Oseltamivir phosphate, which goes by the brand name Tamiflu, is an antiviral medicine that prevents the influenza (flu) virus (type A and B) from spreading throughout the body. A pediatrician may consider Tamiflu for kids, depending on the child’s symptoms.
The drug, when given within two days of the onset of symptoms, helps shorten the length of the flu and its complications by 24-36 hours. However, late treatment with Tamiflu may not be effective.
In this post, learn about the safety, advantages, side effects, dosage, and alternatives to Tamiflu for children.
Is Tamiflu Safe For Children?
“Tamiflu is FDA-approved, often used, and generally safe for children and infants as young as two weeks old,’’ says N. Bande Mangaliso Virgil, MD, FAAP, Board Certified Pediatrician, Pediatric Hospitalist at Piedmont Columbus Regional Midtown Hospitalists, and Assistant Clinical Professor of Pediatrics for the Mercer University of Medicine, Columbus campus.
However, “it can cause certain side effects, commonly gastrointestinal issues such as nausea and vomiting in some children, ” Dr. Mangaliso Virgil adds.
Also, like any other medication, it may cause allergic reactions ranging from rashes to anaphylaxis. Convulsions, mood changes, and hallucinations can also occur in some children, but these are rare.
“In children who don’t have allergic reactions to Tamiflu or the common side effects such as nausea or vomiting, there are little downsides. Although Tamiflu does not cure flu, it can shorten the length and severity of symptoms. So for many infants and children, the benefits outweigh the downsides,” says Dr. Mangaliso Virgil.
Although rare, some children can experience nosebleeds, dizziness, breathing problems, etc., after taking Tamiflu. Seeking a doctor’s prescription may reduce the incidence of side effects in many cases. Contact the pediatrician to identify and manage the side effects.
Why Is Tamiflu Used?
Tamiflu and other antiviral drugs can shorten the duration and reduce the symptoms of influenza in children. Early treatment of flu with Tamiflu may (1)
- Lower the risk of ear infections and the need for antibiotic therapy in children between one and 12 years.
- Decrease the risks for serious flu-related complications such as pneumonia.
- Reduce hospitalization due to flu complications.
- Prevent respiratory failure and death due to flu in hospitalized cases.
Other approved antivirals can also provide similar benefits as Tamiflu. Children with a high risk of flu complications can benefit from Tamiflu if treated as early as possible, usually within two days of the onset of symptoms.
Who Should Be Given Tamiflu?
Tamiflu is often prescribed for children who are at a high risk of flu complications and severe symptoms. Children with the following underlying medical conditions may require Tamiflu (2).
- Heart disease
- Lung disease
- Neuromuscular disorders
- Weakened immune system
- Sickle cell disease
- Kidney disease
- Liver disease
Does Tamiflu Prevent The Flu?
Tamiflu is not a routine flu prevention medication. Sometimes, doctors may prescribe Tamiflu for flu-like symptoms in children who have family members at high risk of influenza complications. However, the US Centers for Disease Control and Prevention do not recommend antiviral medication for widespread prevention since this may lead to the emergence of antiviral resistant viruses (2).
Giving your children an annual influenza vaccine is the best way to protect them against influenza. Anyone aged above six months or older can get a flu shot or nasal spray vaccine before the flu season. Although the flu vaccine may not completely prevent the flu, it may lower the severity and complications.
Tamiflu Dosage For Children
Tamiflu is available as capsules and liquid formulation for children. It is often administered as an oral suspension to children. However, if your child receives a prescription of oseltamivir capsules and is unable to swallow them due to the taste, you can open and mix the capsule with a thick sweetened liquid such as regular or sugar-free chocolate syrup.
An oral dosing dispenser with 30mg, 45mg, and 60mg graduations is provided with Tamiflu. You may measure a 75mg dose using a combination of 30mg and 45mg graduations. Different measuring devices, such as a 5ml oral syringe, are provided for infants younger than one year. You may use the recommended measuring device to deliver an adequate dose of medicine.
