Does Tamiflu help: instructions for use for children and adults

Tamiflu is an antiviral drug that has activity against influenza A and B viruses.

The main active component of the drug, oseltamivir phosphate (Oseltamiviri phosphatis), competitively and selectively Inactivates neuraminidase viruses - an enzyme that promotes reproduction and penetration into healthy cells of viral agents.

The drug facilitates the course of the disease and shortens its duration, reducing the risk of complications such as otitis, sinusitis, bronchitis, or pneumonia. Clinical studies have shown that in children younger than 12 years the duration of the disease is reduced by an average of 2 days.

Manufacturer Tamiflu - Swiss pharmaceutical company F.Hoffmann-La Roche Ltd leading positions in the pharmaceutical industry, as well as the production of high-tech diagnostic equipment.

Clinical and pharmacological group

Antiviral drug.

Terms of sale from pharmacies

Can buyby prescription.

Price

How much does Tamiflu have in pharmacies? The average price in 2018 is at the level of1 250 rubles.

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Composition and form of release

Tamiflu is produced in the following dosage forms:

• Capsules: gelatin, solid, opaque, size # 2; body - gray, with the inscription "Roche the lid - Light yellow color, with the inscription "75 mg contents of capsules - powder from yellowish to white (10 PC. in blisters, 1 blister in a cardboard bundle);
• Powder for the preparation of the suspension for ingestion: granules with a fruity odor, from light yellow to white, caking is allowed. After dilution, an opaque suspension is formed from light yellow to white (in dark glass bottles of 30 grams, 1 bottle in a cardboard bundle complete with a dispensing syringe and a measuring cup).

The composition of 1 capsule includes:

• Active substance: oseltamivir - 75 mg (in the form of oseltamivir phosphate - 9, mg);
• Auxiliary components: talcum, povidone K30, pregelatinized starch, croscarmellose sodium, sodium stearyl fumarate;
• Capsule body: gelatin, titanium dioxide, iron dye oxide black;
• Capsule capsules: gelatin, titanium dioxide, iron oxide dye red and yellow.

The composition of 1 bottle of powder for the preparation of a suspension for oral administration includes:

• Active substance: oseltamivir - 30 mg (in the form of oseltamivir phosphate 3, mg);
• Auxiliary components: sorbitol, sodium saccharin, titanium dioxide, sodium benzoate, monosodium citrate, xanthan gum, permasil 11900-31 Tutti-Frutti.

After dilution, the suspension contains oseltamivir-12 mg / ml.

pharmachologic effect

The pharmacological action of oseltamivir is based on its ability to inactivate neuraminidase virus, an enzyme that helps to defeat healthy cells with viral agents, as well as their dissemination. The enzyme of neuraminidase was first discovered in the study of pathogenic microorganisms that cause gas gangrene (Clostridium perfringens).

Under the influence of the enzyme, the newly formed virus particles are easily separated from the outer shell of the infected cells, which further promotes the viruses through the patient's body. Oseltamivir exerts a pharmacological action outside the cells, circulating in the blood plasma, as well as intercellular fluid. The concentration of the active substance, sufficient for therapeutic efficacy, is fifty percent of the lower limit of the nanomolar range.

Oseltamivir helps to reduce the release of viruses from the body when coughing, sneezing, development of the disease in people who are in contact, which is especially important for the prevention of infection. Isolation of a patient with an influenza infection is desirable, but not always possible. The patient can spread the causative agents of the disease among family members, colleagues at work.

The properties of the drug to limit the spread of viral agents can help improve the epidemiological situation. Reduction of symptoms of intoxication during treatment with Tamiflu is due to a decrease in the concentration of toxins in the blood plasma. Phenomena of intoxication with influenza infection can be so pronounced that the patient is confused, loss of orientation, hallucinations, severe muscular, joint pain ...

Many patients, Tamiflu helped to cope with the manifestations of the disease. The effectiveness of Tamiflu in influenza pathologies allows in many cases to prevent the development of the disease, significantly reduce the timing of treatment, as well as the development of complications, the most serious of which are meningitis, viral pneumonia, sinusitis, otitis.

The maximum efficacy of oseltamivir is observed within 40 hours from the onset of infection with influenza infection. Resistance to the effects of the drug, according to serological studies, there are no more than one percent of viral strains. The drug Tamiflu after ingestion is absorbed in the small intestine, the maximum concentration in the blood plasma, as well as intercellular fluid is noted after two hours. Metabolism occurs under the influence of liver enzymes, resulting in an active metabolite - oseltamivir carboxylate.

