Oseltamivir
Antiviral medication used against influenza A and influenza B / From Wikipedia, the free encyclopedia
Oseltamivir, sold under the brand name Tamiflu, is an antiviral medication used to treat and prevent influenza A and influenza B, viruses that cause the flu.[5] Many medical organizations recommend it in people who have complications or are at high risk of complications within 48 hours of first symptoms of infection.[6] They recommend it to prevent infection in those at high risk, but not the general population.[6] The Centers for Disease Control and Prevention (CDC) recommends that clinicians use their discretion to treat those at lower risk who present within 48 hours of first symptoms of infection.[6][7][8] It is taken by mouth, either as a pill or liquid.[5]
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Pronunciation | /ɒsəlˈtæmɪvɪər/ |
Trade names | Tamiflu, Ebilfumin |
Other names | GS-4104 |
AHFS/Drugs.com | Monograph |
MedlinePlus | a699040 |
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Routes of administration | By mouth |
Drug class | Neuraminidase inhibitor |
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Bioavailability | >80%[4] |
Protein binding | 42% (parent drug), 3% (active metabolite)[4] |
Metabolism | Liver, to oseltamivir carboxylate[4] |
Elimination half-life | 1–3 hours, 6–10 hours (active metabolite)[4] |
Excretion | Urine (>90% as oseltamivir carboxylate), faeces[4] |
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Formula | C16H28N2O4 |
Molar mass | 312.410 g·mol−1 |
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Recommendations regarding oseltamivir are controversial as are criticisms of the recommendations.[6][9][10][11] A 2014 Cochrane Review concluded that oseltamivir does not reduce hospitalizations, and that there is no evidence of reduction in complications of influenza.[11] Two meta-analyses have concluded that benefits in those who are otherwise healthy do not outweigh its risks.[12][13] They also found little evidence regarding whether treatment changes the risk of hospitalization or death in high risk populations.[12][13] However, another meta-analysis found that oseltamivir was effective for prevention of influenza at the individual and household levels.[14]
Common side effects include vomiting, diarrhea, headache, and trouble sleeping.[5] Other side effects may include psychiatric symptoms and seizures.[5][15][16] In the United States it is recommended for influenza infection during pregnancy.[1] It has been taken by a small number of pregnant women without signs of problems.[1] Dose adjustment may be needed in those with kidney problems.[5]
Oseltamivir was approved for medical use in the US in 1999.[5] It was the first neuraminidase inhibitor available by mouth.[17] It is on the World Health Organization's List of Essential Medicines but was downgraded to "complementary" status in 2017.[18][19][20] A generic version was approved in the US in 2016.[21][22] In 2020, it was the 178th most commonly prescribed medication in the United States, with more than 3 million prescriptions.[23][24]