NHS Direct Medicines Fact Sheet
Tamiflu® (oseltamivir)
Fact Sheets are intended as supplements to the NHS Direct approved electronic
medicines information sources offering practical advice and selected facts that the
NHS Direct Advisor may have difficulty in locating. The core NHS Direct electronic
medicines information sources must be consulted for detailed information on
indications, warnings, contraindications, doses, adverse effects and interactions in
accordance with the National Policy on Handling Medicines Calls (NP005).
General information
Tamiflu® is an antiviral medicine that helps you fight the flu but it is not a
cure or a vaccine. It does not kill the H1N1 Swine flu virus and it does not
give you immunity against infection.
Flu viruses spread by entering your body, taking over healthy cells and
forcing them to make copies itself. When complete, the copies try to infect
other cells nearby or are sneezed or coughed out in to the air to infect
other people. Tamiflu® stops the flu virus entering your cells and blocks
the release of the new copies – slowing down the spread through your
body, reducing the symptoms and the length of time that you feel unwell
for, as well as making it harder for the infection to spread to other people
(1,2).
Tamiflu® should be started within 12-48hrs of symptoms appearing but it
works best the sooner it is started (2,3).
Oseltamivir is not a penicillin, sulpha-drug or any other type of antibiotic.
In some circumstances the close contacts of symptomatic cases may be
eligible but the Department of Health’s policy from the 2nd of July means
this is no longer routine (see “Restrictions on use”) (3).
People with impaired immune systems: Despite the statement in the
Summary of Product Characteristics that says the safety and effectiveness
of Tamiflu® in these patients has not been established, people with
impaired immune systems are at greater risk of catching influenza and
suffering serious complications. Therefore, treatment and in some
situations prevention of influenza with Tamiflu® is recommended (3-6).
Contraindications
People allergic to oseltamivir or any of Tamiflu’s® excipients (1).
(People who are allergic to penicillins, “sulpha”, “sulpha drugs”, or other
antibiotics can take Tamiflu®).
Restrictions on use
Infection Prevention: On the 2nd of July the Department of Health changed
its Swine flu policy from one of containment to treatment (7). This means
that antiviral medicines will no longer be routinely used to prevent infection
of close contacts but reserved to treat people who are already ill, or to
prevent infection in those who are at risk of severe complications if they
became ill. The Health Protection Agency gives details of who might be
eligible for prevention doses as well as examples of close contacts (3). As
the virus is now widespread and people will be repeatedly exposed, the
limited supplies of antiviral medicines will be used to reduce the symptoms
and prevent complications in those who are already ill rather than trying to
prevent further spread in the general population (7).
Indications and supply
Tamiflu® is a prescription only medicine (POM) available on the NHS
without charge for those who have confirmed or likely flu infection (1).
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The decision to give prevention courses will be made by the GP on a case
by case basis usually after consultation with an appropriate expert. The
decision will be based on an assessment of the likely consequences the
person will face if they were to catch Swine flu if they belong to a “higher
risk” group. Higher risk patients include those with long term lung, heart,
Date last updated: 28 Sep 09 Review due: 31 Aug 2010
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kidney or liver disease, those with suppressed immune systems (whether
by medicines or illness), people with diabetes, children under 5 years,
adults over 65 years, pregnant women, people with long-term neurological
disease and those with asthma that has needed treatment with medicines
in the last three years. Full details can be found in Appendix 1 of the
HPA’s Treatment Summary (3).
Anyone who thinks they need prevention doses should to speak to their
GP or specialist.
Warnings, cautions, interactions with drugs and food
Cautions:
Most people can take Tamiflu® if requied, but people with severe kidney
disease will need a reduced dose (1) and are advised to discuss options
with their renal specialist (3).
No important interactions with medicines or food have yet been identified
(1,8). Patients can take Tamiflu® with their regular medicines and don’t
need to avoid any foods or juices – including grapefruit juice.
