What is the correct oseltamivir (Tamiflu) dose for a 10‑year‑old child weighing 69 lb (≈31 kg) for treatment of influenza?

Tamiflu Dosing for a 10-Year-Old Weighing 69 lbs

For a 10-year-old child weighing 69 lb (31.4 kg), the correct oseltamivir dose is 60 mg orally twice daily for 5 days for treatment, or 60 mg once daily for 10 days for prophylaxis. 1, 2

Weight-Based Dosing Category

• A child weighing 69 lb (31.4 kg) falls into the >23 kg to ≤40 kg weight bracket, which determines the appropriate dose. 1, 2
• This patient should receive 60 mg per dose, not 45 mg (which is for >15–23 kg) or 75 mg (which is for >40 kg). 1, 2

Treatment Regimen (Acute Influenza)

• Dose: 60 mg orally twice daily for 5 days. 1, 3
• Oral suspension formulation: 10 mL of the 6 mg/mL suspension delivers the 60 mg dose. 1, 3
• Capsule alternative: Two 30 mg capsules can be used if the child can swallow capsules. 2
• Initiate treatment within 48 hours of symptom onset for maximum benefit; earlier initiation (within 12–24 hours) provides substantially greater effectiveness. 1, 4

Prophylaxis Regimen (Post-Exposure)

• Dose: 60 mg orally once daily for 10 days after close contact with an infected individual. 1, 2
• Begin prophylaxis within 48 hours following close contact with a confirmed case. 1, 3

Administration Guidance

• Take with food to significantly reduce nausea and vomiting, which occur in approximately 10–15% of patients. 1, 4, 5
• Use a calibrated oral dosing device to accurately measure 10 mL when using the suspension formulation. 1
• Complete the full 5-day treatment course even if symptoms improve earlier to maintain viral suppression and prevent resistance. 1, 6

Common Pitfalls to Avoid

• Do not round up to 75 mg simply because the child is 10 years old; weight-based dosing takes precedence over age-based recommendations for children ≥12 months. 1, 2
• Do not confuse treatment dosing (twice daily) with prophylaxis dosing (once daily). 1, 2
• Do not use household spoons for measurement; always use the calibrated dosing device provided or a medical-grade oral syringe. 1

Renal Function Considerations

• For children with normal renal function, no dose adjustment is needed. 1, 2
• If this patient had creatinine clearance of 10–30 mL/min, the dose would need reduction to 30 mg once daily for treatment. 1, 6, 3

Clinical Benefits of Early Treatment

• Oseltamivir reduces illness duration by approximately 1–1.5 days (26–36% reduction) when started within 48 hours. 1, 4
• It lowers the risk of secondary complications, especially acute otitis media, by about 44%. 1, 4
• Treatment within 12 hours of symptom onset provides an additional 74.6 hours of benefit compared to starting at 48 hours. 4