Oseltamivir

Indications
 Oral
Influenza A and B
Adult: 75 mg bid for 5 days. Initiate treatment within 2 days of onset of symptoms.
Child: 1-12 yr: Wt ≤15 kg: 30 mg bid; >15-23 kg: 45 mg bid; >23-40 kg: 60 mg bid; >40 kg: 75 mg bid. Initiate treatment within 2 days of onset of symptoms. Duration of treatment: 5 days.
Renal impairment: Dialysis: Not recommended.
CrCl (ml/min)Dosage Recommendation
10-3075 mg once daily or 30 mg bid.
<10Not recommended.

Oral
Prophylaxis of influenza A and B
Adult: 75 mg once daily for 10 days. Initiate treatment within 2 days of exposure. For community outbreak: May continue dosing for up to 6 wk.
Child: 1-12 yr: Wt ≤15 kg: 30 mg once daily; >15-23 kg: 45 mg once daily; >23-40 kg: 60 mg once daily; >40 kg: 75 mg once daily. Initiate treatment within 2 days of contact with an infected individual. Duration of treatment: 10 days.
Renal impairment: Dialysis: Not recommended.
CrCl (ml/min)Dosage Recommendation
10-3075 mg on alternate days or 30 mg daily.
<10Not recommended.


Special Populations: Renal impairment: CrCl 10-30 mL/min: Treatment: 75 mg once a day for 5 days. Prophylaxis: 75 mg every other day. Creatinine clearance <10 mL/min: No recommended dosage adjustment. Hepatic impairment: No recommended dosage adjustment.

Reconstitution: Oral suspension: Reconstitute with 23 ml water to make 25 ml suspension.
Contraindications
 Hypersensitivity. Severe renal impairment.
Warnings / Precautions
 Moderate renal impairment. Pregnancy and lactation. Chronic cardiac disease, hepatic impairment, respiratory disease, immunocompromised patients.
Adverse Reactions
 Nausea, vomiting, abdominal pain, bronchitis, insomnia, vertigo, diarrhoea, dizziness, headache, cough, fatigue, unstable angina, anaemia, pseudomembranous colitis, pneumonia, pyrexia, peritonsillar abscess, elevated liver enzymes, hepatitis, aches and pains, dyspepsia, rhinorrhoea, upper respiratory-tract infections. In children: Vomiting, other GI disturbances, asthma, bronchitis, conjunctivitis, dermatitis, epistaxis, ear disorders, otitis media, lymphadenopathy, pneumonia, sinusitis.
Potentially Fatal: Anaphylaxis, severe dermatologic reactions.
Overdose Reactions
 Symptoms include nausea and vomiting.
Mechanism of Actions
 Oseltamivir is a prodrug of oseltamivir carboxylate (OC). OC is a potent selective competitive inhibitor of neuraminidase (an enzyme required for viral replication) of the influenza virus A and B. It prevents the release of viruses from infected host cell.
Absorption: Readily absorbed from the GI tract (oral).
Distribution: Protein-binding: 3% (carboxylate); 42% (parent drug).
Metabolism: Hepatic; extensively metabolised to oseltamivir carboxylate.
Excretion: Via urine. Half-life: 1-3 hr.
Administration
 May be taken with or without food. (May be taken w/ meals to reduce GI discomfort. Cap may be opened & mixed w/ sweetened food products eg chocolate syr, sweetened condensed milk, apple sauce or yogurt. Swallow mixture immediately after preparation.)
Storage Conditions
 Oral: Capsule: Store at 25°C (77°F). Oral suspension: Store at 25°C (77°F). Once reconstituted, refrigerate at 2-8°C (36-46°F). Do not freeze and use within 10 days.
ATC Classification
 J05AH02 - oseltamivir ; Belongs to the class of neuraminidase inhibitors. Used in the systemic treatment of viral infections.
Storage
 Oral: Capsule: Store at 25°C (77°F). Oral suspension: Store at 25°C (77°F). Once reconstituted, refrigerate at 2-8°C (36-46°F). Do not freeze and use within 10 days.
Available As
  • Oseltamivir 12 mg
  • Oseltamivir 30 mg
  • Oseltamivir 45 mg
  • Oseltamivir 75 mg

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