Ibuprofen, paracetamol and antibiotics are safe to take with Tamiflu® (8).
care,
patients
taking
Warfarin: Tamiflu® is not thought to interact with warfarin, but to be safe
people who have to take a course while they are on warfarin should (as
always) be vigilant for warfarin side effects. The most important sideeffects are listed in the “Yellow Book”, properly known as the “Oral
Anticoagulant Therapy. Important information for patients” book which all
warfarin patients should have. Side-effects that need medical attention
include: nose bleeds for longer than ten minutes, blood in vomit, faeces,
urine or sputum, severe bruising or bruising without any particular physical
cause. Headache is listed but unfortunately it is also an effect of the flu
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HIV Medicines: The Liverpool HIV Pharmacology Group has suggested
that some HIV medicines might boost the levels of Tamiflu® (12). Tamiflu®
has been associated with headache, insomnia and possibly hallucinations
and fits, and it is thought these adverse effects might be linked to high
levels of Tamiflu® in the brain. But it is hard to know if these side-effects
are due to an interaction between Tamiflu and HIV medicines or whether
they are just part of having the flu. Until more information is available (i.e.
until more people taking HIV medicines have used Tamiflu) patients taking
HIV medicines who also need Tamiflu® should have been informed of the
possibility.
Patients taking HIV medicines who also have kidney disease should
discuss their options with their HIV and kidney specialists (3,12). If in
doubt refer the call to UKMi or the caller back to their specialist.
Common side-effects
Interactions:
Although the manufacturer recommends
methotrexate can take Tamiflu® (1,10).
(11). People who take warfarin and have been prescribed Tamiflu® by the
Flu Helpline should inform their GPs or warfarin clinic as soon as possible.
Most people tolerate Tamiflu® very well but its most common side-effects
are also among those you can expect with the flu.
During the first one or two days, nausea and/or vomiting occur in about
11% (11 in 100) of people who take Tamiflu®. Stomach ache and
headache are reported in about 2% (2 in 100) (1). The manufacturer says
that these side-effects usually stop as treatment progresses so encourage
people to complete their courses (1).
Taking or giving Tamiflu® with food may help with the nausea. If people
are having problems with the taste, see the section “Dose and dosage
forms” for advice on how to mix the capsule contents with food and NHS
Direct’s view on the use of Ribena® in children.
As Tamiflu® is a new medicine the MHRA has requested that all adverse
effects are reported via the “Yellow Card Scheme”. Encourage people who
are having difficulty with side-effects to complete a special “Swine flu
Yellow Card Report” online at: http://swineflu.mhra.gov.uk. It should only
Date last updated: 28 Sep 09 Review due: 31 Aug 2010
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take 15 minutes. Note that this is not the usual Yellow Card Reporting site
but a special one set up specifically for Swine flu medicine reports.
Less-common, rare and unknown frequency side-effects
Information about less common side-effects has come from the follow up
of about 2000 adults and 1000 children who received treatment courses
and 3000 adults and 100 children who received prevention courses of
Tamiflu® during clinical studies (1). Many of the adverse effects listed are
common to influenza and it can be difficult to say with certainty whether
they are due to the illness or the oseltamivir. Figures from the patients who
received prevention doses may give a clearer picture but the number of
people studied is small.
When discussing the less common side-effects (even if they are listed
here or in another information source) remember the MHRA Swine flu
Yellow Card website and encourage people to make a report. The
information from these reports is important for getting a better idea of the
adverse effect profile of Tamiflu® and oseltamivir.
A list of the less common, rare or unknown frequency adverse effects
listed in the Summary of Product Characteristics follows: (1).
Respiratory: bronchitis, pneumonia, other undefined respiratory tract
infections, cough, worsening of asthma
Ear, Nose and Throat: dizziness (vertigo), sinusitis, runny nose, bleeding
nose, ear ache
Psychiatric: hallucinations, delirium, confusion, anxiety, bad dreams,
agitation, non-typical behaviour (not defined)
Nervous system: insomnia, fatigue, pain (not defined), fits (convulsions)
Gastrointestinal: diarrhoea, acid reflux (heart burn)
Skin: dermatitis, rash, eczema, urticaria (red wheals on skin), StevensJohnson Syndrome, toxic epidermal necrolysis, angioneurotic oedema,
erythema multiforme
Blood and lymphatic: enlarged lymph nodes
Eye: conjunctivitis, changes in vision (not defined)
Liver and Kidney: hepatitis and raised liver enzymes.
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Time to effect
Tamiflu® reduces the duration of symptoms by one to two days (2).
