-fetal or pre-weaning development were observed. There were no vaccine-related fetal malformations or other evidence of teratogenesis.

Pregnancy Registry

GlaxoSmithKline maintains a surveillance registry to collect data on pregnancy outcomes and newborn health status outcomes following vaccination with FLUARIX during pregnancy. Women who receive FLUARIX during pregnancy should be encouraged to contact GlaxoSmithKline directly or their healthcare provider should contact GlaxoSmithKline by calling 1-888-452-9622.

Nursing Mothers

It is not known whether FLUARIX is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when FLUARIX is administered to a nursing woman.

Pediatric Use

The immune response to FLUARIX has been evaluated in children 6 months to < 5 years of age. In a randomized, controlled study, serum hemagglutination-inhibition (HI) antibody titers were lower in children 6 months to < 3 years of age compared to a US-licensed vaccine. Based on these data, FLUARIX is not approved for use in children younger than 3 years of age. Immune responses in children 3 years to < 5 years of age receiving FLUARIX or a US-licensed vaccine have been evaluated [see Clinical Studies]. Safety has been evaluated in children 6 months to < 18 years of age. The frequencies of solicited and unsolicited adverse events for children 3 years to < 5 years of age and for children 5 years to < 18 years of age were similar for FLUARIX and the comparator vaccine [see ADVERSE REACTIONS].

Geriatric Use

A randomized, single-blind, active-controlled study evaluated immunological non-inferiority in a cohort of subjects ≥ 65 years of age who received FLUARIX (N = 606) or another US-licensed trivalent, inactivated influenza virus vaccine (N = 604) (Sanofi Pasteur SA). In subjects receiving FLUARIX or the comparator vaccine, geometric mean antibody titers post-vaccination were lower in geriatric subjects than in younger subjects (18 to 64 years of age). FLUARIX was non-inferior to the comparator vaccine for each of the 3 influenza strains based on mean antibody titers and seroconversion rates. [See Clinical Studies.] Solicited local and general adverse events were similar for FLUARIX and the comparator vaccine among geriatric subjects (Table 2). For both vaccines, the frequency of solicited events in subjects ≥ 65 years of age was lower than in younger subjects (Table 2). [See ADVERSE REACTIONS.]

Last reviewed on RxList: 1/10/2012
This monograph has been modified to include the generic and brand name in many instances.

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