Tamiflu is indicated for the treatment of acute, uncomplicated illness due to influenza infection in patients 2 weeks of age and older who have been symptomatic for no more than 2 days.
Use the dosing reference below to find the right dosage of Tamiflu for your pediatric and adult patients within two days of symptom onset.
*Adapted from the Tamiflu full Prescribing Information
Important Prescribing Information (revised January 2013)
Please prescribe Tamiflu for appropriate patients as follows.
Formulation and concentration or strength:
- Oral suspension (6 mg/mL) or capsules (30 mg, 45 mg or 75 mg).
- Dose: mL (preferred for oral suspension) or mg (preferred for capsules). Please refer to the dosing table for more information.
Frequency and duration:
- Treatment twice daily for 5 days.
- Prophylaxis: once daily, typically for 10 days for postexposure prophylaxis or for up to 6 weeks during community outbreak.
Dosing and administration
Tamiflu may be taken with or without food. However, when taken with food, tolerability may be enhanced in some patients. The recommended oral treatment and prophylaxis dose of Tamiflu is shown in the table below.
Patients aged 13 years and older should receive Tamiflu 75 mg regardless of weight.
Commonly asked questions by healthcare professionals about the new label and packaging
Has the drug product/formulation changed?
- The drug product/formulation has not changed.
What has changed with Tamiflu (oseltamivir phosphate) for Oral Suspension (OS)?
What if the local pharmacy does not have any Tamiflu for Oral Suspension in stock?
Tamiflu provides the flexibility for healthcare professionals to treat and prevent influenza with alternatives to oral suspension:
- Tamiflu 30-mg or 45-mg capsules, depending on the weight of the child.
- For patients with difficulty swallowing capsules, contents can be mixed into sweetened liquids, such as chocolate syrup, by a caregiver.
In emergency situations, if commercially manufactured Tamiflu for Oral Suspension is not readily available from wholesalers or Genentech, a liquid suspension can be compounded by a pharmacist using Tamiflu 75-mg capsules. Instructions for dosing and compounding may be found in the Tamiflu Prescribing Information.
Taking Tamiflu with other medications1
Information derived from pharmacology and pharmacokinetic studies of oseltamivir suggests that clinically significant drug interactions are unlikely.
Oseltamivir is extensively converted to oseltamivir carboxylate by esterases, located predominantly in the liver.
Drug interactions involving competition for esterases have not been extensively reported in literature. Low protein binding of oseltamivir and oseltamivir carboxylate suggests that the probability of drug displacement interactions is low.
The concurrent use of Tamiflu and live attenuated influenza vaccine (LAIV) intranasal has not been evaluated. However, because of the possibility for interference between these products, LAIV should not be given within 2 weeks before or 48 hours after administration of Tamiflu, unless medically indicated. The concern about possible interference arises from the potential for antiviral drugs to inhibit replication of live virus. Trivalent inactivated influenza vaccine can be administered at any time relative to use of Tamiflu.1
In vitro studies showed no interference with the cytochrome P450 pathway.1
Storing Tamiflu for Oral Suspension1
Store dry powder at 25°C (77°F); excursions permitted to 15° to 30°C (59° to 86°F) [See USP Controlled Room Temperature].
Storing Constituted Tamiflu for Oral Suspension1
Store constituted suspension under refrigeration for up to 17 days at 2° to 8°C (36° to 46°F). Do not freeze. Alternatively, store constituted suspension for up to 10 days at 25°C (77°F); excursions permitted to 15° to 30°C (59° to 86°F) [See USP Controlled Room Temperature].
Tamiflu is indicated for the treatment of acute, uncomplicated illness due to influenza infection in patients 2 weeks of age 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 influenza vaccination
- 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. Prescribers should consider available information on influenza drug susceptibility patterns and treatment effects when deciding whether to use Tamiflu
Serious Skin/Hypersensitivity Reactions
- 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, and erythema multiforme to any component of Tamiflu
- In postmarketing experience, 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
- Closely monitor patients with influenza for signs of abnormal behavior. If neuropsychiatric symptoms occur, evaluate the risks and benefits of continuing treatment for each patient
- Serious bacterial infections may begin with influenza-like symptoms or may coexist with or occur as complications during the course of influenza. Tamiflu has not been shown to prevent such complications
Limitations of Populations Studied
- Efficacy of Tamiflu in the treatment of influenza in patients with chronic cardiac disease and/or respiratory disease has not been established. No information is available regarding treatment of influenza in patients with any medical condition sufficiently severe or unstable to be considered at imminent risk of requiring hospitalization
- Efficacy of Tamiflu for treatment or prophylaxis of influenza has not been established in immunocompromised patients
Concurrent Use with Live Attenuated Influenza Vaccine
- 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
Most Common Adverse Reactions
- Adverse events that occurred more frequently in patients treated with Tamiflu than in patients taking placebo (frequency ≥ 2%) across clinical trials were nausea, vomiting, abdominal pain, ear disorder, and diarrhea
- The safety profile observed in pediatric patients 2 weeks to less than 1 year of age was consistent with the established safety profile of subjects aged 1 year and above, with vomiting, diarrhea and diaper rash being the most frequently reported adverse reactions
For additional important safety information, please see Tamiflu full prescribing information at www.tamiflu.com.
You are encouraged to report side effects to Genentech by calling 1-888-835-2555 or to the FDA by visiting www.fda.gov/medwatch or calling 1-800-FDA-1088.
- Tamiflu® (oseltamivir phosphate) Prescribing Information. South San Francisco, CA: Genentech USA, Inc.; January, 2013.
- Hayden FG, Belshe R, Villanueva C, et al. Management of influenza in households: a prospective, randomized comparison of oseltamivir treatment with or without postexposure prophylaxis. J Infect Dis. 2004;189:440-449.