Saturday, November 7, 2009

When to Take Tamiflu

With the H1N1 flu season hitting most communities, the question of when to give patients Tamiflu comes up for physicians. Tamiflu is the antiviral medication that can shorten the severity of flu symptoms day. To be effective it should be given within the first 48 hours of symptoms.

There are no medical guidelines for who should take Tamiflu. If patients have symptoms severe enough for hospitalization or have a chronic condition or asthma, Tamiflu should definitely be prescribed. Pregnant women and young children are at more risk for severe flu so they should be given Tamiflu when symptoms present, but what about everyone else?

Is shortening the illness by one day worth the $100 Tamiflu costs? Some doctors are concerned about creating resistant strains of influenza if Tamiflu is overused. And giving Tamiflu to "prevent" flu is not recommended because people who live in a household with a flu victim have only a 15-27% chance of catching flu anyway. That said, if a person with high risk factors is exposed to the flu, giving Tamiflu is likely to prevent illness.

As with any medication, adverse events can occur. With Tamiflu adverse event reports were primarily related to unusual neurologic or psychiatric events such as delirium, hallucinations, confusion, abnormal behavior, convulsions, and encephalitis. Most of the reports come from Japan.

I am not prescribing Tamiflu routinely for people with flu symptoms. If they ask for it, and understand how it works and the small risks of taking it, I will write the prescription. Tamiflu is not a substitute for the flu shot.


KM said...

Since living with someone who was diagnosed with H1N1 and got sick again a few weeks later I had wondered about some of these questions. Thanks for this important informative info. You always have the best timely information Dr.Brayer.

Toni Brayer MD said...

Thank you very much, KM

Linda Leighton said...

Thanks, Toni! I hope I can get the H1N1 shot very soon, but it doesn't look too great here yet.

Toni Brayer MD said...

Linda: The H1N1 vaccine is in short supply and distribution is erratic. Even high risk people have not been able to get it and many health care workers who are slated to be firt have not received it. They say there will be enough for everyone but there seems to be no consistent distribution across the U.S.

Dhanesh Mane said...

Hey very informative post. Very useful information of tamiflu. Keep up.

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