Does oseltamivir (Tamiflu) increase lactate levels?

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Last updated: February 23, 2025View editorial policy

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From the Guidelines

Oseltamivir does not typically increase lactate levels in most patients. Oseltamivir (brand name Tamiflu) is an antiviral medication used to treat and prevent influenza A and B. It works by inhibiting the viral neuraminidase enzyme, which prevents the release of new virus particles from infected cells. While oseltamivir can have side effects, an increase in lactate levels is not a commonly reported or expected effect. The most frequent side effects include nausea, vomiting, headache, and fatigue. However, in rare cases, particularly in patients with severe influenza infections or underlying health conditions, lactic acidosis (a buildup of lactic acid in the body) can occur. This is more likely due to the severe illness itself rather than a direct effect of oseltamivir. If a patient experiences symptoms of lactic acidosis while taking oseltamivir (such as rapid breathing, confusion, or severe fatigue), they should seek immediate medical attention. Healthcare providers should monitor high-risk patients for signs of metabolic imbalances, including elevated lactate levels, especially in severe cases of influenza. The most recent guidelines for the use of oseltamivir, as outlined in the 2021 recommendations for prevention and control of influenza in children 1, do not mention an increase in lactate levels as a common side effect. Key points to consider when prescribing oseltamivir include:

  • Dosage: The recommended dosage for oseltamivir varies by age and weight, with specific guidelines for infants, children, and adults 1.
  • Administration: Oseltamivir is administered orally, with or without food, and is available in capsule or oral suspension form 1.
  • Monitoring: Healthcare providers should monitor patients for signs of lactic acidosis, particularly those with underlying health conditions or severe influenza infections 1. It is essential to note that the provided evidence does not directly address the question of whether oseltamivir increases lactate levels. However, based on the available information and the most recent guidelines, oseltamivir is not typically associated with an increase in lactate levels.

From the Research

Oseltamivir and Lactate Levels

  • There is no direct evidence in the provided studies that oseltamivir (Tamiflu) increases lactate levels 2, 3, 4, 5, 6.
  • The studies primarily focus on the pharmacokinetics, pharmacodynamics, and potential interactions of oseltamivir, as well as its effects on influenza virus infections and its penetration into the brain 2, 3, 4, 5, 6.
  • None of the studies mention lactate levels as an outcome or a parameter of interest, suggesting that the relationship between oseltamivir and lactate levels may not have been investigated in these particular studies 2, 3, 4, 5, 6.

Related Findings

  • Oseltamivir is metabolized to its active form, oseltamivir carboxylate, which is then eliminated by the kidneys 2, 3, 4.
  • The drug's pharmacokinetics are not significantly affected by moderate hepatic impairment 4.
  • Oseltamivir has been shown to have a hypothermic effect, which is not dependent on its anti-influenza virus action 5.
  • The drug's penetration into the brain is increased during inflammation, which may contribute to its central nervous system side-effects 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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