How to Prepare Tamiflu Capsules for a 45 mg Dose
If only Tamiflu capsules are available and you need a 45 mg dose, open the capsule and mix the contents with a sweetened liquid, or have a pharmacist compound a suspension—do not attempt to split the capsule itself into portions. 1
Why Capsules Cannot Be Split into Equal Parts
Attempting to physically divide a capsule into portions (like "papertabs") is not recommended and will result in inaccurate dosing. Research demonstrates that when capsules are split, the base consistently contains approximately 75% of the powder while the cap contains only 25%, making equal division impossible 2. This significant variability would lead to either underdosing or overdosing your child.
Recommended Preparation Methods
Option 1: Open Capsule and Mix with Liquid (Immediate Use)
For a single 45 mg dose from a 75 mg capsule:
The guidelines explicitly state that "the capsules may be opened and the contents mixed with a sweetened liquid to mask the bitter taste" 1, 3. However, this approach is problematic for achieving a precise 45 mg dose from a 75 mg capsule, as you would need to measure exactly 60% of the powder—which is impractical and inaccurate.
Option 2: Pharmacy-Compounded Suspension (Preferred Method)
The most reliable approach is to have a retail pharmacy compound a suspension from the capsules 4, 5, 6, 5, 7:
- Final concentration: 6 mg/mL
- For 45 mg dose: Give 7.5 mL of the compounded suspension
- Vehicles used: Cherry Syrup (Humco®), Ora-Sweet® SF, or simple syrup
- Stability:
- Refrigerated (2-8°C): 35 days
- Room temperature (25°C): 5 days
Option 3: Emergency Home Compounding (When Pharmacy Unavailable)
If a pharmacy is not accessible, the FDA label provides detailed instructions for emergency compounding at home 7:
For a child weighing 15-23 kg (requiring 45 mg doses):
Calculate total volume needed: 100 mL for a 5-day treatment course
Materials needed:
- 8 capsules of Tamiflu 75 mg
- 7 mL water
- 91 mL of vehicle (Cherry Syrup, Ora-Sweet® SF, or simple syrup)
- Glass or PET plastic bottle with child-resistant cap
Preparation steps:
- Add 7 mL water to the bottle
- Open all 8 capsules and pour contents into bottle
- Swirl gently for at least 2 minutes to wet the powder
- Add 91 mL of vehicle
- Shake