Tamiflu (oseltamivir) Dosing, Indications, Interactions, Adverse Effects

Tamiflu (Oseltamivir)

Dosing & Uses

Dosage forms and powers

Capsule
•  
30mg
•  45mg
•  75mg

Powder for oral suspension
•  
6mg / ml

Influenza A and B Prophylaxis

•  75 mg PO qday for at least 10 days

Dosage ideas
•  
Start within 48 hours of Exposure
•  For community outbreaks, you can administer for 6 weeks

Influenza A and B Treatment

•  75 mg PO q12hr x5 day

Dosage Ideas
•  
Begin the influenza symptom within 48 hours of starting

H1N1 Influenza A (Swine Flu) Prophylaxis (Off-label)

75 mg PO qDay

Dosage Ideas
•  
Postexposure prophylaxis: Begin within 7 days of exposure and continue for at least 10 days
•  Preexposure prophylaxis: Start during the potential exposure period and continue after 10 days of the last known exposure.

H1N1 Influenza A (Swine Flu) Treatment (off-label)

75 mg PO q12hr x5 day

Dosage Ideas
•  
Begin the influenza symptom within 48 hours of starting

Dose modification

Renal impairment

Treatment
•  CRCL> 60 mL / min: no dose adjustment is necessary
•  CRCL> 30 to 60 mL / min: 30 mg PO bid
•  CRCL> 10 to 30 mL / min: 30 mg po qday
•  End-stage kidney disease (do not undergo dialysis): Not recommended (not studied)
Prophylaxis
•  CRCL> 60 mL / min: no dose adjustment is necessary
•  CRCL> 30 to 60 mL / min: 30 mg po qday
•  CRCL> 10 to 30 mL / min: 30 mg PO every other day
•  End-stage kidney disease (do not undergo dialysis): Not recommended (not studied)

Interections

Clopidogrel

Clopidogril reduces Tamiflu (Oseltamivir) levels by others (see note). Use caution / monitor. Remarks: Clopidogrel can reduce serum concentrations of active metabolite (S) of Tamiflu (Oseltamivir). .

Influenza virus vaccine quadrivalent

The influenza virus vaccine by Tamiflu (Oseltamivir) pharmacodynamic rivalry reduces the effect of quadrivalent. Use caution / monitor. Avoid the administration of live-influenza influenza vaccine intravenous, within 2 weeks or 48 hours after the administration of Tamiflu (Oseltamivir), unless prescribed for medical signs.

Influenza virus vaccine quadrivalent, intranasal

The influenza virus vaccine by Tamiflu (Oseltamivir) pharmacodynamic rivalry reduces the effect of quadrivalent, intranasal. Use caution / monitor. Avoid the administration of live-influenza influenza vaccine intravenous, within 2 weeks or 48 hours after the administration of Tamiflu (Oseltamivir), unless prescribed for medical signs.

Influenza virus vaccine quadrivalent, recombinant

Tamiflu (Oseltamivir) pharmacodynamic rivalry reduces the effect of recombinant, influenza virus vaccine quadrivalent. Use caution / monitor. Avoid the administration of live-influenza influenza vaccine intravenous, within 2 weeks or 48 hours after the administration of Tamiflu (Oseltamivir), unless prescribed for medical signs.

Influenza virus vaccine trivalent

Tamiflu (Oseltamivir) reduces the effect of triangular influenza virus vaccine by pharmacodynamic antioxidants. Use caution / monitor. Avoid the administration of live-influenza influenza vaccine intravenous, within 2 weeks or 48 hours after the administration of Tamiflu (Oseltamivir), unless prescribed for medical signs.

Influenza virus vaccine trivalent, adjuvanted

Tamiflu (Oseltamivir) pharmacodynamic anti-influenza virus vaccine reduces the effect of trivalent by anti-virus. Use caution / monitor. Avoid the administration of live-influenza influenza vaccine intravenous, within 2 weeks or 48 hours after the administration of Tamiflu (Oseltamivir), unless prescribed for medical signs.

Influenza virus vaccine trivalent, recombinant

Tamiflu (Oseltamivir) reduces the effect of the recombinant influenza virus vaccine trivalent by pharmacodynamic rivalry. Use caution / monitor. Avoid the administration of live-influenza influenza vaccine intravenous, within 2 weeks or 48 hours after the administration of Tamiflu (Oseltamivir), unless prescribed for medical signs.

Probenecid

The level of Tamiflu (Oseltamivir) increases by probenecid other. Use caution / monitor. Note: Classification results of probenecid results in 2x increase in contact with Tamiflu (Oseltamivir) carboxylate due to a decrease in active anionic tubular secretion in the kidney. No dosage adjustments are required with probenecid coadministration.

