Tamiflu Dosing for an 8-Year-Old Weighing 32 kg with Influenza
For an 8-year-old child weighing 32 kg with influenza infection, administer oseltamivir 60 mg twice daily for 5 days, which corresponds to 10 mL of oral suspension (6 mg/mL concentration) per dose. 1, 2, 3
Weight-Based Dosing Algorithm
This child falls into the >23-40 kg weight category, which requires the 60 mg dose 1, 2, 3. The weight-based dosing categories for children ≥1 year are:
- ≤15 kg: 30 mg twice daily (5 mL per dose) 1, 2
- >15-23 kg: 45 mg twice daily (7.5 mL per dose) 1, 2
- >23-40 kg: 60 mg twice daily (10 mL per dose) 1, 2, 3
- >40 kg: 75 mg twice daily (12.5 mL per dose) 1, 2
Treatment Duration and Timing
- Initiate treatment within 48 hours of symptom onset for maximum effectiveness 1, 4, 3
- Continue for 5 days regardless of symptom improvement 1, 3
- Treatment reduces illness duration by approximately 1-1.5 days (26-36% reduction) and decreases risk of secondary complications like acute otitis media by 44% 2
Administration Instructions
- Administer with food to improve gastrointestinal tolerability and reduce nausea/vomiting, which occur in approximately 10% of patients 2, 4, 5
- Use an oral dosing dispensing device that accurately measures 10 mL 3
- The oral suspension concentration is 6 mg/mL when properly reconstituted 1, 2, 3
Formulation Options
- Oral suspension (preferred): 10 mL of 6 mg/mL suspension = 60 mg dose 2, 3
- Capsules (alternative): One 30 mg capsule + one 30 mg capsule = 60 mg dose 1, 5
- If capsules cannot be swallowed, they can be opened and contents mixed with liquid 4
Special Considerations
No renal dose adjustment is needed unless the child has significant renal impairment (creatinine clearance <30 mL/min) 2, 4, 5. For moderate renal impairment (CrCl 10-30 mL/min), reduce to 60 mg once daily instead of twice daily 1, 4, 5.
Common pitfall to avoid: Do not confuse this child's weight category with the >40 kg category, which would result in overdosing at 75 mg 1, 2. At 32 kg, the child clearly falls within the >23-40 kg range requiring 60 mg per dose 1, 2, 3.
Prophylaxis Dosing (If Needed)
If this child requires prophylaxis instead of treatment (e.g., household exposure without symptoms), the dose would be 60 mg once daily for 10 days, initiated within 48 hours of exposure 1, 2, 3.