Its content is twenty times that of the original pro-drug. More than seventy percent of the dose taken turns into an active metabolite and enters the blood plasma, which is partially bound to proteins. The active metabolite is excreted mainly by the kidneys, the half-life of Tamiflu is eight to ten hours.

Indications for use

Tamiflu is prescribed for the treatment of influenza in children aged 1 year and adults.

Also, the drug is used to prevent influenza in adults and children aged 12 years who are in groups of increased risk of infection with the virus (in large production teams, military units, in weakened patients) and in children from 1 of the year.

Contraindications

Tamiflu is contraindicated:

• when allergic to any of its components;
• children under the age of 1 year;
• with chronic renal failure, with Cl creatinine less than 10 ml per minute.

Care should be taken by pregnant and lactating women, children from 6 to 12 months.

Intended use for pregnancy and lactation

It is allowed to use pregnant women taking into account the pathogenicity of the strain of the circulating virus. In the course of animal studies conducted by scientists, it was found that Tamiflu does not have a negative effect on the fetus and its development. However, women in the situation should take the drug with caution and only after consulting a doctor.

A small part of the medicine, together with the active ingredient, penetrates into the breast milk. Therefore, when appointing a remedy, the doctor must take into account the potential risks to the newborn, and also to resolve the issue of a possible interruption of HS.

Dosage and route of administration

As indicated in the instructions for use of Tamiflu inside, during meals or regardless of food intake. The tolerability of the drug can be improved if taken with food.

Adults, adolescents or children who can not swallow the capsule can also receive Tamiflu treatment in powder form to prepare a suspension for ingestion.

In cases where Tamiflu in the form of powder for the preparation of a suspension for oral administration is absent, or in the presence of signs of "aging" of capsules (for example, increased brittleness or other physical disabilities), it is necessary to open the capsule and pour its contents into a small amount (maximum 1 teaspoon) of a suitable sweetened food product (chocolate syrup with normal sugar content or without sugar, honey, light brown sugar or table sugar dissolved in water, sweet dessert, condensed milk with sugar, apple puree or yogurt) in order to hide the bitter taste. The mixture must be thoroughly mixed and given to the patient as a whole. It is necessary to swallow the mixture immediately after preparation. Detailed recommendations are given in the subsection "Preparation of the suspension ex tempore".

Standard dosage regimen for prevention:

1. The drug should be taken no later than 2 days after contact with patients.
2. Adults and adolescents aged & g; 2 years - 75 mg 1 time / day inside for at least 10 days after contact with the patient. During the seasonal flu epidemic - 75 mg 1 time / day for 6 weeks. Prophylactic action lasts as long as the drug takes.
3. Children with a body weight> 40 kg or at the age of 8 to 12 years who can swallow capsules can also receive preventive therapy, taking one 75 mg capsule once a day.
4. Children aged 1 year and older are recommended Tamiflu powder to prepare a suspension for ingestion of 12 mg / ml or capsules 30 and 45 mg. To determine the recommended dosage regimen, see the use Tamiflu powder for the preparation of a suspension for ingestion of 12 mg / ml or capsules 30 and 45 mg. It is possible to prepare a suspension of ex tempore using capsules of 75 mg (see FIG. "Preparation of a suspension ex tempore".).

Standard dosing regimen for treatment:

1. The drug should be taken no later than 2 days after the onset of symptoms of the disease.
2. Adults and adolescents aged 12 years and older - 75 mg 2 times / day inside for 5 days. An increase in the dose of more than 150 mg / day does not lead to an enhanced effect.
3. Children with a body weight of more than 40 kg or at the age of 8 years and older who know how to swallow capsules can also receive treatment, taking one 75 mg capsule 2 times / day.
4. Children aged 1 to 8 years are recommended Tamiflu powder for the preparation of a suspension for ingestion of 12 mg / ml or capsules 30 and 45 mg (for children over 2 years). To determine the recommended dosage regimen, see the instructions for medical use. Tamiflu: powder for the preparation of a suspension for ingestion of 12 mg / ml or capsules 30 and 45 mg. It is possible to prepare a suspension of ex tempore using capsules of 75 mg (see FIG. subsection "Preparation of a suspension ex tempore").

Patients with hepatic damage

Dose adjustments in the treatment and prevention of influenza in patients with impaired liver function of mild to moderate severity are not required. Safety and pharmacokinetics Tamiflu in patients with severe impairment of liver function has not been studied.

