Episode 905: Oseltamivir (Tamiflu) for Influenza

Emergency Medical Minute

Contributor: Aaron Lessem MD

Educational Pearls:

• Oseltamivir (Tamiflu) is an antiviral medication used commonly to treat influenza

• Trials show that the medication reduces the duration of illness by less than 1 day (~16 hours in one systematic review)

• Benefit only occurs if taken within 48 hours of symptom onset

• Must be taken for 5 days

• A 2024 meta-analysis reviewed 15 randomized-controlled trials for the risk of hospitalization

• No reduction in hospitalizations with oseltamivir in patients over the age of 12

• No difference in high-risk patients over the age of 65 or those with comorbidities

• The authors note that the confidence interval in these populations is wide, indicating a need for subsequent studies in high-risk populations

• Oseltamivir is associated with adverse effects including nausea, vomiting, and neurologic symptoms

• The risk of adverse effects may outweigh the benefits of a small reduction in the duration of illness

References

1. Hanula R, Bortolussi-Courval É, Mendel A, Ward BJ, Lee TC, McDonald EG. Evaluation of Oseltamivir Used to Prevent Hospitalization in Outpatients with Influenza: A Systematic Review and Meta-Analysis. JAMA Intern Med. 2024;184(1):18-27. doi:10.1001/jamainternmed.2023.0699

2. Jefferson T, Jones M, Doshi P, Spencer EA, Onakpoya I, Heneghan CJ. Oseltamivir for influenza in adults and children: Systematic review of clinical study reports and summary of regulatory comments. BMJ. 2014;348(April):1-18. doi:10.1136/bmj.g2545

Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit