From the Guidelines
Tamiflu (oseltamivir) can rarely cause seizures as a side effect, particularly in children and adolescents, but the risk is considered low and the medication remains a safe and effective treatment for influenza when used as prescribed. According to the most recent evidence from the 2024 guidelines for prevention and control of influenza in children 1, oseltamivir is the preferred treatment for influenza in children, and its benefits outweigh the risks. While seizures have been reported in post-marketing surveillance and clinical use, the exact mechanism by which Tamiflu might trigger seizures is not fully understood. Other neuropsychiatric side effects, including confusion, hallucinations, and abnormal behavior, have also been reported. However, a review of controlled clinical trial data and ongoing surveillance has failed to establish a link between oseltamivir and neurologic or psychiatric events 1.
Some key points to consider when evaluating the risk of seizures with oseltamivir include:
- The risk of seizures appears to be higher in patients with underlying neurological conditions, fever, or influenza infection itself 1
- Other neuropsychiatric side effects, including confusion, hallucinations, and abnormal behavior, have also been reported 1
- The exact mechanism by which Tamiflu might trigger seizures is not fully understood, but it may relate to how the drug affects neurotransmitters in the brain 1
- For most patients, especially those without pre-existing neurological conditions, Tamiflu remains a safe and effective treatment for influenza when used as prescribed 1
It's essential to note that the benefits of oseltamivir in treating influenza, particularly in high-risk populations, outweigh the risks. If someone experiences seizures while taking Tamiflu, they should seek immediate medical attention, and their healthcare provider may recommend discontinuing the medication. The decision to use oseltamivir should be based on individual patient factors, including the severity of illness, underlying medical conditions, and local influenza activity.
In terms of monitoring and management, patients taking oseltamivir should be closely monitored for signs of neuropsychiatric side effects, including seizures, and healthcare providers should be prepared to adjust treatment as needed. Additionally, patients and caregivers should be educated on the potential risks and benefits of oseltamivir and the importance of seeking medical attention if symptoms persist or worsen.
Overall, while the risk of seizures with oseltamivir is a concern, the medication remains a valuable treatment option for influenza, particularly in high-risk populations. By carefully evaluating individual patient factors and closely monitoring for potential side effects, healthcare providers can minimize the risks and maximize the benefits of oseltamivir treatment.
From the FDA Drug Label
Oseltamivir phosphate for oral suspension can cause serious side effects, including: Change in behavior. People, especially children, who have the flu, can develop nervous system problems and abnormal behavior that can lead to death. During treatment with oseltamivir phosphate for oral suspension, tell your healthcare provider right away if you or your child have confusion, speech problems, shaky movements, seizures, or start hearing voices or seeing things that are not really there (hallucinations)
Yes, Oseltamivir (Tamiflu) can cause seizures, as stated in the drug label 2.
From the Research
Oseltamivir (Tamiflu) and Seizures
- There is evidence to suggest that oseltamivir (Tamiflu) may be associated with seizures, particularly in children and adolescents 3.
- A study published in Prescrire international in 2007 reported that oseltamivir has been linked to severe and sometimes fatal neuropsychiatric disorders, including seizures, suicidal behavior, hallucinations, delirium, and extrapyramidal disorders 3.
- Another study published in Expert review of respiratory medicine in 2016 mentioned that febrile seizures are a potential complication of influenza in children, but it did not specifically address the relationship between oseltamivir and seizures 4.
- The other studies reviewed did not provide direct evidence of a link between oseltamivir and seizures 5, 6, 7.