Driving, machinery and alcohol
Taking Tamiflu® should not further impair a person’s ability to drive or
operate machinery. Tamiflu® is not expected to enhance the sedative
effects of alcohol (1).
With or without food?
Taking with food can reduce the stomach upsets seen in the first one or
two days of treatment, otherwise timing with food is not important (1).
Vomiting after a dose
Oseltamivir is absorbed quite quickly but the manufacturer advises taking
Tamiflu® with food (even a snack) as it reduces the chances of feeling or
being sick after a dose (9,13,14). It is not possible to be certain, but if you
vomit more than 30 minutes after taking a dose then it is likely that most of
the Tamiflu® will have been absorbed.
The first 48hrs of Tamiflu® are the most important. If you or your child
vomits very soon after a dose (within 30 minutes) then wait quarter of an
hour and take (or give) another dose. Only repeat the dose once. If you or
your child vomits again, wait until the next dose is due before having any
more. Your capsules will run out early but remember the first 48 hours are
the most important.
Taking and extra dose by mistake
Taking an extra dose it is unlikely to do any harm (1,15). People may feel
a bit sick but that is a common side-effect of Tamiflu®.
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Forgetting a dose
If you forget a dose, do not double the next dose. Take the forgotten dose
as soon as you remember as long as the next one is not due in a few
hours. If the next dose is due in a few hours then just carry on as you are
supposed to – don’t take any “catch-up” doses (16).
Pregnancy and breastfeeding
Excipients
The Tamiflu® capsule shell contains gelatin (1) which is commonly
obtained from animal (bovine/beef) sources. If people do not want to take
the Tamiflu® capsules because of the gelatin, refer to the section “Tamiflu®
Capsules: Opening the capsules and masking the flavour” for advice.
No lactose is present in the capsule core (1).
Pregnancy: Pregnant women aren’t any more likely to catch the flu but
they seem to be at greater risk of complications if they do (3). The
Department of Health has decided that Relenza® (zanamivir) is the
antiviral of first choice for the treatment and prevention of influenza during
pregnancy. Because Relenza® is inhaled; only low levels appear in the
blood posing less risk to a pregnancy than Tamiflu®. As the benefits
gained by taking an antiviral outweigh the risks, Tamiflu® can be used if
Relenza® is otherwise contraindicated or medical opinion deems it to be
the better choice (17).
Although there is very little information about the safety of Tamiflu ® in
human pregnancy, animal studies do not suggest there is a risk to the
foetus. Influenza during pregnancy can lead to pneumonia in the mother
and infection might pose a risk to the unborn baby. Although Relenza® is
first choice, Tamiflu® can be used in pregnancy if necessary (18,19).
Breastfeeding: The Department of Health has decided that Tamiflu® is the
antiviral of choice for the treatment and prevention of influenza in women
who are breastfeeding (17). Very small amounts pass into the breast milk
but not enough to cause concern. Breastfeeding can continue as normal
while taking Tamiflu® (20)
Enteral feeding tubes
Tamiflu® can be given via feeding tubes (e.g. nasogastric, PEG) but it may
require the use of special mixing techniques and syrup vehicles (21).
Refer these enquires to UKMi.
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Dose and dosage forms
 Post exposure prevention (prophylaxis) and treatment doses and course lengths differ.
 Doses for children under the age of 13 years are based on body weight. If the weight if the child is not known, then dose according to age (22).
 Infants under one year will be given liquid doses. As the capsules can be opened and the contents mixed with food, toddlers, children and adults will
be given capsules (22). The powder tastes very bitter and experience has shown that unless the flavour is disguised with blackcurrant juice
or chocolate syrup young children often refuse further doses. See the section that follows on Tamiflu® Capsules for advice on how parents
can best disguise the flavour of the powder.
Age if weight not known (22)
Adults and children over 13 years
7 years and under 13 years
3 years and under 7 years
Over 1 year and under 3 years
One year and under
Weight (22)
Over 40kg
23kg up to 40kg
15kg up to 23kg
Under 15kg
Post Exposure Prophylaxis (22)
75mg once a day for 10 days
60mg once a day for 10 days
45mg once a day for 10 days
30mg once a day for 10 days
See next section
Treatment of Symptoms (22)
75mg twice a day for 5 days
60mg twice a day for 5 days
45mg twice a day for 5 days
30mg twice a day for 5 days
See next section
Tamiflu® Capsules: Opening the capsules and masking the flavour
Capsules come in 30mg, 45mg and 75mg strength packed in boxes of ten capsules (13,14).