Adverse Effect

1-10%
•  Stomach Pain
•  Conjunctivitis
•  Ear disorder
•  Bleeding nose
•  Insomnia
•  Nausea
•  Vomiting
•  Vertigo

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•  Growth of diabetes
•  Anemia
•  Arrhythmia
•  Confusion
•  Delirium
•  Hemorrhagic colitis
•  Hepatitis
•  Humorous fracture
•  Peritonsillar abscess
•  Pneumonia
•  Pseudomembranous colitis
•  Pyrexia
•  Red spots
•  Seizure
•  Transaminases increased
•  Toxic epidermal necrolysis
•  Unstable angina
•  Swelling of the face or tongue

Postmarketing Reports

•  Hypothermia
•  Diaper rash (2 weeks to •  Dermatitis
•  Hives
•  Itching
•  Stevens-johnson syndrome
•  Eritheme multiforme
•  Gastrointestinal bleeding
•  Abnormal liver function test

Warnings

Contraindications

Hypersensitivity

Cautions

•  Be careful in chronic cardiac disease, severre hepatitis loss, kidney dose, respiratory disease patients.
•  Most effective when used within 24-48 hours of start of symptoms
•  Age •  Oral suspension should be mixed before delivery
•  Immunocompromised patients have no safety and efficacy established
•  Therapy is not an option for influenza virus vaccine
•  Severe skin / susceptibility responses such as Stevens-Johnson syndrome, poisonous epidermal necrolysis and erythema multiforme; Close the treatment and start treatment if allergic reactions or doubts occur
•  Patients with influenza, which can be included in patients receiving medicines, especially child-patients, may increase the risk of illusion or abnormal behavior in their disease, potentially fatal neuropsychiatric adverse events; Monitoring for signs of unusual behavior
•  Presidents should be potentially cautious for secondary bacterial infection and treat them appropriately

Oral suspension and hereditary fructose intolerance

•  Fructose can be harmful to patients with hereditary fructose intolerance
•  A dose of 75 ml oral suspension saves 2g of sorbitol; This is higher than the daily maximum limit of sorbet for patients with hereditary fructose intolerance, and may cause dyspepsia and diarrhea.

Pregnancy and Breastfeeding

Pregnancy Category: C

Accelerated use of antiviral drugs during the 2009 H1N1 influenza pandemic improved survival among critically ill pregnant women; During the pandemic, CDC examined serious flu reports (as a result of death or ICU admission) in 347 pregnant women; Only four women (7%) of those who died were given antiviral within two days of symptoms compared to 41% of the survivors. (MMWR September 9, 2011; 60 [35]: 11 9 2-6)

Breastfeeding: unknown; Be careful

Pregnancy categories

A: Generally acceptable. Controlled studies in pregnant women do not show any evidence of embryonic risk.

B: May be acceptable. Either animal studies show no risk, but human studies are not available or animal studies have performed minimal risk and human studies and have shown no risk.

C: Experiment with caution if profit is more than risk. Animal studies do not show risk and human studies, neither animal nor human studies are conducted.

D: Use in life-threatening emergency when no safe medication is available. Positive evidence of human fetal risk.

X: Do not use it during pregnancy. Incorporated risk potential benefits included the lines are tilted. Safe options exist.

NA: Information is not available.

Medicine

Mechanism of Action

Viral stops neuraminidases; Prevents the release of virus from the cells and prevents the virus from crossing the mucous lining of the respiratory tract.

Absorption

Bioavailability: 75%

Peak plasma time: 2.5-6 hours

Distribution

Protein bound: 3% (oseltamivir carboxylase); 42% (oseltamivir)

VD: 23-26L

Elemination

Half life: 1-3hr (oseltamivir); 6-10 hours (oseltamivir carboxylate)

Immersion: fee; Urine (> 90% oseltamivir as carboxylate)

Administration

Oral Administration

Pills and oral suspension can be taken with or without food

Tolerance can be increased when taken with food

Emergency preparation of oral suspension from 75 mg capsules

The instructions given below are for 100 ml of 6 mg / ml suspension

1. Place 7 ml of distilled water in polyethyleneterephthalate (PET) or glass bottle

2. Bottle of empty 75-mg capsule (i.e., 600 mg) of empty material

3. Slow suspension to ensure adequate wetness of powder for at least 2 minutes

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4. Gradually add 91-ml of Ora-sweet, cherry syrup, or simple syrup

5. Close the bottle for approximately 30 minutes and stir well. Move the patient well before use

Stable for 5 days at room temperature or 5 weeks cold at 2-8 degrees Celsius (36-46 degrees Fahrenheit)

Patient Handout

Tamiflu (Oseltamivir) Oral

Important: How to use this information: This is a summary and not all possible information about this product. This information does not ensure that this product is safe, effective or appropriate for you. This information is not personalized medical advice and it is not substituted for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

OSLTMVIIER – ORAL
(oss-el-TAM-eh-veer)
Common brand name (s): Tamiflu (Oseltamivir)

Uses:

Tamiflu (Oseltamivir) is used to treat symptoms due to flu virus (influenza). It helps in formulating symptoms (such as a nose, cough, sore throat, fever / cold, pain, exhaustion) less severe and reduce the recovery time to 1-2 days.

