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(oh-sell-TAM-ih-veer)
Tamiflu
Class: Anti-infective/Antiviral

 Action Inhibition of influenza virus neuraminidase with possible alteration of virus particle aggregation and release.

 Indications Treatment of uncomplicated acute illness caused by influenza infection in patients > 1 yr who have been symptomatic for £ 2 days; prophylaxis of influenza in patients ³ 13 yr.

 Contraindications Standard considerations.

 Route/Dosage

Treatment of Influenza

ADULTS AND ADOLESCENTS ³ 13 YR: PO 75 mg twice daily for 5 days. Renal impairment (Ccr 10 to 30 mL/min): PO 75 mg once daily for 5 days. ADULTS AND CHILDREN ³ 1 YR (who cannont swallow capsules): Suspension PO £ 15 kg (£ 33 lbs) administer 30 mg (2.5 mL) twice daily. > 15 to 23 kg (> 33 to 51 lbs) administer 45 mg (3.8 mL) twice daily. > 23 to 40 kg (51 to 88 lbs) administer 60 mg (5 mL) twice daily > 40 kg (> 88 lbs) administer 75 mg (6.2 mL) twice daily.

Influenza Prophylaxis

ADULTS AND ADOLESCENTS ³ 13 YR: PO 75 mg once daily for ³ 7 days. Renal impairment (Ccr 10 to 30 mL/min): PO 75 mg every other day.

 Interactions None well documented.

 Lab Test Interferences None well documented.

 Adverse Reactions

RESP: Bronchitis. CNS: Insomnia; vertigo. GI: Nausea; vomiting.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Influenza treatment: Safety and efficacy not established in children < 1 yr. Influenza prophylaxis: Safety and efficacy not established in children < 13 yr. Repeated courses: Safety and efficacy not established. Renal impairment: Administer with caution.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • Store at room temperature in a dry, closed container out of the reach of children.
  • Administer within 2 days of the onset of symptoms.
  • Administer with or without food.
  • Food has increased tolerability for some patients.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Monitor patient for potential hypersensitivity.
  • Monitor for adverse events including nausea, vomiting, and diarrhea.
OVERDOSAGE: SIGNS & SYMPTOMS
  Nausea, vomiting

 Patient/Family Education

  • Instruct patient to begin treatment as soon as possible at the first appearance of flu symptoms.
  • Instruct patient of the importance of nonpharmacological therapies such as adequate hydration and rest.
  • Instruct patient to take oseltamivir as directed and to take any missed doses as soon as remembered unless it is within 2 hr before the next scheduled dose, and then continue to take oseltamivir at the usual scheduled times.
  • Teach patient that oseltamivir is not a substitute for a flu vaccination, and to continue to receive an annual flu vaccination.
  • Advise patient to notify physician immediately if pregnant, planning to become pregnant, or planning to breastfeed.

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