Tamiflu Dosage/Direction for Use

Tamiflu may be taken with or without food (see Pharmacology: Pharmacokinetics under Actions). However, Tamiflu taken with food may enhance tolerability in some patients.
Standard Dosage: Treatment of Influenza: Treatment should begin within the first or second day of onset of symptoms of influenza.
Adults and Adolescents: The recommended oral dose of Tamiflu capsules in adults and adolescents ≥13 years is 75 mg twice daily, for 5 days. Adults and adolescents ≥13 years of age that are unable to swallow capsules may receive a dose of 75 mg Tamiflu suspension b.i.d. for 5 days.
Children: Children weighing >40 kg who are able to swallow capsules, may also receive treatment with a 75 mg capsule twice daily or one 30 mg capsule plus one 45 mg capsule twice a day as an alternative to the recommended dose of Tamiflu suspension. (See Table 2.)

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Children <1 year of age: The recommended oral dose of Tamiflu for children 0 to 12 months is 3 mg/kg twice daily, for 5 days. These dosing recommendations are not intended for infants who have a post-conceptual age of less than 36 weeks. (See Table 3.)

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It is recommended that Tamiflu powder for oral suspension be constituted by a pharmacist prior to dispensing to the patient (see Special Instructions for Use, Handling and Disposal under Cautions for Usage).
Prophylaxis of Influenza: Adults and Adolescents: The recommended oral dose of Tamiflu for prophylaxis of influenza following close contact with an infected individual is 75 mg once daily for 10 days. Therapy should begin within two days of exposure. The recommended dose for prophylaxis during a community outbreak of influenza is 75 mg once daily. Safety and efficacy have been demonstrated for up to six weeks. The duration of protection lasts for as long as dosing is continued.
Children ≥1 Year of Age: Children weighing >40 kg, who are able to swallow capsules, may also receive prophylaxis with a 75 mg capsule once daily or one 30 mg capsule plus one 45 mg capsule once a day, for 10 days as an alternative to the recommended dose of Tamiflu suspension. (See Table 4.)

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It is recommended that Tamiflu powder for oral suspension be constituted by a pharmacist prior to dispensing to the patient (see Special Instructions for Use, Handling and Disposal under Cautions for Usage).
Special Dosage Instructions: Pediatric Use: The efficacy of Tamiflu in children less than one year of age has not been established (see Pharmacology: Pharmacokinetics: Pharmacokinetics in Special Populations under Actions). Pharmacokinetic data indicates that a dosage of 3 mg/kg twice daily in children 0-12 months of age 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 Indications/Uses.)
Geriatric Use: No dose adjustment is required for elderly patients in the treatment or prophylaxis of influenza (see Pharmacology: Pharmacokinetics: Pharmacokinetics in Special Populations under Actions).
Patients with Renal Impairment: Treatment of Influenza: No dose adjustment is necessary for patients with creatinine clearance above 60 mL/min. In patients with a creatinine clearance of >30-60 mL/min, it is recommended that the dose be reduced to 30 mg of Tamiflu twice daily for 5 days. In patients with a creatinine clearance of 10-30 mL/min, it is recommended that the dose be reduced to 30 mg of Tamiflu once daily for 5 days. In patients undergoing routine hemodialysis an initial dose of 30 mg of Tamiflu can be administered prior to the start of dialysis if influenza symptoms develop during the 48 hours between dialysis sessions. To maintain plasma concentrations at a therapeutic level, a dose of 30 mg should be administered after every hemodialysis session. For peritoneal dialysis a dose of 30 mg of Tamiflu administered prior to the start of dialysis followed by further 30 mg doses administered every 5 days is recommended for treatment (see Pharmacology: Pharmacokinetics: Pharmacokinetics in Special Populations under Actions and Precautions). The pharmacokinetics of oseltamivir have not been studied in patients with "end-stage renal disease" (i.e., creatinine clearance of <10 mL/min) not undergoing dialysis. Hence, dosing recommendation cannot be provided for this group.
Prophylaxis of Influenza: No dose adjustment is necessary for patients with creatinine clearance above 60 mL/min. In patients with a creatinine clearance of >30-60 mL/min, it is recommended that the dose be reduced to 30 mg of Tamiflu once daily. In patients with creatinine clearance between 10 and 30 mL/min receiving Tamiflu it is recommended that the dose be reduced to 30 mg of Tamiflu every other day. In patients undergoing routine hemodialysis an initial dose of 30 mg of Tamiflu can be administered prior to the start of dialysis. To maintain plasma concentrations at a therapeutic level, a dose of 30 mg should be administered after every alternate hemodialysis session. For peritoneal dialysis an initial dose of 30 mg of Tamiflu administered prior to the start of dialysis followed by further 30 mg doses administered every 7 days is recommended for prophylaxis (see Pharmacology: Pharmacokinetics: Pharmacokinetics in Special Populations under Actions and Precautions). The pharmacokinetics of oseltamivir have not been studied in patients with "end-stage renal disease" (i.e., creatinine clearance of <10 mL/min) not undergoing dialysis. Hence, dosing recommendation cannot be provided for this group.
Patients with Hepatic Impairment: No dose adjustment is required for patients with mild or moderate hepatic dysfunction in the treatment or prophylaxis of influenza (see Pharmacology: Pharmacokinetics: Pharmacokinetics in Special Populations under Actions). The safety and pharmacokinetics in patients with severe hepatic impairment have not been studied.
Immunocompromised Patients: Treatment of Influenza: The recommended duration for immunocompromised patients is 10 days. No dose adjustment is necessary (see Clinical Trials under Adverse Reactions and Pharmacology: Pharmacodynamics: Clinical/Efficacy Studies under Actions).
Prophylaxis of Influenza: Seasonal prophylaxis in immunocompromised patients 1 year of age and older is recommended for 12 weeks. No dose adjustment is necessary (see Standard dosage: Prophylaxis of Influenza as previously mentioned).
Route of Administration: Oral.