Infectious Disease Compendium

Oseltamivir (Tamiflu®)

CrCl Formula

CrCl > 80: 75 mg po bid for 5 days.

It gives good blood levels (but no clinical data) when dosed 75 mg every 48 h (q48h) combined with 500 mg probenecid four times a day (PubMed).

CrCl 80-50:

CrCl 50-10:

CrCl < 10:

Hemodialysis:

Peritoneal dialysis:

Important side effects

Bronchitis, insomnia, vertigo, nausea, vomiting. Postmarketing reports from Japan suggests that patients with influenza receiving oseltamivir, particularly children, may be at increased risk for self-injury and delirium. Enough such that the CDC thought it warrented an alert in Nov, 2006.

Important drug interactions

Rants and Screeds

What the hell is your patient getting influenza for anyway? Haven't you heard of the vaccine, bub?

Pearls

92% of influenza is now resistant to amantadine and rimantadine; only useful if given within the first 72 hours of illness and shortens the illness by a day or so. Given how awful influenza is, its probably worth it.

Treatment of choice

Use for

Influenza A and B. Avian influenza as well.

Don't use for

Class