Q. What is Tamiflu and what is it approved for?
A. Tamiflu (oseltamivir phosphate) is an antiviral drug. It works by attacking the flu virus to keep it from multiplying in your body and by reducing the symptoms of the flu. Tamiflu can sometimes keep you from getting the flu if you take it before you get sick.
The term “flu” refers to illness caused by the influenza virus. The flu is a respiratory infection that can cause symptoms such as fever, chills, aches and pains, cough, and sore throat. The flu can range from mild common cold symptoms, to the typical “flu” symptoms described above, to life-threatening pneumonia and other complications, including secondary bacterial infections.
Tamiflu is used to treat people 2 weeks of age and older who have the flu (influenza A and B viruses). Tamiflu is also sometimes used for prevention (prophylaxis) of the flu in people 1 year of age and older, but it is not a substitute for getting the flu vaccine.
Q. Is Tamiflu a substitute for the flu vaccine?
A. No. Getting the flu vaccine is the best way to protect against getting the flu and to control the spread of the flu.
Other important parts of avoiding flu include avoiding unnecessary close contact between sick and well people, covering coughs and sneezes, and washing hands frequently.
More information on flu vaccines and other flu control measures is available on the Flu.gov website.
Q. What do the terms treatment of the flu and prevention (prophylaxis) of the flu mean?
A. Treatment is used when a person is given Tamiflu because they have the signs and symptoms of the flu or have been diagnosed with the flu. Tamiflu has been shown to lessen the amount of time people are sick with the flu.
Prevention (prophylaxis) is a term used when someone who does not have flu symptoms is given Tamiflu to help stop them from getting the flu because they are exposed to or come into close contact with someone (for example live with or take care of someone) who has the flu.
Q. Do I take Tamiflu the same way for treatment and prevention (prophylaxis) of the flu?
A. No. The number of times a day (frequency) and the number of days (duration) that you take Tamiflu are different for treatment and prevention of the flu. Your healthcare provider will tell you how to take Tamiflu. Take it exactly as your healthcare provider prescribes.
Q. What should people do if they continue to have or start to develop flu symptoms while taking Tamiflu?
A. If flu symptoms do not go away, or if new symptoms develop while taking Tamiflu, people should contact their healthcare provider. Other illnesses may cause people to have symptoms similar to the flu, or may occur at the same time as the flu, and they might need other treatment.
Q. Does Tamiflu come in a liquid as well as capsules?
A. Yes, Tamiflu is available as a liquid (oral suspension) and as oral capsules of different sizes. Your healthcare provider will prescribe the strength that is right for you.
Q. Do I need to make the Tamiflu liquid (oral suspension)?
A. No, a pharmacist should mix Tamiflu liquid before giving it to you. If you get a bottle with only powder in it, you should return the medication to the pharmacy so it can be mixed correctly.
Q. Is there enough Tamiflu suspension?
A. At some times there might not be enough of the pre-packaged liquid Tamiflu made by the manufacturer. Some pharmacies may need to make a liquid for patients from the pills instead. You should always follow the directions on the medicine label for how much and how often to give the medication. You should speak with your healthcare provider if you have any questions.
Q. Does the liquid (oral suspension) need to be refrigerated?
A. Yes, liquid Tamiflu (oral suspension) should be stored in the refrigerator. Ask the pharmacist how long to keep the medicine, and then throw away the unused medicine after that time. You should only use the medication for as long as your healthcare provider has directed.
Q. Does liquid Tamiflu (oral suspensions) need to be shaken?
A. Yes, shake liquid Tamiflu well each time before you give it.
Q. What do I use to give liquid Tamiflu (oral suspension)?
A. The pharmacist should give you a syringe to measure the dose of liquid Tamiflu. You and your pharmacist should look at the syringe and compare it to the directions on the medicine label. You should be able to use the syringe to measure the right amount that is written on the medicine label. If you have any questions about whether the measurements on the syringe, the medication label, and the prescription are all the same, make sure that you and your pharmacist and your doctor have answered those questions before you use the Tamiflu.
Q. What should I do if I am given Tamiflu capsules but can not swallow them?
A. If you have trouble swallowing Tamiflu capsules, you should tell your healthcare provider. Adults and children 1 year of age and older can be correctly dosed with capsules even if they can not swallow the capsules. If liquid Tamiflu is not available and you have capsules that give the right dose (30 mg, 45 mg or 75 mg), you may pull open the Tamiflu capsules and mix the powder with a small amount of sweetened liquid such as regular or sugar-free chocolate syrup. You don’t have to use chocolate syrup but thick, sweet liquids work best at covering up the taste of the medicine.
