Oseltamivir

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[edit] BRAND NAMES

[edit] STRUCTURE

Oseltamivir.jpg

[edit] MECHANISM OF ACTION

Oseltamivir is the ethyl ester prodrug of the antiviral molecule, oseltamivir carboxylate, a potent and selective inhibitor of influenza A and B neuraminidase (NA). Influenza neuraminidase (NA) is essential for virus release from its host cells.

[edit] INDICATIONS

  • Treatment of acute, uncomplicated influenza type A and B in patients 2 weeks of age and older who have been symptomatic for no more than 2 days. (Efficacy not established in patients who begin therapy after 48 hours of symptoms).
  • Prophylaxis of influenza in patients 1 year and older.

Oseltamivir is not a substitute for annual influenza vaccination.

[edit] DOSAGE

  • Treatment of influenza:
    • Adults and adolescents (13 years and older): 75 mg twice daily for 5 days
    • Pediatric patients 1 to 12 years of age:
      • 15 kg or less: 30 mg twice daily for 5 days
      • 15.1 kg thru 23 kg: 45 mg twice daily for 5 days
      • 23.1 kg thru 40 kg: 60 mg twice daily for 5 days
      • 40.1 kg or more: 75 mg twice daily for 5 days
    • Pediatric patients 2 weeks to less than 1 year of age: 3mg/kg twice daily for 5 days.
    • Renally impaired adult patients (creatinine clearance 10-30 mL/min): Reduce to 75 mg once daily for 5 days


  • Prophylaxis of influenza:
    • Adults and adolescents (13 years and older): 75 mg once daily for at least 10 days
    • Community outbreak in Adults and adolescents (13 years and older): 75 mg once daily for up to 6 weeks
    • Pediatric patients 1 to 12 years of age:
      • 15 kg or less: 30 mg once daily for 10 days
      • 15.1 kg thru 23 kg: 45 mg once daily for 10 days
      • 23.1 kg thru 40 kg: 60 mg once daily for 10 days
      • 40.1 kg or more: 75 mg once daily for 10 days
    • Community outbreak in Pediatric patients 1 to 12 years of age:
      • 15 kg or less: 30 mg once daily for up to 6 weeks
      • 15.1 kg thru 23 kg: 45 mg once daily for up to 6 weeks
      • 23.1 kg thru 40 kg: 60 mg once daily for up to 6 weeks
      • 40.1 kg or more: 75 mg once daily for up to 6 weeks
    • Renally impaired adult patients (creatinine clearance 10-30 mL/min): Reduce to 75 mg once every other day or 30 mg once daily

[edit] CONTRAINDICATIONS

Patients with known serious hypersensitivity to oseltamivir

[edit] WARNINGS AND PRECAUTIONS

  • Cases of anaphylaxis and serious skin reactions including toxic epidermal necrolysis, Stevens-Johnson Syndrome, and erythema multiforme have been reported in postmarketing experience with Oseltamivir. Oseltamivir should be stopped and appropriate treatment instituted if an allergic-like reaction occurs or is suspected.
  • Neuropsychiatric events: Patients with influenza, including those receiving Oseltamivir, particularly pediatric patients, may be at an increased risk of confusion or abnormal behavior early in their illness. Monitor for signs of abnormal behavior

[edit] INTERACTIONS

  • Live attenuated influenza vaccine, intranasal:
    • Do not administer until 48 hours following cessation of Oseltamivir.
    • Do not administer Oseltamivir until 2 weeks following administration of the live attenuated influenza vaccine, unless medically indicated.

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category C (US): There are insufficient human data upon which to base an evaluation of risk of Oseltamivir to the pregnant woman or developing fetus. Use only if clearly needed.
  • Nursing mothers: Caution should be exercised when administered to a nursing woman.

[edit] SIDE EFFECTS

Most common adverse reactions (>1% and more common than with placebo):

  • Treatment studies: Nausea, vomiting
  • Prophylaxis studies: Nausea, vomiting, diarrhea, abdominal pain

[edit] RELATED LINKS

[edit] BIBLIOGRAPHY

[edit] REFERENCES