Patients with renal involvement

Prevention:

Patients with QC greater than 60 ml / min dose adjustment is not required. In patients with SC from 30 to 60 ml / min, the dose of Tamiflu should be reduced to 30 mg 1 time / day. In patients with SC from 10 to 30 ml / min it is recommended to reduce the dose of Tamiflu to 30 mg every other day. Patients who are on permanent hemodialysis, Tamiflu in the initial dose of 30 mg can be taken before the start of dialysis ("1st session"). To maintain plasma concentrations at the therapeutic level, Tamiflu should be taken at 30 mg after each subsequent odd dialysis session. For patients on peritoneal dialysis, Tamiflu should be taken at an initial dose of 30 mg before dialysis, then 30 mg every 7 days. The pharmacokinetics of oseltamivir in patients with terminal stage of renal failure (KK≤10 ml / min) not on dialysis has not been studied. In this regard, there are no recommendations for dosing in this group of patients.

Treatment:

Patients with QC greater than 60 ml / min dose adjustment is not required. In patients with QC from 30 to 60 ml / min dose Tamiflu should be reduced to 30 mg 2 times / day for 5 days. In patients with SC from 10 to 30 ml / min, the dose of Tamiflu should be reduced to 30 mg 1 time / day for 5 days. Patients on permanent hemodialysis, Tamiflu in the initial dose of 30 mg can be taken before the beginning of dialysis, if the flu symptoms appeared within 48 hours between dialysis sessions. To maintain plasma concentrations at the therapeutic level, Tamiflu should be taken at 30 mg after each dialysis session. For patients on peritoneal dialysis, Tamiflu should be taken at an initial dose of 30 mg before dialysis, then 30 mg every 5 days. Pharmacokinetics in patients with terminal stage of renal failure (KK≤10 ml / min) not on dialysis has not been studied. In this regard, there are no recommendations for dosing in this group of patients.

Patients with weakened immunity (after transplantation)

For seasonal prevention of influenza in immunocompromised patients over the age of 1 year - within 12 weeks, dose adjustment is not required.

Children

Tamiflu in this dosage form should not be administered to children under 1 year of age.

Preparation of Tamiflu suspension ex tempore

In cases where there is a problem with swallowing capsules in adults, adolescents and children, and there is no Tamiflu in the dosage form "powder for oral suspension" or if there are signs of "aging" of capsules, it is necessary to open the capsule and pour its contents into a small amount (maximum 1 teaspoon) of a suitable sweetened food product (cm. above) in order to hide the bitter taste. The mixture must be thoroughly mixed and given to the patient as a whole. The mixture should be swallowed immediately after preparation.

If patients require a dose of 75 mg, the following instructions should be followed:

1. Holding one capsule of 75 mg of Tamiflu over a small container, gently uncover the capsule and pour the powder into a container.
2. Add a small amount (not more than 1 teaspoon) of a suitable sweetened food product (to hide a bitter taste) and mix well.
3. Stir the mixture thoroughly and drink it immediately after preparation. If a small amount of the mixture remains in the container, rinse the container with a small amount of water and drink the remaining mixture.

If patients require doses of 30-60 mg, the following instructions must be followed for proper dosing:

1) Holding one capsule of 75 mg of Tamiflu over a small container, gently uncover the capsule and pour the powder into the container.

2) Add 5 ml of water to the powder with a syringe with labels indicating the amount of liquid collected. Stir well for 2 minutes.

3) Collect the required amount of the mixture from the container in the syringe according to the table below.

Body mass	The recommended dose	Amount of a mixture of Tamiflu for one dose
≤15 kg	30 mg	2 ml
& g; 5-23kg	45 mg	3 ml
& g; 3-40 kg	60 mg	4 ml

There is no need to take an undissolved white powder, because it is an inactive filler. Pressing the plunger of the syringe, enter all its contents into the second container. The remaining unused mixture must be discarded.

4) In the second container add a small amount (not more than 1 teaspoon) of a suitable sweetened food product to hide the bitter taste, and mix well.

5) Mix the mixture thoroughly and drink it immediately after preparation. If a small amount of the mixture remains in the container, rinse the container with a small amount of water and drink the remaining mixture.

It is necessary to repeat this procedure before each drug intake.

Side effect

In adult patients, vomiting and nausea are most common, which most often occur after reception of the first dose of Tamiflu, are transient in nature and pass independently, without requiring cancellation preparation.