Q. Should women who are pregnant or nursing take Tamiflu?
A. Tamiflu may be of benefit for some pregnant and nursing women. At this time, the U.S. Centers for Disease Control and Prevention (CDC) recommends that pregnant women who are sick from influenza should be treated with a flu drug because of concerns that they could develop more severe illness. Pregnant and nursing women are advised to talk with a healthcare professional before using Tamiflu.
More information is available at flu.gov.
Q. What are the most common side effects of Tamiflu?
A. The most common side effects of Tamiflu are nausea and vomiting. Usually, nausea and vomiting are not severe and happen in the first 2 days of treatment. Taking Tamiflu with food may lessen the chance of getting these side effects. Other side effects include stomach (abdominal) pain, nosebleeds, headache, and feeling tired (fatigue).
Q. What are the serious side effects of Tamiflu?
A. Children and teenagers with the flu may be at a higher risk for seizures, confusion, or abnormal behavior early during their illness. These serious side effects may happen shortly after beginning Tamiflu or may happen in people when the flu is not treated. These serious side effects are not common but may result in accidental injury to the patient. People who take Tamiflu should be watched for signs of unusual behavior and a healthcare provider should be contacted right away if the patient shows any unusual behavior while taking Tamiflu.
Rare cases of allergic reactions, including serious skin rashes, have happened in people who take Tamiflu. If a rash develops, stop taking Tamiflu and contact a healthcare provider right away.
FDA encourages consumers to report any side effects and medication errors from Tamiflu to FDA at 1-800-FDA-1088.
- Tamiflu (oseltamivir phosphate) Information
- Influenza (Flu) Antiviral Drugs and Related Information
Tamiflu and Children: Clearing up the Confusion
Influenza makes you feel miserable. Fever, muscle aches, chills, headache, cough and fatigue add up to an unpleasant five or six days. As a parent, it’s just as difficult to watch your child suffer through the discomfort of “the flu.” That’s why so many moms or dads ask their pediatrician to prescribe the antiviral drug Tamiflu (oseltamivir) when a child develops influenza-like symptoms. Unfortunately, there seems to be a lot of confusion about Tamiflu—how it works, what it does, and when it should be prescribed. Randy Sterkel, MD, community pediatrician and medical director of the St. Louis Children’s Hospital Answer Line and Doug Carlson, MD, director of the CARES unit and hospitalist medicine at St. Louis Children’s Hospital weigh in on the latest findings and recommendations about Tamiflu.
What is Tamiflu?
“Tamiflu is an antiviral medication that blocks the actions of the influenza virus in the body,” says Dr. Sterkel. “If it is given within the first 48 hours of onset of symptoms, it can help decrease the length of time the patient feels ill—but only by about one to one and one half days. And it only works on true influenza—not on colds or other viral illnesses that may seem like flu. If a child has been sick for more than 48 hours, current data from the Centers for Disease Control suggests that there is virtually no benefit from Tamiflu.”
How Does Tamiflu Work?
“It is important for parents to understand that Tamiflu is not like an antibiotic used to cure strep throat or urinary tract infection,” says Dr. Carlson. “Tamiflu does not cure the flu—instead it helps by potentially shortening the duration of the symptoms. Viral illnesses such as influenza are self-limiting and will resolve themselves without treatment. With plenty of rest, fluids, and extra attention from a caregiver, most children will start to feel better and be on the road to recovery within four to five days.”
Who Should Get Tamiflu?
“Tamiflu should be considered for children who are at high-risk for developing complications of the flu or for those children exhibiting severe symptoms,” says Dr. Sterkel.
Who is Considered High Risk?
Children with underlying medical conditions:
- Lung disease
- Heart disease
- Neuromuscular disorders
- Weakened immune system
- Children with diabetes, sickle cell disease, kidney or liver disease
Does Tamiflu Have Any Side Effects?
“Influenza does not typically cause gastrointestinal symptoms such as diarrhea, nausea or vomiting,” says Dr. Carlson. “Parents need to know that patients who take Tamiflu may develop gastrointestinal side effects from the medication. At this point we have to consider whether or not a child is better off by simply managing his or her symptoms with fever reducers, rest, and plenty of fluids rather than introducing the potential for nausea, diarrhea or vomiting. Minor side effects from Tamiflu are common, but there are also rare but more serious side effects to consider when deciding to treat.”
Will Tamiflu Prevent the Flu?