This drug can also be used to stop the flu if you have come in contact with someone who already has flu (like a sick domestic member) or if there is a flu outbreak in the community. Talk to your doctor for more information.

This drug works by preventing the spread of flu virus. This is not an option for flu vaccine. (See also the Notes section.)

How To Use:

Please read the Patient Information Sheet when available from your pharmacist before taking this medicine. If you have any questions, consult your doctor or pharmacist.

Take this medicine from mouth or without food. You can take it from food or milk to reduce the stomach problems. As soon as symptoms of the flu come out or take this medicine immediately after exposure to the flu. Tamiflu (Oseltamivir) works best if you start taking it within 2 days of any one of these events.

If you have flu, then take Tamiflu (Oseltamivir), guided by your doctor, usually twice a day for 5 days.

To stop the flu, take Tamiflu (Oseltamivir), directed by your doctor, usually for at least 10 days in the day. Follow the instructions of your doctor for how long this medicine has to be taken.

Dosage is based on your medical condition, kidney function, and reaction to treatment. Dosage in children is also based on weight.

If you can not swallow capsules, ask about the liquid suspension form of Tamiflu (Oseltamivir) from your doctor or pharmacist. If the liquid is not available and if your doctor or pharmacist has been guided, then you can open the capsules and mix the ingredients with a small amount of sweet liquid (e.g regular / sugar free chocolate syrup, corn syrup, caramel topping, or dissolved in water Light brown sugar). Stir the mixture and take full dose.

This drug works best when the amount of drug in your body is kept at constant level. Therefore, take this medication at all intervals at the same distance at all times. Continue to set it up to full time. Preventing the drug very early can allow the virus to grow, resulting in the infection or failure to save you from the flu.

Tell your doctor if your condition persists or gets worse or new symptoms appear.

Side Effects:

Nausea and vomiting can occur. If any of these effects persists or gets worse, immediately inform your doctor or pharmacist.

Remember that your doctor has prescribed this medicine because it has decided that your benefit is higher than the risk of side effects. Many people using this drug do not have serious side effects.

Flu yourself or Tamiflu (Oseltamivir) rarely can change serious mental / mood. This can be more likely in children. Ask your doctor immediately after any signs of abnormal behavior: confusion, movement, self-injury

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A very serious allergic reaction to this drug is rare. However, if you see any symptoms of severe allergic reactions, get immediate medical help, including: tooth, itching / swelling (especially the face / tongue / throat), severe dizziness, breathing Trouble.

This is not a complete list of potential side effects. If you see other effects not listed above, contact your doctor or pharmacist.

In the US –

Call your doctor for medical advice about side effects. You can report FDA’s side effects on 1-800-FDA-1088 or www.fda.gov/medwatch.

In Canada – Contact your doctor for medical advice about side effects. You can report side effects to Health Canada at 1-866-234-2345.

Precautions:

Before taking Tamiflu (Oseltamivir), tell your doctor or pharmacist if you are allergic to this; Or if you have any other allergies. This product may have passive elements, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this drug, tell your doctor or pharmacist your medical history, especially: kidney disease (including dialysis treatment).

Before performing the surgery, tell your doctor or dentist about all the products (including prescription drugs, non-prescription medicines and herbal products).

During pregnancy, this drug should be used only if it is clearly required. Discuss the risks and benefits with your doctor.

This medicine passes in breast milk but there is no possibility of harming a nursing infant. Consult your doctor before breastfeeding.

Drug Interactions:

Drug interactions can change how your medicines work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescriptions / non-prescription medicines and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change any drug dosage without your doctor’s approval.

Tell your doctor if you have received flu vaccine in the nose 2 weeks before treatment of this medicine. This medication can reduce your safety with the flu vaccine given in the nose. Waiting for at least 2 days to finish the treatment with this drug before receiving the flu vaccine given in the nose.

Over Dose

If someone has entered a greater amount and has serious symptoms like having difficulty passing or breathing, call 911. Otherwise, call the Poison Control Center immediately. American residents can call their local poison control center at 1-800-222-1222. Canadian residents can call a provincial poison control center.

Notes:

Do not share this medication with others.

This drug is not an option for flu vaccine. To reduce the likelihood of getting flu, consult your doctor about the risks of getting an annual flu shot and significant benefits.

Missed dose:

If you miss the dose, then as soon as you miss it. If this is within 2 hours of your next dose, leave the missed dose. Take your next dose at regular times. Do not double the dose to catch up.

Storage:

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush the medicines under the toilet or put them in the groove unless instructed to do so. When properly finished this product is discarded or it is not required. For more information about how to safely leave your product, consult your pharmacist or local waste disposal company.

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