With a frequency of 1% or more, the following adverse reactions also occurred: dizziness, weakness, sleep disorders, headache, bronchitis, cough, abdominal pain, diarrhea, rhinorrhea, upper respiratory tract infections, dyspeptic disorders, pains of various localization.

Children often experienced vomiting, as well as nausea, bronchitis, asthma (including its aggravation), sinusitis, pneumonia, nasal bleeding, conjunctivitis, acute otitis media, hearing impairment, lymphadenopathy, diarrhea, abdominal pain and dermatitis. Some of these side effects occurred suddenly and stopped on their own, without causing the cessation of therapy.

In the postmarketing period, adverse reactions from the following systems and organs were noted:

• Gastrointestinal tract and liver: rarely - gastrointestinal bleeding; very rarely - increased activity of hepatic enzymes, hepatitis.
• Skin and subcutaneous tissue: rarely - hives, dermatitis, eczema, skin rash; very rarely - Quincke's edema, anaphylactoid and anaphylactic reactions, erythema multiforme, Lyell's syndrome.
• Neuropsychic sphere: convulsions, abnormal behavior, hallucinations, anxiety, impaired consciousness, agitation, delirium, nightmares, disorientation in space and time (however, the role of Tamiflu in the emergence of these phenomena is not known to the end, since similar violations were noted in other patients with influenza, which the drug does not received).

Overdose

Cases of drug overdose have not been recorded, however, in order to avoid the development of the above-described side effects and damage from the liver, do not exceed the dose specified in the instructions.

If you randomly ingest a large number of capsules at a time, you should induce vomiting, rinse your stomach and give enterosorbents and, if necessary, carry out symptomatic therapy.

special instructions

Patients (especially adolescents and children) who took Tamiflu for the treatment of influenza were cases of development of seizures and delirium-like neuropsychiatric disorders, not dangerous for life. However, the association of these phenomena with the administration of the drug has not been proven, since the risk of developing similar reactions in patients with influenza, taking oseltamivir does not exceed the likelihood of the occurrence of the same disorders in patients with influenza who did not take oseltamivir. It is recommended to observe the behavior of patients for the timely detection of any abnormalities.

Special studies on the effect of Tamiflu on the ability to drive vehicles and engage in other Potentially dangerous activity associated with high concentration of attention and rapid response was not carried out. However, given the safety profile of the drug, such an effect is unlikely.

Interaction with other drugs

Drug interaction, as a rule, does not occur.

When the drug is combined with probenecid (or other means that block tubular secretion), the AUC of the active metabolite increases approximately 2-fold, but at the same time to adjust the dosage of the antiviral agent is not necessary.

Reviews

We offer you to read reviews of people who used Tamiflu:

1. Natasha. I took tamiflu on day 3 after infection as in the instructions. The temperature and symptoms of the flu have been knocked out. But the stuffiness in the ears appeared and dry cough and tremor in space. I do not know if this is due to the predisposition of the body, but the drug is hard to bear personally for me. It is better not to engage in self-medication by spiking yourself with drugs, but to call a doctor.
2. Julia. My husband works in the ambulance. During the flu epidemic he had 27 calls per day. He took Tamiflu and did not get sick. Her mother-in-law took it during the illness, very quickly cured without complications and antibiotics. The drug is excellent, only a little expensive. And another minus - during the epidemic he disappeared from the pharmacy counters.
3. Alyona. As soon as the epidemic of influenza begins, I immediately buy this remedy. The high price does not scare me - health is much more important! No side effects were noted, but, even if the entire work collective is walking with disgusting state of health and high temperature, I feel fine. Only this means I'm saved.

Analogues

In this case, we can say one thing: the drug itself, which is an active active substance (oseltamivir), is quite expensive. Synonyms of the drug are no less effective than Tamiflu, but their cost is not very different:

• Relenza from 950 to 1200 rubles;
• Flutol from 1050 to 1300 rubles;
• Arbidol from 500 to 800 rubles;
• Oseltamivir - from 1904 to 1250 rubles;
• Amiksin - from 905 rubles.

Before buying an analogue, consult your doctor.

Shelf life and storage conditions

Store at a temperature of no more than 25 ° C. Keep away from children. The prepared suspension can be stored for no longer than 17 days (at a temperature of 2 to 8 ° C) or not more than 10 days (at a temperature of up to 25 ° C).

Shelf life: capsules - 7 years; powder for suspension - 2 years.

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