Some people may be reluctant to take the capsules because the capsule shell contains gelatin (an animal product), others may have been given capsules
and then find they have difficulty swallowing them. Young children are usually unwilling to swallow capsules. For patients taking 30mg, 45mg, 60mg or 75mg
doses advise the following (1,13,14,25):
 The capsule can be opened and the powder contents stirred into one teaspoonful of “squeezy” chocolate syrup or one or two teaspoons-full (5mL to
10mL) of undiluted concentrated blackcurrant drink such as Ribena®. “Squeezy” chocolate syrup refers to the runny syrup that is poured or squirted
over desserts; not the chocolate spreads. Despite the wording on Ribena® labels saying they are unsuitable for children under three, if the small
amount means children accept their doses of Tamiflu® then it can be used. The manufacturer of Tamiflu® recommends other foods to disguise the taste
such as honey for children over two years, brown sugar dissolved in water, condensed milk, apple sauce or yogurt. These may be acceptable to older
children and adults but experience has shown that for the youngest, undiluted blackcurrant drink concentrate or chocolate syrup work best (25).
Emphasise the need to thoroughly mix the powder with the syrup or juice – any exposed powder on top of the juice or syrup risks the bitter taste. If the
child is due for a dose of paracetamol or ibuprofen syrup then the paracetamol or ibuprofen could be given straight afterwards.
 Try to swallow all of the mixture. The oseltamivir in the capsule is very soluble and it will dissolve easily so don’t worry if there is some powder left over
as it not the active part of Tamiflu® (9).
 Do not mix it up in advance; make it up when the next dose is due. Don’t leave any “sitting around”.
Children needing 60mg doses will be given 30mg capsules. The contents of two capsules will be required for each dose (22).
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Infants up to and including 12 months of age. Dose according to weight and age. Doses are different for infants under six months of age (22).
There are two liquid preparations that differ in strength and dosage: an Oseltamivir Solution made by the NHS and Tamiflu® Suspension made
by Roche. Whenever possible the Oseltamivir Solution will be supplied by the NHS but depending upon stock holdings at antiviral collection
points some parents or carers may be given the Roche Tamiflu® Suspension. Please make sure you know which preparation the parent or carer
has. Although the Tamiflu® Suspension is not currently licensed for flu prevention in infants under one, or for the treatment of flu symptoms in
infants less than six months, it has been approved for both indications in under ones by the Department of Health under the National Pandemic
Plan.
Oseltamivir Solution 15mg/mL in 20mL bottles made by NHS Manufacturing (24). The solution is ready to be used and will be labelled with an expiry date
of seven days after opening (25). The solution is not flavoured and has a bitter taste so it is advised to mix the required dose with one or two teaspoons-full
(5mL to 10mL) of a concentrated blackcurrant juice such as Ribena®. Parents should try to ensure that the child swallows the entire dose (3).
Infants under 6 months of age
Infants 6 months to one year of age
Post Exposure Prophylaxis (22)
Treatment of Symptoms (22)
Post Exposure Prophylaxis (22)
Treatment of Symptoms (22)
2mg/kg once a day for 10 days
2mg/kg twice a day for 5 days
3mg/kg once a day for 10 days
3mg/kg twice a day for 5 days
Oseltamivir Solution 15mg/mL
Dose calculation based on 2mg/kg, the lowest weight in each range and rounded
up to the nearest 0.1mL
Oseltamivir Solution 15mg/mL
Dose calculation based on 3mg/kg and the lowest weight in each range
Weight range (kg)
Dose in mL (22)
Weight range (kg)
3.0 – 3.6
3.7 – 4.3
4.4 – 5.0
5.1 – 5.7
5.8 – 6.4
6.5 – 7.1
7.2 – 7.8
7.9 – 8.5
8.6 – 9.2
9.3 – 9.9
0.4
0.5
0.6
0.7
0.8
0.9
1.0
1.1
1.2
1.3
6.0 – 6.4
6.5 – 6.9
7.0 – 7.4
7.5 – 7.9
8.0 – 8.4
8.5 – 8.9
9.0 – 9.4
9.5 – 9.9
10.0 – 10.4
10.5 – 10.9
11.0 – 11.4
11.5 – 11.9
12.0 – 12.4
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Dose in mL
(22)
1.2
1.3
1.4
1.5
1.6
1.7
1.8
1.9
2.0
2.1
2.2
2.3
2.4
Number of
Bottles (22)
1
2
Date last updated: 28 Sep 09 Review due: 31 Aug 2010
Version: 4.3
Tamiflu® Suspension Tutti-Frutti flavour, 60mg/5mL (= 12mg/mL) in 75mL bottles made by Roche with an oral measuring syringe and reconstitution
measure. The suspension comes as a dry powder that needs to be mixed with water (reconstituted). Once reconstituted, it can be kept at room
temperature (25C, 77F) for 10 days, or in a refrigerator at 2 to 8C for 17 days (23). The reconstituted suspension must be shaken before use and should
not be frozen.
