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Oseltamivir (trade names include Tamiflu, Antiflu, Fluhalt, Fluvir, GPO-A-Flu, Rimivat) is an antiviral medication from neuraminidase inhibitors pharmacological group. This medicine is used for the treatment and prevention of influenza A and influenza B (flu). It works by blocking the actions of influenza virus types A and B in your body.



Related medications:

Acyclovir (Zovirax)

Amantadine (Symmetrel)

Daclatasvir (Daklinza)

Famciclovir (Famvir)

Laninamivir (Inavir)

Peramivir (Rapivab)

Ribavirin (Rebetol)

Valacyclovir (Valtrex)

Zanamivir (Relenza)


Pharmacological and medical categories:

Anti flu medicines

Antiinfective medications

Antiviral drugs

Influenza's neuraminidase enzyme inhibitors


ATC codes:

J - Antiinfectives for systemic use

J05 - Antivirals for systemic use

J05A - Direct acting antivirals

J05AH - Neuraminidase inhibitors

J05AH02 - Oseltamivir


ICD-10 codes:

Influenza due to certain identified influenza viruses - J09


Indications and usage:

Tamiflu (Oseltamivir) 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.

Limitations of Use:

Not a substitute for annual influenza vaccination.

Consider available information on influenza drug susceptibility patterns and treatment effects when deciding whether to use.

Not recommended for patients with end-stage renal disease not undergoing dialysis.


Dosage and administration:

Treatment of influenza

Adults and adolescents (13 years and older): 75 mg twice daily for 5 days

Pediatric patients 1 to 12 years of age: Based on weight twice daily for 5 days

Pediatric patients 2 weeks to less than 1 year of age: 3mg/kg twice daily for 5 days

Renally impaired adult patients (creatinine clearance > 30-60 mL/min): Reduce to 30 mg twice daily for 5 days

Renally impaired adult patients (creatinine clearance >10-30 mL/min): Reduce to 30 mg once daily for 5 days

ESRD patients on hemodialysis: Reduce to 30 mg immediately and then 30 mg after every hemodialysis cycle. Treatment duration not to exceed 5 days

ESRD patients on CAPD: Reduce to a single 30 mg dose immediately

Prophylaxis of influenza

Adults and adolescents (13 years and older): 75 mg once daily for at least 10 days

Community outbreak: 75 mg once daily for up to 6 weeks

Pediatric patients 1 to 12 years of age: Based on weight once daily for 10 days

Community outbreak: Based on weight once daily for up to 6 weeks

Renally impaired adult patients (creatinine clearance >30-60 mL/min): Reduce to 30 mg once daily

Renally impaired adult patients (creatinine clearance >10-30 mL/min): Reduce to 30 mg once every other day

ESRD patients on hemodialysis: Reduce to 30 mg immediately and then 30 mg after alternate hemodialysis cycles for the recommended duration of prophylaxis

ESRD patients on CAPD: Reduce to 30 mg immediately and then 30 mg once weekly for the recommended duration of prophylaxis


Overdosage:

Reports of overdoses with oseltamivir have been received from clinical trials and during postmarketing experience. In the majority of cases reporting overdose, no adverse events were reported. Adverse events reported following overdose were similar in nature to those observed with therapeutic doses of Tamiflu.


Dosage forms and strengths:

Tamiflu (Oseltamivir) capsules: 30 mg, 45 mg, 75 mg.

For oral suspension: 360 mg oseltamivir base supplied as powder (constituted to a final concentration of 6 mg/mL).


Contraindications:

Patients with known serious hypersensitivity to oseltamivir or any of the components of Tamiflu.


Warnings and precautions:

Serious skin/hypersensitivity reactions such as Stevens-Johnson Syndrome, toxic epidermal necrolysis and erythema multiforme: Discontinue Tamiflu and initiate appropriate treatment if allergic-like reactions occur or are suspected.

Neuropsychiatric events: Patients with influenza, including those receiving Tamiflu (Oseltamivir), particularly pediatric patients, may be at an increased risk of confusion or abnormal behavior early in their illness. Monitor for signs of abnormal behavior.


Adverse reactions, side effects:

Most common adverse reactions ( > 1% and more common than with placebo):

Treatment studies - nausea, vomiting, headache.

Prophylaxis studies - nausea, vomiting, headache, pain.


Drug interactions:

Live attenuated influenza vaccine (LAIV), intranasal:

Avoid administration of LAIV within 2 weeks before or 48 hours after Oseltamivir (Tamiflu) use, unless medically indicated.


Use in specific populations:

Pregnancy: No data in pregnant women. Use only if clearly needed.

Nursing mothers: Caution should be exercised when administered oseltamivir to a nursing woman.


Pregnancy categories:

B1 - Australia

C - United States (Risk cannot be ruled out)


Salts and other forms:

Oseltamivir Base

Oseltamivir Phosphate


Synonyms, international and chemical names:

Oseltamiviiri

Oseltamiviro

Oseltamivirum

Oseltamiwir

Oszeltamivir


Brands, generics, trade names:

Antiflu - Cipla

Fluhalt - Ranbaxy, Pharmaniaga

Fluvir - Hetero Healthcare

GPO-A-Flu - The Government Pharmaceutical Organization

Rimivat - Andromaco Laboratorios

Tamiflu - Roche, Genentech, Gilead


References:

Oseltamivir main article on Wikipedia: https://en.wikipedia.org/wiki/Oseltamivir

Oseltamivir compound on PubChem: https://pubchem.ncbi.nlm.nih.gov/compound/oseltamivir

Oseltamivir Phosphate compound on PubChem: https://pubchem.ncbi.nlm.nih.gov/compound/Oseltamivir-phosphate

Oseltamivir on DrugBank: https://www.drugbank.ca/drugs/DB00198

Oseltamivir Phosphate on DrugBank: https://www.drugbank.ca/salts/DBSALT000881

Oseltamivir FAQ on MedlinePlus (revised 01/15/2018): https://medlineplus.gov/druginfo/meds/a699040.html

Tamiflu (Oseltamivir Phosphate) capsules and powder for suspension drug label info on DailyMed (revised October 21, 2020): https://dailymed.nlm.nih.gov/dailymed/lookup...

Oseltamivir containing drugs on Drugs-About.com: https://drugs-about.com/ing/oseltamivir.html

Oseltamivir for sale on Pharma Doctor: https://pharma-doctor.com/oseltamivir.html

Oseltamivir international drug names on Drugs.com: https://www.drugs.com/international/oseltamivir.html

Tamiflu (Oseltamivir Phosphate) capsules and powder for suspension official prescribing information and medication guide from the U.S. FDA (revised 12/2012): https://www.accessdata.fda.gov/drugsatfda_docs/label...

Tamiflu (Oseltamivir Phosphate) capsules and powder for suspension product monograph from Genentech, Inc. (revised 08/2019): https://www.gene.com/download/pdf/tamiflu_prescribing.pdf

Tamiflu (Oseltamivir Phosphate) official website from by Genentech USA, Inc.: https://www.tamiflu.com/

Tamiflu (Oseltamivir Phosphate) 75 mg hard capsules patient information leaflet on Medicines.org.uk (revised August 2020): https://www.medicines.org.uk/emc/files/pil.1194.pdf

Antiflu (Oseltamivir Phosphate) capsules and powder for suspension on Cipla pharmaceutical company website (revised July 2017): https://www.ciplamed.com/content/antiflu-capsules-suspension

Revised: March 2021