Tamiflu Dosage for a 27.2kg Patient
For a 27.2kg patient with normal renal function, the recommended Tamiflu dose is 60 mg twice daily for 5 days for treatment, or 60 mg once daily for 10 days for prophylaxis. 1
Weight-Based Dosing Algorithm
This patient falls into the >23-40 kg weight category, which requires 60 mg per dose. 2, 1 The weight-based dosing categories are:
- ≤15 kg: 30 mg per dose 1
15-23 kg: 45 mg per dose 1
- >23-40 kg: 60 mg per dose 1
40 kg: 75 mg per dose 1
Formulation and Administration
Administer 10 mL of the oral suspension (6 mg/mL concentration) to deliver the 60 mg dose. 2, 1 The oral suspension is preferred for pediatric patients in this weight range. 2
- If capsules are used instead, the 60 mg dose can be given as two 30 mg capsules 2
- If commercial suspension is unavailable, pharmacies can compound it to the same 6 mg/mL concentration 2, 1
Give with food to reduce gastrointestinal side effects, as nausea and vomiting occur in approximately 10-15% of patients but are significantly reduced when taken with meals. 2, 3
Treatment vs. Prophylaxis Regimens
For treatment of influenza:
- 60 mg (10 mL) twice daily for 5 days 1, 3
- Initiate within 48 hours of symptom onset for maximum benefit 1, 3
For prophylaxis (post-exposure):
- 60 mg (10 mL) once daily for 10 days 1, 3
- Start within 48 hours of exposure to an infected individual 3
Critical Consideration: Renal Function Assessment
If this patient has impaired renal function (creatinine clearance 10-30 mL/min), dose reduction is mandatory. 2, 1 The adjusted dosing would be:
- Treatment: Reduce to the standard weight-based dose (60 mg) given once daily instead of twice daily for 5 days 1, 3
- Prophylaxis: Reduce to 30 mg once daily for 10 days, OR give 60 mg every other day for 10 days (5 total doses) 1, 3
Always calculate creatinine clearance before dosing, as renal impairment significantly increases drug exposure and toxicity risk. 2, 4 Oseltamivir is eliminated primarily through renal tubular secretion, and clearance decreases linearly with declining renal function. 4
Common Pitfalls to Avoid
Do not round down to 45 mg just because the patient is closer to 23 kg than 40 kg—at 27.2 kg, this patient definitively falls into the >23-40 kg bracket requiring 60 mg. 1, 5
Do not use adult dosing (75 mg) until the patient exceeds 40 kg. 1
Do not confuse GFR with creatinine clearance when assessing renal function for dose adjustments. 1
Ensure accurate volume measurement using a calibrated oral dosing syringe or cup that can measure 10 mL precisely. 5