Infants under 6 months of age
Infants 6 months to one year of age
Post Exposure Prophylaxis (22)
Treatment of Symptoms (22)
Post Exposure Prophylaxis (22)
Treatment of Symptoms (22)
2mg/kg once a day for 10 days
2mg/kg twice a day for 5 days
3mg/kg once a day for 10 days
3mg/kg twice a day for 5 days
Tamiflu® Suspension 60mg/5mL
Tamiflu® Suspension 60mg/5mL
Dose calculation based on 2mg/kg and the lowest weight in each
Dose calculation based on 3mg/kg and the lowest weight in each range
Weight range (kg)
Dose in mL (22)
Weight range (kg)
Dose in mL (22)
3.0 – 3.5
3.6 – 4.1
4.2 – 4.7
4.8 – 5.3
5.4 – 5.9
6.0 – 6.5
6.6 – 7.1
7.2 – 7.7
7.8 – 8.3
8.4 – 8.9
9.0 – 9.5
0.5
0.6
0.7
0.8
0.9
1.0
1.1
1.2
1.3
1.4
1.5
6.0 – 6.3
6.4 – 6.7
6.8 – 7.1
7.2 – 7.5
7.6 – 7.9
8.0 – 8.3
8.4 – 8.7
8.8 – 9.1
9.2 – 9.5
9.6 – 9.9
10.0 – 10.3
10.4 – 10.7
10.8 – 11.1
11.2 – 11.5
11.6 – 11.9
12.0 – 12.3
1.5
1.6
1.7
1.8
1.9
2.0
2.1
2.2
2.3
2.4
2.5
2.6
2.7
2.8
2.9
3.0
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Date last updated: 28 Sep 09 Review due: 31 Aug 2010
Version: 4.3
References
1) Summary of Product Characteristics – Tamiflu® 75mg Hard
Capsule (oseltamivir) Roche Products Limited. Last revision of text
9 September 2009 Accessed via http://emc.medicines.org.uk on 28
September 2009.
2) Martin J, editor. British National Formulary for Children 2009.
London: BMJ Group and RPS Publishing; 2009. Accessed via
http://bnfc.org/bnfc/bnfc/current/129086.htm?q=%22oseltamivir%2
2#_hit on 22 July 2009
3) Health Protection Agency. Summary of prescribing guidance for
the treatment and prophylaxis of influenza-like illness: Treatment
phase v1.5. 7 July 2009. Accessed via
http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/12435814750
43 on 22 July 2009.
4) UKMI Q+A 275.1 Use of oseltamivir in immunocompromised
patients. Northwest Medicines Information Centre. Accessed via
http://www.nelm.nhs.uk/en/NeLM-Area/Evidence/Medicines-Q-A/Use-of-oseltamivir-in-immunocompromisedpatients/?query=oseltamivir&rank=3 on 22 June 2009.
5) Oseltamivir, Amantadine (review) and zanamivir for the prophylaxis
of influenza. NICE Technology Appraisal Guidance 158.
September 2008. Accessed via
http://www.nice.org.uk/guidance/TA158 on 22 June 2009.
