Oseltamivir

Kathryn Dzintars, Pharm.D., BCPS
Pediatric Dosing Author: Bethany Sharpless Chalk, Pharm.D., BCPPS
Oseltamivir is a topic covered in the Johns Hopkins ABX Guide.

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INDICATIONS

FDA

  • Uncomplicated acute illness due to influenza A and B infection in patients > 2 weeks of age and older who have been symptomatic for no more than 2 days.
    • Efficacy not established (by prospective trials) if symptom onset > 48h duration.
  • Prophylaxis of influenza in ages ≥ 1 yr of age.

NON-FDA APPROVED USES

  • Severe illness due to influenza A and B infection in immunocompromised and elderly pts who are hospitalized, even if > 48h symptoms--though limited data regarding efficacy 3 - 5 days post symptom onset.
  • The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics recommend the use of oseltamivir for prophylaxis in infants > 3 months of age.
  • COVID-19:
    • Coronaviruses are not known to utilize neuraminidase in viral replication; therefore, oseltamivir is unlikely to be of any therapeutic value.
      • In one series of 138 hospitalized patients with COVID-19, approximately 90% received oseltamivir, with no reported evidence of benefit.

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INDICATIONS

FDA

  • Uncomplicated acute illness due to influenza A and B infection in patients > 2 weeks of age and older who have been symptomatic for no more than 2 days.
    • Efficacy not established (by prospective trials) if symptom onset > 48h duration.
  • Prophylaxis of influenza in ages ≥ 1 yr of age.

NON-FDA APPROVED USES

  • Severe illness due to influenza A and B infection in immunocompromised and elderly pts who are hospitalized, even if > 48h symptoms--though limited data regarding efficacy 3 - 5 days post symptom onset.
  • The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics recommend the use of oseltamivir for prophylaxis in infants > 3 months of age.
  • COVID-19:
    • Coronaviruses are not known to utilize neuraminidase in viral replication; therefore, oseltamivir is unlikely to be of any therapeutic value.
      • In one series of 138 hospitalized patients with COVID-19, approximately 90% received oseltamivir, with no reported evidence of benefit.

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Last updated: March 27, 2020