“Tamiflu is not routinely given to prevent a person from getting the flu,” says Dr. Sterkel. “In some cases, if a child with flu-like symptoms lives in the same household as an adult or child at high risk for influenza complications, a physician may prescribe Tamiflu. However, the CDC does not recommend widespread use of antiviral medications for prevention because of the potential for antiviral resistant viruses to emerge. The best way to prevent influenza is with an annual vaccination. We recommend that everyone ages six months and older get an annual flu shot or nasal spray vaccination as soon as they are available in the fall. It is not 100 percent effective but is an excellent defense to help spare you and your child from the discomfort and potential complications of influenza.”
The Truth About Scary Tamiflu Side Effects
At least once every flu season, we hear a chilling story about someone who has experienced an abnormal or dangerous psychiatric event after taking the prescription antiviral flu medication Tamiflu. The latest accounts? That Tamiflu can cause suicide or suicidal thoughts.
Tamiflu, known generically as oseltamivir, can be taken by anyone who has the flu. But it’s most often recommended for people who are at the highest risk of developing serious complications—that means kids, older folks, and those whose immune systems are already weakened.
However, it’s not exactly a game-changer: The medication can shorten a bout of the flu by less than a day. And for the medication to work its best, Tamiflu needs to be taken within the first 48 hours or so after symptoms first appear. “Outside of that, it’s almost like you missed that window of the medicine being able to work at peak effectiveness,” says Sonia Patel, PharmD, chief pharmacist at the digital pharmacy Capsule.
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That urgency sends some people clamoring to get their hands on a prescription before fully understanding Tamiflu’s drawbacks. “Any time you’re considering taking a drug, you have to consider whether the benefit you’re going to get from it is worth the risk,” says Nicole Bouvier, MD, associate professor of infectious diseases at the Icahn School of Medicine at Mount Sinai in New York City. “In most people, flu is definitely an unpleasant illness … but you’ll get over it almost as fast as if you took Tamiflu. For the average healthy person, I think the potential risks are just not worth the benefits.”
Here are a few of those potential Tamiflu side effects you should know about.
Nausea and vomiting
The most common Tamiflu side effects are nausea and vomiting, two symptoms that might be accompanied by abdominal pain. Usually these symptoms are not severe, and if they are going to strike, they’ll show up in the first few days of taking the medicine, according to the FDA.
“The drug course is pretty short anyway—it’s five days,” Dr. Bouvier says. “By the time most people develop the symptoms, they’re practically done anyway.” If you’re having severe stomach issues, it’s probably not Tamiflu, she adds, but a stomach bug you picked up or something you ate. Taking Tamiflu with food might help lower your chances of having to deal with any of these unpleasant—but not too severe—side effects, Patel adds.
RELATED: Parents Reportedly Don’t Take the Flu Seriously Enough—and it Could Be Hurting Their Children
A wide range of strange behavior has been reported after taking Tamiflu, including dizziness, hallucinations, delirium, and even suicidal or homicidal thoughts or behavior, mostly in kids. So far, science hasn’t been able to parse out what’s actually causing these events, Dr. Bouvier says. “You don’t really know whether it’s the drug that’s causing it, whether it has something to do with being infected with flu, or if it would have happened anyway without flu infection or treatment.”
Somewhat comforting at least is that these instances are extremely rare, affecting less than 1% of people who take Tamiflu, Patel says. According to a review of the clinical studies of Tamiflu, there were 3,051 psychiatric incidents reported to the makers of Tamiflu during a time period when 48 million people were prescribed the drug—and, curiously, these cases were concentrated mostly in Japan, according to the Centers for Disease Control and Prevention (CDC). “It needs to be investigated more,” Dr. Bouvier says. “It’s hard to draw any conclusions now.”
RELATED: 11-Year-Old New York Boy Dies from Flu-Related Complications Despite Being Vaccinated
As with any medication, it’s possible to be allergic to an ingredient in Tamiflu. Allergic reactions to the drug are rare, but they can happen—and they might involve serious rashes. Call your doctor right away if you think you’re having an allergic reaction to Tamiflu. Symptoms could include a rash, trouble breathing, or any swelling of the hands or face, according to the Mayo Clinic.
Elderly people are always prone to side effects because of interactions with other medications they might be taking at the same time, Dr. Bouvier says. Because they are more likely to be taking more medicines, the elderly have a higher chance of one or more of those meds not playing nicely with Tamiflu.
However, the flu tends to be more complicated in elderly people, as well as in young children; both groups are more likely to be hospitalized with the illness, for example. Even with the potential risks, Dr. Bouvier says, they may stand to benefit more from the drug than a healthy and young adult.
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The flu is hitting hard and you may have friends and family that are getting sick. Here is the information you need to know about current treatment options for the flu.
Your best protection from catching the flu is to get a flu vaccine (more information here). The vaccine does not work 100% of the time, but there are other simple steps you can take to prevent flu, such as washing your hands with soap frequently and avoiding contact with sick family, friends or coworkers.
