The pharmacokinetics of oseltamivir in pediatric subjects over 12 years of age are similar to those in adult subjects [see Use In Specific Populations ]. Half-lives observed in the geriatric subjects were similar to those seen in young adults. Based on drug exposure and tolerability, dose adjustments are not required for geriatric patients for either treatment or prophylaxis [see Use In Specific Populations].
Drug Interaction Studies 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. In vitro studies demonstrate that neither oseltamivir nor oseltamivir carboxylate is a good substrate for P mixed-function oxidases or for glucuronyl transferases.
Coadministration of probenecid results in an approximate two-fold increase in exposure to oseltamivir carboxylate due to a decrease in active anionic tubular secretion in the kidney. However, due to the safety margin of oseltamivir carboxylate, no dose adjustments are required when coadministering with probenecid. No clinically relevant pharmacokinetic interactions have been observed when coadministering oseltamivir with amoxicillin , acetaminophen , aspirin, cimetidine , antacids magnesium and aluminum hydroxides and calcium carbonates , rimantadine, amantadine , or warfarin.
Microbiology Mechanism Of Action Oseltamivir phosphate is an ethyl ester prodrug requiring ester hydrolysis for conversion to the active form, oseltamivir carboxylate. Oseltamivir carboxylate is an inhibitor of influenza virus neuraminidase affecting release of viral particles. Antiviral Activity The antiviral activity of oseltamivir carboxylate against laboratory strains and clinical isolates of influenza virus was determined in cell culture.
The concentrations of oseltamivir carboxylate required for inhibition of influenza virus in cell culture were highly variable depending on the assay method used and the virus tested. The relationship between the antiviral activity in cell culture, inhibitory activity in the neuraminidase assay, and the inhibition of influenza virus replication in humans has not been established.
Resistance Cell culture studies: Influenza A virus isolates with reduced susceptibility to oseltamivir carboxylate have been recovered by serial passage of virus in cell culture in the presence of increasing concentrations of oseltamivir carboxylate. Reduced susceptibility isolates have been obtained during treatment with oseltamivir and from sampling during community surveillance studies.
Changes in the viral neuraminidase that have been associated with reduced susceptibility to oseltamivir carboxylate are summarized in Table 8. For children from 1 to 12 years old Take 1 dose, based on your child's weight, once daily, for 10 days or as long as prescribed. Tamiflu is not approved for flu prevention in children less than 1 year of age. FAQs Below are several commonly asked questions and their answers.
If you have additional questions not covered here, be sure to ask your doctor. What should I do if I miss a dose of Tamiflu?
If you forget to take your medicine, take the missed dose as soon as you remember, unless it is 2 hours or less before your next scheduled dose. Then continue to take Tamiflu at the usual times. Do not take 2 doses at a time to make up for a missed dose.
If you miss several doses, tell your doctor and follow the advice given to you. Before taking Tamiflu, tell your doctor if you have received a nasal flu vaccine within the past 2 weeks, or if you have kidney disease, heart disease, lung disease, or any other serious disease or health problem. Also tell your doctor if you have any condition causing swelling or disorder of the brain.
Take Tamiflu for as many days as it has been prescribed for you even if you begin to feel better. Your symptoms may start to improve before the infection is completely treated. Some people using oseltamivir have had rare side effects of sudden confusion, delirium, hallucinations, unusual behavior, or self-injury. These symptoms have occurred most often in children.
It is not known whether this medicine was the exact cause of these symptoms. However, anyone using this medicine should be watched closely for signs of confusion or unusual behavior. Call a doctor at once if you or the child using this medicine has any of these symptoms. Before taking this medicine Tamiflu should not be used in place of getting a yearly flu shot.
The Centers for Disease Control CDC recommends an annual flu shot to help protect you each year from new strains of influenza virus. You can get a flu shot even while using Tamiflu.
You should not use this medicine if you are allergic to oseltamivir. Do not use Tamiflu to prevent influenza in a child younger than 1 year old.
Do not use oseltamivir to treat influenza in a child younger than 2 weeks old. Tell your doctor if you have ever had: It is not known whether this medicine will harm an unborn baby. However, getting sick with influenza during pregnancy can cause complications leading to birth defects, low birth weight, preterm delivery, or stillbirth. Your doctor will decide whether you should receive oseltamivir if you are pregnant.
The Centers for Disease Control and Prevention CDC recommends that pregnant women may receive a yearly flu vaccine to prevent influenza. Oseltamivir is not to be used in place of the yearly flu shot. It is not known whether Tamiflu passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby. How should I take Tamiflu? Take Tamiflu exactly as prescribed by your doctor.
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