Oseltamivir: Difference between revisions
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**Greatest benefit if within 48hrs of symptom onset<ref>CDC Guidelines. 2015-2016. http://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm</ref> | **Greatest benefit if within 48hrs of symptom onset<ref>CDC Guidelines. 2015-2016. http://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm</ref> | ||
***However, may be beneficial up to 4-5 days, including in pregnant patients | ***However, may be beneficial up to 4-5 days, including in pregnant patients | ||
***Early treatment of hospitalized | ***Early treatment of hospitalized patients can reduce death | ||
==See Also== | ==See Also== | ||
Revision as of 16:49, 21 June 2016
Administration
- Type: Antiviral
- Routes of Administration: Oral
- Common Trade Names: Tamiflu
Adult Dosing
Influenza
- 75mg PO BID x 5 days
Pediatric Dosing
Influenza
- Age <1 year: 3mg/kg PO BID x 5 days
- <15kg: 30mg PO BID x 5 days
- 15-23kg: 45mg PO BID x 5 days
- 24-40kg: 60mg PO BID x5d
- Adult: 75mg PO BID x 5 days
Special Populations
- Pregnancy Rating:C
- Lactation risk: Low concentrations of oseltamivir seen in breast milk; levels are unlikely to lead to toxicity in a breast-fed infant. The manufacturer recommends that caution be used if administered to a nursing woman.
- High Risk for Complications and Recommended for Treatment per CDC:
- Children < 2 yo
- Adults > 65 yo
- Chronic Pulmonary Disease including Asthma
- Cardiovascular disease (excluding HTN only)
- Renal, hepatic, hematological, and metabolic disorders (including sickle cell, diabetes)
- Neurological and Neurodevelopmental disorders (brain disorders, spinal cord, peripheral nerve disorders, cerebreal palsy, epilepsy, stroke, MR, developmental delay, muscular dystrophy)
- Immunosuppressed including on HAART
- Pregnant or Postpartum (2 weeks after delivery)
- <19 yo on long term aspirin
- American Indians/Alaskan natives
- Morbid Obesity (BMI >= 40)
- Nursing home or chronic care facility residents.
Renal Dosing
- CrCl >30 to 60 mL/minute: 30 mg BID for 5 days
- CrCl >10 to 30 mL/minute: 30 mg qday for 5 days
- ESRD not undergoing dialysis: Use is not recommended (efficacy in ESRD has not been established.)
Hepatic Dosing
- efficacy in hepatic impairment has not been established
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
Common
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
Mechanism of Action
Comments
- Influenza
- Shortens duration of illness by 16.8 hrs while NNTH (number needed to harm) was 28 in regards to causing n/v, HA, and renal and psych syndromes[1]
- Greatest benefit if within 48hrs of symptom onset[2]
- However, may be beneficial up to 4-5 days, including in pregnant patients
- Early treatment of hospitalized patients can reduce death
See Also
References
- ↑ Jefferson T, et al. Oseltamivir for influenza in adults and children: systematic review of clinical study reports and summary of regulatory comments. BMJ. 2014; 348:g2545.
- ↑ CDC Guidelines. 2015-2016. http://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm