Tamiflu review – How does Tamiflu work?

The British Medical Journal answers your questions about Tamiflu pills, the drug being used to treat swine flu.

Tamiflu pill – What is it?
Tamiflu is an antiviral drug. The scientific name is oseltamivir. It works by slowing down the speed at which the virus can reproduce in the body. It comes as a capsule, as well as in liquid form for children and adults who have problems swallowing.

Who can take Tamiflu?
Tamiflu is licensed to treat all types of flu in adults and children over the age of one. It isn’t used much for ordinary (seasonal) flu, but is being used widely for swine flu.

Some doctors think it should be used only if people have severe symptoms, or are at risk of being seriously ill with swine flu (for example, people who have other health problems). But in practice, most people with symptoms of swine flu are being offered Tamiflu pills. Babies under one can take it if a doctor agrees it is necessary. They’ll need the liquid formulation and a lower dose.

What does it do?
Tamiflu pill isn’t a cure for flu. Research has found that it may reduce the amount of time people have symptoms of flu, by about a day. And it may reduce the risk of people getting complications such as pneumonia. It may also protect you from getting flu symptoms, if you’ve come into contact with someone who has flu.

Tamiflu doesn’t work for everyone. It works best if you take it within 48 hours of getting flu symptoms. That’s when the virus is reproducing fastest in the body, and when you’re most infectious.

All the research so far looks at how Tamiflu pills works against seasonal flu. There hasn’t been time for any large-scale research into Tamiflu for swine flu. But laboratory trials show the swine flu virus is affected by antiviral drugs, including Tamiflu pills.

What about Tamiflu side effects?
The most common side effects from Tamiflu are nausea and vomiting. Other reported side effects are stomach pain, diarrhoea and headache. Some children and teenagers have reported unusual feelings, for example vivid nightmares and feeling delirious.

If you get these symptoms while taking Tamiflu pills, it’s hard to know whether they’re caused by Tamiflu, or by the flu virus. Flu can cause most of these symptoms.

A research study showed that nausea and vomiting were no more common in adults taking Tamiflu for flu, than people taking a dummy (placebo) drug for flu. But nausea and vomiting were more common in adults taking Tamiflu pills to prevent flu.

Tamiflu latest research
The latest research looked at Tamiflu for children. It re-examined studies in children, and questioned whether the harms outweighed the benefits. Taking all the research together, it’s not clear whether Tamiflu can prevent complications in children, such as ear infections or asthma attacks.

Children with flu are more likely to vomit if they take Tamiflu pills. Up to seven in 100 children with flu are likely to have vomiting without treatment. Researchers calculate that an additional one in every 20 children would get vomiting with Tamiflu treatment. Vomiting can cause children to become dehydrated, so it’s good to ensure they have plenty of fluids.

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