Can Oscillococcinum and Tamiflu Be Taken Together?
Yes, oscillococcinum and Tamiflu (oseltamivir) can be taken together as there are no known drug interactions between them, though oscillococcinum lacks robust evidence for clinical efficacy in influenza treatment.
Drug Interaction Profile
No documented interactions exist between oseltamivir and oscillococcinum. The ACIP guidelines note that limited clinical data are available regarding drug interactions with oseltamivir, but interactions primarily occur with agents excreted via the renal anionic pathway (such as probenecid), not with homeopathic preparations 1.
Oscillococcinum is a highly diluted homeopathic preparation made from wild duck heart and liver extract that does not contain pharmacologically active concentrations of any substance that would interact with oseltamivir's mechanism of action as a neuraminidase inhibitor 2, 3.
Evidence for Each Agent
Oseltamivir (Tamiflu) Efficacy
Oseltamivir reduces symptom duration by approximately 16.8 hours in adults (from 7 days to 6.3 days) when initiated within 48 hours of symptom onset 4.
In children, oseltamivir reduces symptom duration by 29 hours in otherwise healthy children, though no effect was demonstrated in asthmatic children 4.
For prophylaxis, oseltamivir reduces the risk of symptomatic influenza by 3.05% (NNTB = 33) in individuals and 13.6% (NNTB = 7) in household contacts 4.
Oscillococcinum Efficacy
The evidence for oscillococcinum is insufficient and of low quality. A Cochrane review found that oscillococcinum may reduce symptom duration by 0.28 days (approximately 7 hours), but this was based on only two low-quality studies 2.
A more recent 2012 Cochrane review concluded there is "insufficient good evidence to enable robust conclusions" about oscillococcinum for influenza treatment or prevention 3.
No evidence supports oscillococcinum for influenza prevention 2, 3.
Clinical Recommendation
Prioritize oseltamivir as the evidence-based treatment for influenza, initiated within 48 hours of symptom onset at 75 mg twice daily for 5 days in adults 1, 5.
If a patient wishes to take oscillococcinum concurrently, there is no safety concern regarding drug interactions, but they should understand it has minimal to no proven clinical benefit 3.
Taking oseltamivir with food reduces gastrointestinal side effects (nausea occurs in 3.66% more patients on oseltamivir; NNTH = 28) 5, 4.
Important Caveats
Do not delay or substitute oseltamivir with oscillococcinum in high-risk patients (elderly, immunocompromised, pregnant women, or those with chronic medical conditions), as oseltamivir has demonstrated mortality and morbidity benefits in these populations 1, 5.
Oseltamivir remains effective even when initiated beyond 48 hours in hospitalized or severely ill patients 6.
Monitor for oseltamivir adverse effects including nausea (NNTH = 28), vomiting (NNTH = 22), and rare neuropsychiatric events, particularly in adolescents 1, 4.