Dosing, Administration and Storage
Dosing, Administration and Storage of TAMIFLU
TAMIFLU is available in capsules — in 30mg, 45mg, and 75mg doses — and a liquid form for pediatric and
mature patients who may have difficulty swallowing a capsule. 1
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ADULT DOSING |
DOSAGE |
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Treatment |
75 mg bid for 5 days |
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Prophylaxis |
75 mg qd for 10 days 1 |
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RENAL IMPAIRMENT DOSING* (for patients with creatinine clearance between 10 mL/min and 30 mL/min) |
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Treatment dosing |
75 mg once daily for 5 days |
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Prophylaxis dosing |
75 mg every other day or
30 mg oral suspension once daily 1
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*No recommended dosing regimens are available for patients undergoing routine hemodialysis
and continuous peritoneal dialysis treatment with end-stage renal disease.
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PEDIATRIC (1-12 years) DOSING |
BODY WEIGHT lbs (kg) |
DOSAGE |
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Treatment dosing |
≤33 lbs (≤15 kg)
>33 lbs to 51 lbs (>15 kg to 23 kg)
>51 lbs to 88 lbs (>23 kg to 40 kg)
>88 lbs (>40 kg)
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30 mg/bid/5 days
45 mg/bid/5 days
60 mg/bid/5 days
75 mg/bid/5 days
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Prophylaxis dosing* |
≤33 lbs (≤15 kg)
>33 lbs to 51 lbs (>15 kg to 23 kg)
>51 lbs to 88 lbs (>23 kg to 40 kg)
>88 lbs (>40 kg)
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30 mg/qd/10 days
45 mg/qd/10 days
60 mg/qd/10 days
75 mg/qd/10 days
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*For prophylaxis in pediatric patients during a community outbreak of influenza dosing may be continued for up to six weeks.1
The duration of protection lasts as long as dosing is continued.
For those pediatric patients that can swallow capsules, TAMIFLU is provided in the following strengths:
- 30mg and 45mg capsules (TAMIFLU small capsules)
- 75 mg capsules (patients >88lbs)
For those pediatric patients that cannot swallow capsules, the following options are:
- TAMIFLU oral suspension
- TAMIFLU 30mg or 45mg capsules mixed at home with sweetened liquid
- Pharmacy compounding of TAMIFLU 75mg capsules into an oral suspension
An oral dosing dispenser with 30 mg, 45 mg, and 60 mg graduations is provided with the oral suspension; the 75 mg dose can be measured using a combination of 30 mg and 45 mg. It is recommended that patients use this dispenser. In the event that the dispenser provided is lost or damaged, another dosing syringe or other device may be used to deliver the following volumes: 2.5 mL (½ tsp) for children ≤15kg, 3.8 mL (¾ tsp) for >15 to 23 kg, 5.0 mL (1 tsp) for >23 to 40 kg, and 6.2 mL (1 ¼ tsp) for >40 kg.
For instructions on preparing TAMIFLU liquid, please read:
Taking TAMIFLU with Other Medications
TAMIFLU has been shown to have a minimal chance of negatively interacting with other medications.
Over-the-counter medications may be prescribed to reduce severity of symptoms while the antiviral action of
TAMIFLU takes effect. 1
The concurrent use of TAMIFLU and live attenuated influenza vaccine (LAIV) intranasal has not been evaluated.
However, due to the possibility for interference between these products, LAIV should not be given within 2
weeks before or 48 hours after taking TAMIFLU, unless it is deemed appropriate by your doctor. Trivalent
inactivated influenza vaccine can be administered at any time relative to use of TAMIFLU.
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How to Store TAMIFLU
TAMIFLU capsules should be stored at room temperature (77°F [25°C]) and kept in a dry place.
