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Adults, adolescents or children (>40 kg) who are able to swallow capsules may receive appropriate doses of Tamiflu capsules.
Treatment: Treatment should be initiated as soon as possible within the first two days of onset of symptoms of influenza.
For adolescents (13 to 17 years of age) and adults: The recommended oral dose is 75 mg oseltamivir twice daily for 5 days (or 10 days in immunocompromised patients).
Paediatric population: For infants and children 1 year of age or older: The recommended dose of Tamiflu 6 mg/mL oral suspension is indicated in the table as follows. Tamiflu 30 mg and 45 mg capsules are available as an alternative to the recommended dose of Tamiflu 6 mg/mL suspension.
The following weight-adjusted dosing regimens are recommended for infants and children 1 year of age or older: See Table 2.
Click on icon to see table/diagram/imageChildren weighing >40 kg and who are able to swallow capsules may receive treatment with the adult dosage of 75 mg capsules twice daily for 5 days as an alternative to the recommended dose of Tamiflu suspension.
For infants less than 1 year of age: The recommended treatment dose for infants 0-12 months of age is 3 mg/kg twice daily. This is based upon pharmacokinetic and safety data indicating that this dose in infants 0-12 months provides plasma concentrations of the pro-drug and active metabolite that are anticipated to be clinically efficacious with a safety profile comparable to that seen in older children and adults (see Pharmacology: Pharmacokinetics under Actions).
A 3 mL oral dispenser (graduated in 0.1 mL steps) should be used for dosing children 0-12 months of age requiring 1 mL to 3 mL of Tamiflu 6 mg/mL oral suspension. For higher doses the 10 mL syringe should be used. The following dosing regimen is recommended for treatment of infants below 1 year of age: See Table 3.
Click on icon to see table/diagram/imageThis dosing recommendation is not intended for premature infants, i.e. those with a post-conceptual age less than 36 weeks. Insufficient data are available for these patients, in whom different dosing may be required due to the immaturity of physiological functions.
Prevention: Post-exposure prevention: For adolescents (13 to 17 years of age) and adults: The recommended dose for prevention of influenza following close contact with an infected individual is 75 mg oseltamivir once daily for 10 days. Therapy should begin as soon as possible within two days of exposure to an infected individual.
For infants and children 1 year of age or older: Tamiflu 30 mg and 45 mg capsules are available as an alternative to the recommended dose of Tamiflu 6 mg/mL suspension.
The recommended post-exposure prevention dose of Tamiflu is: See Table 4.
Click on icon to see table/diagram/imageChildren weighing >40 kg and who are able to swallow capsules may receive prophylaxis with a 75 mg capsule once daily for 10 days as an alternative to the recommended dose of Tamiflu suspension.
For infants less than 1 year of age: The recommended prophylaxis dose for infants less than 12 months during a pandemic influenza outbreak is half of the daily treatment dose. This is based upon clinical data in children >1 year of age and adults showing that a prophylaxis dose equivalent to half the daily treatment dose is clinically efficacious for the prevention of influenza (see Pharmacology: Pharmacokinetics under Actions for exposure simulation).
In case of a pandemic, a 3 mL oral dispenser (graduated in 0.1 mL steps) should be used for dosing children below 1 year of age requiring 1 mL to 3 mL of Tamiflu 6 mg/mL oral suspension. For higher doses the 10 mL syringe should be used.
The following dosing regimen is recommended for infants less than 1 year of age: See Table 5.
Click on icon to see table/diagram/imageThis dosing recommendation is not intended for premature infants, i.e. those with a post-conceptual age less than 36 weeks. Insufficient data are available for these patients, in whom different dosing may be required due to the immaturity of physiological functions.
Prevention during an influenza epidemic in the community: Prevention during an influenza epidemic has not been studied in children below 12 years of age. The recommended dose for adults and adolescents for prevention of influenza during a community outbreak is 75 mg oseltamivir once daily for up to 6 weeks (or up to 12 weeks in immunocompromised patients).
Special populations: Hepatic impairment: No dose adjustment is required either for treatment or for prevention in patients with hepatic dysfunction. No studies have been carried out in paediatric patients with hepatic disorder.
Renal impairment: Treatment of influenza: Dose adjustment is recommended for adults and adolescents (13 to 17 years of age) with moderate or severe renal impairment. Recommended doses are detailed in the table as follows. (See Table 6.)
Click on icon to see table/diagram/imagePrevention of influenza: Dose adjustment is recommended for adults and adolescents (13 to 17 years of age) with moderate or severe renal impairment as detailed in the table as follows. (See Table 7.)
Click on icon to see table/diagram/imageThere is insufficient clinical data available in infants and children (12 years of age and younger) with renal impairment to be able to make any dosing recommendation.
Elderly: No dose adjustment is required, unless there is evidence of moderate or severe renal impairment.
Immunocompromised patients: Treatment: For treatment of influenza, the recommended duration for immunocompromised patients is 10 days (see Precautions, Adverse Reactions, Pharmacology: Pharmacodynamics under Actions). No dose adjustment is necessary. Treatment should be initiated as soon as possible within the first two days of onset of symptoms of influenza.
Seasonal prophylaxis: Longer duration of seasonal prophylaxis up to 12 weeks has been evaluated in immunocompromised patients (see Precautions, Adverse Reactions, Pharmacology: Pharmacodynamics under Actions).
Method of administration: For dosing, a 3 mL and 10 mL oral dispenser is provided in the box.
It is recommended that Tamiflu powder for oral suspension be constituted by a pharmacist prior to dispensing to the patient (see Special precautions for disposal and other handling under Cautions for Usage).
