Adult Dosing

Prophylaxis of Influenza

• 75 mg PO daily x 10 days
• Start therapy within two days of exposure
• During community outbreak of influenza continue for 6 wks (immunocompetent patients) and 12 wks (immunocompromised patients)

Note:

• CDC recommended duration is 10 days when administered after a household exposure and 7 days after the most recent known exposure in other situations. For control of outbreaks in long-term care facilities and hospitals, CDC recommends antiviral chemoprophylaxis for a minimum of 2 weeks and up to 1 week after the most recent known case was identified

Treatment of Influenza

• 75 mg PO bid x 5 days
• Note: Start treatment within two days of onset of symptoms of influenza

Pediatric Dosing

Prophylaxis of Influenza

• <1 yr [Not FDA approved]
• 1 yr
• 15 kg body weight: 30 mg PO Daily x 10 days
• >15-23 kg body weight: 45 mg PO Daily x 10 days
• >23-40 kg body weight: 60 mg PO Daily x 10 days
• >40 kg body weight: 75 mg PO Daily x 10 days
• Start therapy within two days of exposure
• During community outbreak of influenza continue for 6 wks

• Not recommended in children <1 yrs of age
• CDC recommended duration is 10 days when administered after a household exposure and 7 days after the most recent known exposure in other situations. For control of outbreaks in long-term care facilities and hospitals, CDC recommends antiviral chemoprophylaxis for a minimum of 2 weeks and up to 1 week after the most recent known case was identified

Treatment of Influenza

• 1 yr
• 15 kg body weight: 30 mg PO bid x 5 days
• >15-23 kg body weight: 45 mg PO bid x 5 days
• >23-40 kg body weight: 60 mg PO bid x 5 days
• >40 kg body weight: 75 mg PO bid x 5 days

Note:

• Start treatment within two days of onset of symptoms of influenza
• Not recommended in children <1 yrs of age

[Outline]

• Adult Dosing
• Pediatric Dosing

• Treatment of uncomplicated acute illness due to influenza virus types A and B infection in adults and children 1 yr and older who have had symptoms for no more than 2 days
• Prevention of influenza virus types A and B in patients aged 1 yr and above

• Hypersensitivity to any of the ingredients of the product
• Patients <1 yr of age

• N/A

Renal Dose Adjustment (Based on CrCl)

Prophylaxis of Influenza in Adults

• 10-30 mL/minute: 75 mg PO every other day or 30 mg PO Daily
• <10mL/minute: Avoid use
• Hemodialysis: Not defined
• CAPD: Not defined

Treatment of Influenza in Adults

• 10-30 mL/minute: 75 mg PO Daily x 5 days
• <10mL/minute: Avoid use
• Hemodialysis: Not defined
• CAPD: Not defined

Hepatic Dose Adjustment

• Mild to moderate impairment (Child Pughs A/B): Not indicated
• Severe impairment (Child Pughs C): Use with caution, dosage adjustment not defined

• Rare cases of anaphylaxis and serious skin infections including Stevens- Johnson Syndrome and erythema multiforme have been reported. Discontinue the drug and institute appropriate treatment, if allergic like reaction occurs or is suspected
• Instances of variety of neurologic and behavioral symptoms including hallucinations, delirium and abnormal behavior, resulting in to fatal outcomes have also been reported with oseltamivir. Closely monitor the patient for signs of abnormal behavior and evaluate the risks and benefits of continuing treatment, if any such symptom occurs
• Serious bacterial infections may coexist with or occur as complications during the course of influenza. Oseltamivir does not prevent such complications
• Efficacy of oseltamivir in the treatment of influenza in patients with chronic cardiac disease or respiratory disease has not been established
• Efficacy of oseltamivir for treatment or prophylaxis of influenza in immunocompromised patients has not been established
• For children who cannot swallow capsules, if the oral suspension is not available, the capsules may be opened and mixed with sweetened liquids
• Concomitant use with live influenza vaccine is not recommended within 2 weeks before or 48 hours following oseltamivir administration

Cautions: Use cautiously in

• Severe hepatic impairment
• Renal impairment
• Cardiac disease
• Respiratory disease
• Immunocompromised patients
• Hereditary fructose intolerance (SUSP)

Pregnancy Category:C

Breastfeeding: Safety unknown. Limited data indicate that oseltamivir and its active metabolite are poorly excreted in breast milk and would not be expected to cause any adverse events in breast fed infants, especially if the infant >2 months. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 31 May 2011). Manufacturer recommends using oseltamivir only if the potential benefit for the lactating mother justifies the potential risk to the breast-fed infant.

• CNS: Hallucinations, delirium, abnormal behavior, dizziness, headache, insomnia
• CV: Dysrhythmia
• GI: Nausea, vomiting, diarrhea, abdominal pain, hemorrhage, colitis
• RESP: Bronchitis, cough, asthma, pneumonia, sinusitis
• EENT: Vertigo, epistaxis, ear disorder, conjunctivitis, otitis media, tympanic membrane disorder
• HEMA: Lymphadenopathy
• DERM: Dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme
• HYPERSENSITIVITY: Anaphylactic/anaphylactoid reactions, fatigue

• Antiviral agent; inhibits influenza virus neuraminidase with possible alteration of virus particle aggregation and release
• Readily absorbed from the GI tract
• Metabolized by hepatic esterase to oseltamivir carboxylate
• Renally excreted (>99% unchanged)
• Half-life
• Oseltamivir: 1-3 hrs
• Oseltamivir carboxylate: 6-10 hrs

US Trade Name(s)

• Tamiflu

US Availability

Tamiflu

• CAPS: 30, 45, 75 mg
• PWDR for SUSP: 6 mg/mL

Canadian Trade Name(s)

• Tamiflu

Canadian Availability

Tamiflu

• CAPS: 30, 45, 75 mg
• PWDR for SUSP: 12 mg/mL

UK Trade Name(s)

• Tamiflu

UK Availability

Tamiflu

• CAPS: 30, 45, 75 mg
• PWDR for SUSP: 12 mg/mL

Australian Trade Name(s)

• Tamiflu

Australian Availability

Tamiflu

• CAPS: 30, 45, 75 mg
• PWDR for SUSP: 12 mg/mL

[Outline]

Antimicrobials

Antiviral Agents

Anti-Influenza; Neuraminidase Inhibitors

Infectious Disease

Antiviral Agents

Anti-Influenza; Neuraminidase Inhibitors

Pricing data from www.DrugStore.com in U.S.A.

• Tamiflu 75 MG CAPS [Disp Pack] (GENENTECH)
  10 mg = $110.99
  30 mg = $321.98
• Tamiflu 30 MG CAPS [Box] (GENENTECH)
  10 mg = $110.08
  30 mg = $321.51
• Tamiflu 12 MG/ML SUSR [Bottle] (GENENTECH)
  25 ml = $53.54
  75 ml = $145.91
• Tamiflu 45 MG CAPS [Box] (GENENTECH)
  10 mg = $110.08
  30 mg = $321.51

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

• Tamiflu 30 MG Oral Capsule (Hoffmann-La Roche Inc)
• Tamiflu 45 MG Oral Capsule (Hoffmann-La Roche Inc)
• Tamiflu 75 MG Oral Capsule (Hoffmann-La Roche Inc)