Contraindications for Tamiflu (Oseltamivir)
The only absolute contraindication to Tamiflu is known serious hypersensitivity to oseltamivir or any component of the product. 1
Absolute Contraindication
- Serious hypersensitivity reactions to oseltamivir or any formulation component constitute the sole FDA-recognized contraindication 1
- Severe allergic reactions that warrant absolute avoidance include:
What Are NOT Contraindications (Common Pitfalls)
Many conditions that clinicians mistakenly consider contraindications are actually safe for oseltamivir use:
- Pregnancy is not a contraindication—oseltamivir can be safely used during pregnancy 2
- Young age is not a contraindication—oseltamivir is approved for infants as young as 2 weeks of age with appropriate postmenstrual age-based dosing 2
- Infants <3 months can receive oseltamivir, though prophylaxis is not recommended unless the situation is judged critical due to limited safety data 2
- Chronic medical conditions including asthma, chronic pulmonary disease, cardiovascular disease, diabetes, and immunodeficiency are not contraindications 2
- Mild febrile illness is not a contraindication—do not withhold oseltamivir due to minor fever alone 2
- Renal insufficiency is not a contraindication—dose adjustment is required but the medication can still be used 2
Special Considerations Requiring Dose Adjustment (Not Contraindications)
- Moderate to severe renal impairment (CrCl 10-30 mL/min) requires dose reduction to 75 mg once daily for treatment or 30 mg once daily (or 75 mg every other day) for prophylaxis 2
- Preterm infants require substantially lower weight-based dosing due to immature renal function, with doses ranging from 1.0-3.0 mg/kg based on postmenstrual age 2
Drug Interaction Consideration
- Live attenuated influenza vaccine (LAIV) should not be administered within 48 hours before oseltamivir use, and oseltamivir should not be used for 14 days after LAIV vaccination, as the antiviral may interfere with vaccine efficacy 2