Store constituted liquid TAMIFLU under refrigeration for up to 17 days at 36° to 46°F (2° to 8°C). Do not freeze. Alternatively, store constituted liquid TAMIFLU for up to 10 days at 77°F (25°C ). As with all medications,
keep out of the reach of children. 1
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Important Safety Information
Indications
TAMIFLU is indicated for the treatment of uncomplicated influenza caused by viruses types A and B in patients 1 year and older who have been symptomatic for no more than 2 days.
TAMIFLU is also indicated for the prophylaxis of influenza in patients 1 year and older.
Efficacy of TAMIFLU in patients who begin treatment after 48 hours of symptoms has not been established.
TAMIFLU is not a substitute for early and annual vaccination as recommended by the Centers for Disease Control's Advisory Committee on Immunization Practices (ACIP).
There is no evidence for efficacy of TAMIFLU in any illness caused by agents other than influenza viruses Types A and B.
Influenza viruses change over time. Emergence of resistance mutations could decrease drug effectiveness. Other factors (for example, changes in viral virulence) might also diminish clinical benefits of antiviral drugs. Prescribers should consider available information on influenza drug susceptibility patterns and treatment effects when deciding whether to use TAMIFLU.
Safety Information
TAMIFLU is contraindicated in patients who have had severe allergic reactions such as anaphylaxis or serious skin reactions such as toxic epidermal necrolysis, Stevens-Johnson syndrome, or erythema multiforme to any component of TAMIFLU.
In postmarketing experience, rare cases of anaphylaxis and serious skin reactions, including toxic epidermal necrolysis, Stevens-Johnson syndrome and erythema multiforme, have been reported with TAMIFLU. Tamiflu should be stopped and appropriate treatment instituted if an allergic-like reaction occurs or is suspected.
Influenza can be associated with a variety of neurologic and behavioral symptoms, which can include events such as hallucinations, delirium and abnormal behavior, in some cases resulting in fatal outcomes. These events may occur in the setting of encephalitis or encephalopathy but can occur without obvious severe disease. There have been postmarketing reports (mostly from Japan) of delirium and abnormal behavior leading to injury, and in some cases resulting in fatal outcomes, in patients with influenza who were receiving TAMIFLU. Because these events were reported voluntarily during clinical practice, estimates of frequency cannot be made but they appear to be uncommon based on TAMIFLU usage data. These events were reported primarily among pediatric patients and often had an abrupt onset and rapid resolution. The contribution of TAMIFLU to these events has not been established. Patients with influenza should be closely monitored for signs of abnormal behavior. If neuropsychiatric symptoms occur, the risks and benefits of continuing treatment should be evaluated for each patient.
Serious bacterial infections may begin with influenza-like symptoms or may co-exist with or occur as complications during the course of influenza. TAMIFLU has not been shown to prevent such complications.
Treatment efficacy in subjects with chronic cardiac and/or respiratory disease has not been established. No difference in the incidence of complications was observed between the treatment and placebo groups in this population.
No information is available regarding treatment of influenza in patients at imminent risk of requiring hospitalization.
Efficacy of TAMIFLU has not been established in immunocompromised patients.
The concurrent use of TAMIFLU with live attenuated influenza vaccine (LAIV) intranasal has not been evaluated. However, because of the potential for interference between these products, LAIV should not be administered within 2 weeks before or 48 hours after administration of TAMIFLU, unless medically indicated.
Adverse events that occurred more frequently in patients treated with TAMIFLU than in patients taking placebo and occurred in ≥2% of patients were (TAMIFLU%, placebo%):
- Treatment in adults – nausea (10%, 6%), vomiting (9%, 3%), bronchitis (2%, 2%)
- Treatment in pediatrics – vomiting (15%, 9%), abdominal pain (5%, 4%), epistaxis (3%, 3%), ear disorder (2%, 1%)
- Prophylaxis of adults – headache (18%, 18%), nausea (7%, 3%), diarrhea (3%, 2%), vomiting (2%, 1%), abdominal pain (2%, 1%)
- Prophylaxis of pediatrics – vomiting (10%, 2%), abdominal pain (3%, 0%), nausea (4%, 1%)