The treatment dosage for 1- to 12-year-old children is given in the table below (3).
|Body weight (kg)||Age (years)||Dose for 5 days||Number of Bottles of Oral Suspension Needed for the 5-Day Regimen||Number of Capsules Needed for the 5-Day Regimen|
|≤ 15||1-2||30mg twice daily||1||10 capsules (30mg)|
|> 15-23||3-5||45mg twice daily||2||10 capsules (45mg)|
|> 23-40||6-9||60mg twice daily||2||20 capsules (30mg)|
|> 40||10-12||75mg twice daily||3||10 capsules (75mg)|
The dosage for children younger than one year is not based on weight. Tamiflu dosage for infants is mentioned in the table below.
|Dose by Age||Recommended Treatment Dose for 5 Days of Tamiflu Oral Suspension|
|12mg (1mL) twice daily|
|3-5 months||20mg (1.6mL) twice daily|
|6-11 months||25mg (2mL) twice daily|
These dose tables are for reference purposes only. The dose may vary for treatment and prevention based on individual factors. The treatment dose and the prophylactic (preventative) dose may vary based on factors such as renal impairment, age, body weight, and other conditions, so always obtain a prescription from your pediatrician.
A prophylactic Tamiflu dose based on body weight is recommended for children aged one to 12 years and who were in close contact with an infected person. Children aged three months to one year receive prophylactic doses of Tamiflu based on age. Flu prophylaxis with Tamiflu is not recommended for infants younger than three months.
Tamiflu Alternatives For Children
There are four antiviral drugs, including Tamiflu, that are approved by the U.S. Food and Drug Administration (FDA) and are recommended by the U.S. Centers for Disease Control and Prevention for use in children. The other three antivirals include (1)
- Relenza (zanamivir). It can be used to treat flu in children aged seven or older. Inhaled zanamivir is available under the brand name Diskhaler. This antiviral medication is not recommended for children with respiratory conditions such as asthma and chronic lung diseases.
- Xofluza (baloxavir): It is a single-dose pill for flu in children aged one year and older. This is usually given during early outpatient treatment.
- Rapivab (peramivir): This is an intravenous (IV) antiviral medication for flu in children aged two years and above.
You may seek a pediatrician’s prescription for appropriate flu antivirals for your child based on their individual needs.
Frequently Asked Questions
1. Does Tamiflu reduce fever in kids?
Tamiflu reduces the duration of influenza symptoms, such as fever, stuffy nose, sore throat, cough, chills, fatigue, and muscle aches (2).
2. Does Tamiflu make your kids less contagious?
Tamiflu can reduce the duration of influenza symptoms. However, even after taking Tamiflu, an infected child can stay contagious for days. According to the CDC, “people with influenza-like illness remain at home until at least 24 hours after they are free of fever (100° F [37.8°C]) or signs of fever without the use of fever-reducing medications (4).”
When given within two or two and a half days of the onset of symptoms, it can minimize the risk of influenza complications in children. It can also be used as a preventative medication for children with heart, lung, liver, and kidney disease and those with a weaker immune system, neuromuscular diseases, and other underlying conditions during the viral season. Despite being available without a prescription in medical stores, it is recommended to seek a dosing prescription of Tamiflu for kids. Although Tamiflu is used to prevent flu, it is not a substitute for flu vaccination, the most effective flu prevention technique.
- Tamiflu can help reduce the severity and duration of flu symptoms.
- Children with other health conditions such as lung diseases, cancer, diabetes, weakened immune system, may require Tamiflu.
- Relenza, Xofluxa, and Rapivab are a few alternatives for Tamiflu.
2. Tamiflu and Children; Clearing up the confusion; St. Louis Children’s Hospital
3. Antiviral Dosage Duration Tables; Centers for Disease Control and Prevention
4. H1N1 Flu; Centers for Disease Control and Prevention