From the Guidelines
Tamiflu (oseltamivir) is indicated for the treatment of uncomplicated influenza in patients who have been symptomatic for no more than 48 hours and for prophylaxis of influenza in certain situations, as recommended by the American Academy of Pediatrics in 2021 1.
Key Points:
- For treatment, the standard adult dose is 75 mg twice daily for 5 days, while children's dosing is weight-based.
- For prophylaxis, adults take 75 mg once daily for at least 7 days following exposure or up to 6 weeks during community outbreaks.
- Tamiflu works best when started within 24-48 hours of symptom onset, as it inhibits viral neuraminidase, preventing the release of new virus particles from infected cells.
- The medication can reduce the duration of flu symptoms by about 1-2 days and may decrease complications in high-risk individuals, including those with chronic medical conditions, immunocompromised patients, pregnant women, young children, and adults over 65.
- Common side effects include nausea, vomiting, and headache, which can be minimized by taking the medication with food.
- Tamiflu is not a substitute for annual influenza vaccination, which remains the primary preventive measure against seasonal flu.
High-Risk Groups:
- Children at high risk of complications, including those with chronic medical conditions, immunocompromised patients, and young children.
- Adults over 65 years old.
- Pregnant women.
Dosage:
- Adults: 75 mg twice daily for 5 days for treatment, and 75 mg once daily for at least 7 days for prophylaxis.
- Children: weight-based dosing, with doses ranging from 30 mg to 75 mg twice daily for treatment, and 30 mg to 75 mg once daily for prophylaxis.
Administration:
- Oseltamivir is administered orally without regard to meals, although administration with meals may improve gastrointestinal tolerability.
- The medication is available in capsule and oral suspension formulations.
From the FDA Drug Label
Oseltamivir phosphate for oral suspension is an influenza neuraminidase inhibitor (NAI) indicated for: Treatment of acute, uncomplicated influenza A and B in patients 2 weeks of age and older who have been symptomatic for no more than 48 hours. Prophylaxis of influenza A and B in patients 1 year and older.
Tamiflu (oseltamivir) is indicated for:
- Treatment of acute, uncomplicated influenza A and B in patients 2 weeks of age and older who have been symptomatic for no more than 48 hours.
- Prophylaxis of influenza A and B in patients 1 year and older. 2
From the Research
Indications for Tamiflu
Tamiflu, also known as oseltamivir, is indicated for the treatment of uncomplicated influenza in patients two weeks of age or older who have been symptomatic for no more than two days 3. The recommended dosage is 75 mg twice daily by mouth for five days.
Patient Population
- Tamiflu is indicated for patients with uncomplicated influenza A and B 4.
- It may increase survival when used within five days of symptom onset in influenza H1N1-infected patients who require ICU admission 3.
- There appears to be no benefit in starting treatment more than 48 hours after symptom onset in hospitalized general medicine patients or outpatients infected with either H1N1 or other influenza strains 3.
Treatment Duration
- The standard treatment duration is five days 3.
- There are scant data supporting the use of oseltamivir for longer than five days in any patient population, with the possible exception of critically ill H1N1-infected ICU patients, who may benefit from extended treatment in some cases 3.
Alternative Regimens
- Alternative regimens of neuraminidase inhibitors, including higher doses or different administration routes, have been studied, but have not demonstrated significant benefits over standard treatment 5.
- Other antiviral agents, such as zanamivir, laninamivir, and baloxavir, have also been shown to reduce symptomatic seasonal influenza in persons exposed to influenza 6.