From the Guidelines
The probability of Tamiflu (oseltamivir) causing nausea in a 10-year-old female with influenza B is approximately 10-15%. Nausea is one of the more common side effects of Tamiflu in children, along with vomiting, which occurs in about 15% of pediatric patients 1. The risk of gastrointestinal side effects may be reduced by taking Tamiflu with food. For a 10-year-old, the typical dosage is 60 mg twice daily for 5 days (based on weight between 23-40 kg), which should be started within 48 hours of symptom onset for maximum effectiveness. Parents should be aware that while nausea is possible, it's usually mild and temporary. The benefit of Tamiflu in reducing the duration of flu symptoms (by approximately 1-1.5 days) and potentially preventing complications often outweighs this side effect risk. The medication works by inhibiting viral neuraminidase, preventing the release of new virus particles from infected cells, which explains both its therapeutic effect and some of its side effect profile.
Some key points to consider:
- Oseltamivir is administered orally or by feeding tube without regard to meals, although administration with meals may improve gastrointestinal tolerability 1.
- The AAP considers oseltamivir to be the preferred postexposure chemoprophylaxis for patients with influenza A and/or B 1.
- Postexposure chemoprophylaxis should only be used when antiviral agents can be initiated within 48 hours of exposure 1.
- The CDC recommends routine chemoprophylaxis with oseltamivir or zanamivir for 7 days after last known exposure; minimum of 14 days and continuing for 7 days after last known exposure if part of institutional outbreak 1.
It's essential to weigh the benefits and risks of Tamiflu treatment, considering the individual patient's circumstances and the severity of their influenza symptoms. In general, the benefits of Tamiflu in reducing the duration and severity of flu symptoms, as well as preventing complications, often outweigh the risks of side effects like nausea. However, each case should be evaluated individually, taking into account the patient's medical history, current health status, and other factors that may influence the risk-benefit balance.
From the FDA Drug Label
Adverse Reactions from Treatment and Prophylaxis Trials in Pediatric Subjects (1 year to 12 years of age) A total of 1,481 pediatric subjects (including otherwise healthy pediatric subjects aged 1 year to 12 years and asthmatic pediatric subjects aged 6 to 12 years) participated in clinical trials of oseltamivir phosphate for the treatment of influenza. Vomiting was the only adverse reaction reported at a frequency of >1% in subjects receiving oseltamivir phosphate (16%) compared to placebo (8%) Amongst the 148 pediatric subjects aged 1 year to 12 years who received oseltamivir phosphate at doses of 30 to 60 mg once daily for 10 days in a post-exposure prophylaxis study in household contacts (n = 99), and in a separate 6–week seasonal influenza prophylaxis safety study (n = 49), vomiting was the most frequent adverse reaction (8% on oseltamivir phosphate versus 2% in the no prophylaxis group) Nausea is not explicitly mentioned for the pediatric population, however for adults and adolescents, it is reported as 10% for the treatment group.
The probability of Tamiflu making a 10-year-old female with flu B nauseous is not directly stated in the provided drug label for the pediatric population. However, for adults and adolescents, the reported probability of nausea is 10%. Since the question is about a pediatric subject, and there is no direct information available for this age group regarding nausea, no conclusion can be drawn 2.
From the Research
Tamiflu and Nausea in a 10-year-old Female with Flu B
- The probability of Tamiflu (oseltamivir) making a 10-year-old female with flu B nauseous is not directly stated in the provided studies.
- However, according to 3, nausea and vomiting were the most commonly reported events in clinical trials of oseltamivir in healthy adults and high-risk patients.
- The study also notes that gastrointestinal events were mild and transient, and both nausea and vomiting were less likely when oseltamivir was taken with food.
- There is no specific data provided on the incidence of nausea in pediatric patients, particularly a 10-year-old female with flu B.
- Other studies, such as 4 and 5, discuss the efficacy and safety of oseltamivir in treating influenza, but do not provide specific information on the probability of nausea in a 10-year-old female with flu B.
- A study published in 6 raises questions about the risk-benefit ratio of oseltamivir, but does not provide specific data on the incidence of nausea in pediatric patients.