If you have the flu, there are several prescription medications available including: oral oseltamivir (Tamiflu), inhaled zanamivir (Relenza), or the intravenous drug peramivir (Rapivab). However, studies show that these medications only help you recover one day faster from the flu. Rather than going to the doctor’s office to get examined and get a prescription, you might prefer to stay home and rest and drink plenty of fluids.
Over the counter (OTC) medications don’t cure the flu but they can help you feel better by treating symptoms such as aches, coughs, and sore throats. A list of safe options can be found here. Antibiotics do NOT work against the flu because it is caused by a virus and not by bacteria.
Tamiflu is heavily advertised, but many doctors believe that Tamiflu does not work well enough to justify the high cost of the drug, or the CDC recommendation that all patients take it. These doctors point out that there is very little high quality evidence that Tamiflu reduces the rate of serious complications from the flu. Since Tamiflu gets so much attention in the media, you may want to know more. Here is the info that you need to help you decide if you want to try it for yourself or a loved one.
Is Tamiflu (Oseltamivir) Effective for Treating the Flu?
Tamiflu is a prescription antiviral medication used for treatment of the flu and to prevent catching the flu if you have been near someone sick. It has been heavily advertised, but there is lots of controversy over whether or not it is actually effective.
On average patients who start taking Tamiflu within 48 hours of getting sick will recover one day faster than patients who do not take anything. Roche, the makers of Tamiflu, claim that Tamiflu also reduces the number of patients who have serious complications from the flu, such as pneumonia (by 44%) or hospitalization (by 63%). However, the Tamiflu only worked in patients who had tested positive for the flu on a laboratory test, not patients with flu-like symptoms who subsequently were found to not have the flu. Other researchers examined the same study data and concluded that Tamiflu does not reduce hospitalizations or other complications when analyzing all people who went to the doctor because of flu-like symptoms. This means that if your doctor prescribes Tamiflu without giving you a flu test, it is less likely to help you get better. That’s because many patients who think they have the flu have a cold instead, and they will not benefit from Tamiflu.
On the other hand, when Tamiflu was used to prevent the flu in people exposed to confirmed cases of flu, it was able to reduce their likelihood of getting sick by as much as 55%.
Tamiflu has been approved for use in adults, infants as young as 2 weeks, children, and pregnant women. Tamiflu does not work as well in patients that are over 65.
Is Tamiflu Safe?
The most common side effects of Tamiflu are:
- Stomach pains
The more serious side effects include:
- Sudden confusion
- Unusual behavior
The serious side effects are very rare, but tend to occur more often in children, so if your child is taking Tamiflu and you notice any of these symptoms, speak to your doctor immediately and discontinue use of Tamiflu.
You should also stop using Tamiflu immediately and seek medical attention if you have any signs of allergic reaction, including hives, difficulty breathing, swelling of the lips, tongue or throat or skin rash.
To help the FDA determine how common these Tamiflu side effects are, it is important to report any side effects to the FDA by calling 1-800-FDA-1088.
With all these risks, and so little benefit, why take Tamiflu? The director of the Centers for Disease Control and Prevention thinks it is worth it, but experts in the field disagree. As a patient, you should weigh the risks and benefits before deciding if Tamiflu is right for you. If you can start taking Tamiflu quickly within 48 hours of getting flu symptoms and a positive flu test, it is more likely to work, but still may only shorten your flu by one day. Patients such as pregnant women, infants, or patients with a weakened immune system are more at risk of complications from the flu and might be more likely to benefit from Tamiflu, but should talk to their doctors to weigh the risks and benefits before deciding.
As mentioned above, there are two other FDA-approved antiviral medications to treat the flu virus. However, these medications are not better than Tamiflu at treating the flu, and also have serious side effects.
Inhaled zanamivir (Relenza) is FDA approved for the treatment of flu in children and adults ages 7 and older. Rapivab is given intravenously in a hospital, doctors office or clinic, and was approved by the FDA in December 2014 for patients 18 and older with uncomplicated flu. However, it was shown to only reduce fever 12 hours earlier than placebo, which means it usually provides even less relief than Tamiflu. Relenza is inhaled and can cause serious breathing problems in patients. Both drugs must be taken within 2 days of the first flu symptoms in order to work, similar to Tamiflu.
You may wonder why the FDA approved these flu treatments that have such modest benefits. It is important to understand that when the FDA approves a drug or device, that doesn’t mean the scientists there recommend it for patients to use. It only means that they think it has some benefit for some patients, and that the average patient is more likely to benefit than to be harmed. However, as with many other medications, some patients will not benefit at all, and some may be very seriously harmed.
All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.