Tamiflu Dosing for a 2.7-Year-Old, 35-Pound Child
For a 2.7-year-old female weighing 35 pounds (15.9 kg), the recommended dose of Tamiflu (oseltamivir) is 45 mg twice daily for 5 days for treatment, or 45 mg once daily for 10 days for prophylaxis. 1, 2, 3
Weight-Based Dosing Algorithm
This child falls into the >15-23 kg (>33-51 lb) weight category, which determines the appropriate dose 4, 1:
- Weight: 35 pounds = 15.9 kg
- Treatment dose: 45 mg twice daily for 5 days 4, 1
- Prophylaxis dose: 45 mg once daily for 10 days 4, 1
Practical Administration
Using Oral Suspension (Preferred for Young Children)
The 45 mg dose equals 7.5 mL of the 6 mg/mL oral suspension 4, 3:
- Administer 7.5 mL twice daily (approximately 12 hours apart) for treatment 4
- Administer 7.5 mL once daily for prophylaxis 4, 1
- Give with food to reduce nausea and vomiting, which occur in 5-15% of pediatric patients 5, 2
Using Capsules (Alternative)
If using the 45 mg capsule formulation 4:
- One 45 mg capsule twice daily for treatment
- One 45 mg capsule once daily for prophylaxis
- Capsules can be opened and mixed with sweetened liquid if the child cannot swallow them whole 4, 5
Critical Timing Considerations
Treatment must be initiated within 48 hours of symptom onset for maximum effectiveness 5, 2. The earlier treatment begins, the greater the reduction in illness duration and severity 6.
For prophylaxis, initiate within 48 hours of exposure to an infected individual 3.
Common Pitfalls to Avoid
- Do not use age-based dosing for this child - weight-based dosing is required for all children ≥12 months 4, 1, 2
- Do not round down to 30 mg - this child weighs >15 kg (>33 lb), requiring the 45 mg dose 1, 2
- Avoid administering live attenuated influenza vaccine (LAIV) within 48 hours before oseltamivir, and do not use oseltamivir for 14 days after LAIV vaccination 1, 5
- No renal dose adjustment is needed unless the child has documented renal impairment (creatinine clearance <30 mL/min) 4, 5
Dispensing Information
For treatment (5 days), dispense 2 bottles of oral suspension to ensure adequate supply for the full 7.5 mL twice daily regimen 3. Each bottle contains 60 mL when reconstituted 3.