Oseltamivir
TAMIFLU
What it isNeuraminidase inhibitor blocking viral release; influenza treatment and prophylaxis.
Why this oneCapsules and an oral suspension make it practical for young children and household or institutional prophylaxis, unlike inhaled zanamivir.
What limits itNausea is common; renal impairment requires adjustment, and neuropsychiatric events are reported in children.
FDA-approved for
- influenza (1999)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Treatment of influenza | Adults & adolescents ≥13 yr | 75 mg BID x5 days | 75 mg BID | 75 mg BID |
| Treatment of influenza | Children 1-12 yr | Weight-based BID x5 days | Weight-based BID | 75 mg BID |
| Treatment of influenza | Infants 2 wk to <1 yr | 3 mg/kg BID x5 days | 3 mg/kg BID | 3 mg/kg BID |
| Prophylaxis of influenza | Adults & adolescents ≥13 yr | 75 mg QD (≥10 days; up to 6 wk in community outbreak) | 75 mg QD | 75 mg QD |
| Prophylaxis of influenza | Children 1-12 yr | Weight-based QD x10 days | Weight-based QD | 75 mg QD |
Renal Treatment: CrCl >30-60 → 30 mg BID; >10-30 → 30 mg QD; ESRD/HD → 30 mg then 30 mg after each dialysis; CAPD → single 30 mg. Prophylaxis: CrCl >30-60 → 30 mg QD; >10-30 → 30 mg QOD; ESRD/HD → 30 mg after alternate dialysis; CAPD → 30 mg then 30 mg weekly
Hepatic No adjustment for mild-moderate; severe not evaluated
Treatment duration 5 days; prophylaxis ≥10 days (up to 6 weeks in community outbreak)
Instructions
- Begin as soon as possible (within 48 h of symptom onset for treatment or exposure for prophylaxis)
- May be taken with or without food (food improves tolerability)
- Pediatric weight-based dose: ≤15 kg = 30 mg, >15-23 kg = 45 mg, >23-40 kg = 60 mg, >40 kg = 75 mg per dose
- Oral suspension available for patients unable to swallow capsules
Cautions
- Serious skin/hypersensitivity reactions (anaphylaxis, toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme) — discontinue if suspected
- Neuropsychiatric events (delirium, abnormal behavior), primarily in pediatric patients
Adverse reactions
- Nausea
- Vomiting
- Headache
- Pain (prophylaxis)
Pregnancy Observational data suggest no increased risk of birth defects; may be used when indicated
Lactation Undefined
NO BOXED WARNINGS
Principal riskNeuropsychiatric events reported in children
Cost, est. cash$10–$500/month
Generic entry2016
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityAgent-specific renal, hepatic, hematologic, metabolic and drug-interaction toxicity.
Mechanism of action: Oseltamivir ballicule
