Should Oseltamivir (Tamiflu) Be Taken With Food?
Oseltamivir can be taken with or without food, but taking it with food is strongly recommended to reduce gastrointestinal side effects, particularly nausea and vomiting. 1
Administration Guidance
The FDA drug label explicitly states that oseltamivir "may be taken with or without food; however, tolerability may be enhanced if oseltamivir phosphate for oral suspension is taken with food." 1
Taking oseltamivir with food significantly reduces the severity of nausea and vomiting, which are the most common adverse effects of the medication. 2, 3
Evidence for Food Administration
In clinical trials, nausea occurred in approximately 10% and vomiting in approximately 9% of adults receiving oseltamivir for treatment, compared to 6% and 3% respectively in placebo recipients. 2
Among children treated with oseltamivir, 14.3% experienced vomiting compared with 8.5% of placebo recipients. 2
The ACIP guidelines specifically note that "nausea and vomiting might be less severe if oseltamivir is taken with food." 2
Multiple guideline sources confirm that gastrointestinal effects are "mild, transient, and less likely when taken with food." 3, 4, 5
Clinical Implications
Only approximately 1% of patients discontinued oseltamivir due to gastrointestinal side effects in clinical trials, suggesting these symptoms are generally manageable. 2
The gastrointestinal adverse effects can be reduced to approximately 10% by administering the medication with food. 6
There is no reduction in drug efficacy when oseltamivir is taken with food—this is purely a tolerability consideration. 1, 4
Practical Recommendation
Advise patients to take oseltamivir with a light meal or snack to minimize nausea and vomiting. 5
If gastrointestinal symptoms occur despite taking with food, they are typically transient and resolve without requiring discontinuation. 4, 5
The standard dosing remains 75 mg twice daily for 5 days for treatment in adults, regardless of whether taken with or without food. 1