What is the treatment for influenza?

From the Guidelines

Treatment for influenza should be initiated as soon as possible for high-risk individuals, including those who are hospitalized, have severe or progressive illness, or are at higher risk for complications, with antiviral medications such as oseltamivir, zanamivir, or baloxavir, as recommended by the most recent guidelines 1. Key recommendations:

• Rest at home to recover and prevent spreading the virus
• Drink plenty of fluids to stay hydrated
• Use over-the-counter medications to relieve symptoms:
  • Acetaminophen or ibuprofen for fever and body aches
  • Decongestants for nasal congestion
  • Cough suppressants for persistent cough For high-risk individuals or severe cases, antiviral medications may be prescribed:

• Oseltamivir (Tamiflu): 75 mg twice daily for 5 days
• Zanamivir (Relenza): 10 mg inhaled twice daily for 5 days
• Baloxavir (Xofluza): Single dose based on weight (40-80 mg) These antivirals work best when started within 48 hours of symptom onset, as noted in the 2024 guidelines 1, and can reduce the duration and severity of illness by inhibiting viral replication. Antibiotics are not effective against influenza as it is a viral infection, however, they may be prescribed if a secondary bacterial infection develops, as stated in the 2019 clinical practice guidelines 1. Prevention is crucial: annual flu vaccination is recommended for most individuals to reduce the risk of infection and severe complications, as emphasized in the 2011 recommendations 1. Some key groups that should be treated with antivirals include:

• Persons of any age who are hospitalized with influenza
• Outpatients of any age with severe or progressive illness
• Outpatients who are at high risk of complications from influenza, including those with chronic medical conditions and immunocompromised patients
• Children younger than 2 years and adults ≥65 years
• Pregnant women and those within 2 weeks postpartum, as outlined in the 2019 guidelines 1.

From the FDA Drug Label

1 INDICATIONS AND USAGE

1.1 Treatment of Influenza Oseltamivir phosphate for oral suspension is indicated for the treatment of acute, uncomplicated illness due to influenza A and B infection in patients 2 weeks of age and older who have been symptomatic for no more than 48 hours.

1 INDICATIONS AND USAGE

1.1 Treatment of Influenza RELENZA (zanamivir) inhalation powder is indicated for treatment of uncomplicated acute illness due to influenza A and B virus in adults and pediatric patients aged 7 years and older who have been symptomatic for no more than 2 days.

The treatment for influenza includes oseltamivir (PO) and zanamivir (INH), which are indicated for the treatment of acute, uncomplicated illness due to influenza A and B infection.

• Oseltamivir is approved for patients 2 weeks of age and older who have been symptomatic for no more than 48 hours 2.
• Zanamivir is approved for adults and pediatric patients aged 7 years and older who have been symptomatic for no more than 2 days 3.

From the Research

Treatment Options for Influenza

The treatment for influenza typically involves the use of antiviral medications, such as oseltamivir. The following are some key points to consider:

• Oseltamivir is a prodrug of oseltamivir carboxylate, a potent and selective inhibitor of the neuraminidase glycoprotein essential for replication of influenza A and B viruses 4.
• Studies have shown that oseltamivir can reduce the duration of influenza symptoms by up to 1.5 days and the severity of illness by up to 38% when initiated within 36 hours of symptom onset 4, 5, 6.
• The standard adult dose for treatment is 75 mg twice a day for five days, and the dose for prophylaxis is 75 mg once daily for at least seven days following contact with an infected individual 7.
• Oseltamivir may also be effective in preventing influenza in high-risk populations, such as the elderly or those with chronic cardiac or respiratory disease 4, 8.

Administration and Efficacy

The efficacy of oseltamivir is influenced by the timing of administration:

• Earlier initiation of therapy is associated with shorter illness duration and reduced severity of symptoms 6.
• Initiation of therapy within the first 12 hours after fever onset can reduce the total median illness duration by 3.1 days (41%) compared to intervention at 48 hours 6.
• Oseltamivir is generally well-tolerated, with nausea and vomiting being the most commonly reported adverse events, which are typically mild and transient 4, 7, 5, 6.

Special Considerations

The following special considerations should be taken into account:

• Oseltamivir may be effective in treating influenza in patients with chronic respiratory and/or cardiac conditions, and in preventing influenza in high-risk populations 4, 5.
• The dose of oseltamivir may need to be adjusted in patients with renal failure, but no adjustments are required in patients with hepatic impairment 7.
• There is limited evidence to support the use of oseltamivir for longer than five days in any patient population, except possibly in critically ill patients with influenza H1N1 infection 8.