Zanamivir (Relenza) is a neuraminidase inhibitor with activity against influenza A and B strains. Like os-eltamivir, zanamivir is a reversible competitive antagonist of viral neuraminidase. It inhibits the release of progeny virus, causes viral aggregation at the cell surface, and impairs viral movement through respiratory secretions. Resistant variants with hemagglutinin and/or neuraminidase mutations have been produced in vivo; however, clinical resistance to zanamivir is quite rare at present.
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