6) Amantadine, oseltamivir and zanamivir for the treatment of
influenza. NICE Technology Appraisal Guidance 168. February
2009. Accessed via http://www.nice.org.uk/guidance/TA168 on 22
July 2009.
7) Health Protection Agency. Treatment approach announced for
pandemic flu. 2 July 2009. Accessed via
http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_
C/1246519368102 on 13 July 2009
8) Baxter K editor, Stockley’s Drug Interactions. London:
Pharmaceutical Press (electronic version). Accessed via:
http://www.medicinescomplete.com/mc/stockley on 22 July 2009.
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9) American Society of Health-System Pharmacists. AHFS Drug
Information 2008 (electronic version). Accessed via
http://www.medicinescomplete.com on 22 July 2009
10) UKMi Q+A 276.1 Use of oseltamivir in patients taking
methotrexate. Northwest Medicines Information Centre. Accessed
via http://www.nelm.nhs.uk/en/NeLM-Area/Evidence/Medicines-Q-A/Use-of-oseltamivir-in-patients-takingmethotrexate/?query=oseltamivir&rank=3 on 22 July 2009.
11) Oral Anticoagulant Therapy. Important information for patients.
National Patient Safety Agency and The British Society for
Haematology. 2007. London.
12) Influenza Antiviral Interactions. Liverpool HIV Pharmacology
Group. Chart Update May 2009. Accessed via http://www.hivdruginteractions.org on 22 July 2009.
13) Patient Information Leaflet - Tamiflu 30mg and 45mg Hard
Capsules (oseltamivir) UK/Ireland/Malta. Roche Products Limited.
Last approval January 2009. Accessed via
http://emc.medicines.org.uk on 22 July 2009.
14) Patient Information Leaflet - Tamiflu 75mg Hard Capsules
(oseltamivir) UK/Ireland/Malta. Roche Products Limited. Last
approval January 2009. Accessed via http://emc.medicines.org.uk
on 22 July 2009.
15) Toxbase Monograph: oseltamivir. National Poisons Information
Service. Updated April 2009. Accessed via
http://toxbase.u5e.com/Poisons-Index-A-Z/O-Products/Oseltamivir/
on 22 July 2009.
16) NHS Direct Q+A N22.2 What should patients do if they miss a
dose of their medicine? Wessex Drug and Medicines Information
Centre. Accessed via:
http://nww.intranet.nhsdirect.nhs.uk/Portals/91a3b107-a934-41308dde-43ac5d918dd3/Q&A22misseddosesSWFINAL.DOC on 22
July 2009.
17) Department of Health. Pandemic Influenza: Recommendations on
the use of antiviral medicines for pregnant women, women who are
breastfeeding and children under one year of age. 5 June 2009.
Accessed via
Date last updated: 28 Sep 09 Review due: 31 Aug 2010
Version: 4.3
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Pub
licationsPolicyAndGuidance/DH_100361 on 22 July 2009.
18) Anon. Oseltamivir in Pregnancy. National Poisons Information
Service and the UK Teratology Information Service. Updated
06/05/09. Accessed via www.toxbase.org on 22 July 2009.
19) Anon. Management of pregnant women during an influenza A
(H1N1) (Swine Flu) pandemic. National Poisons Information
Service and the UK Teratology Information Service. National
Poisons Information Service and the UK Teratology Information
Service. Updated 06/05/09. Accessed via www.toxbase.org on 22
July 2009.
20) UKMi Q+A 179.1 Oseltamivir or zanamivir - Can mothers
breastfeed after treatment for influenza? Trent Medicines
Information Service. Accessed via
http://www.nelm.nhs.uk/en/NeLM-Area/Evidence/Medicines-Q-A/Oseltamivir-or-zanamivir---Can-mothers-breastfeed-aftertreatment-for-influenza/ on 22 July 2009.
21) Advice on administration of oseltamivir (Tamiflu) via enteral feeding
tubes. White & Bradnam (2007) Handbook of Drug Administration
via Enteral Feeding Tubes. PharmPress Accessed via
http://www.nelm.nhs.uk/en/NeLM-Area/Evidence/Medicines-Q-A/Advice-on-administration-of-oseltamivir-Tamiflu-via-enteralfeeding-tubes/ on 22 July 2009.
22) Department of Health. Authorisation of antiviral medicines.
Guidance on the use of FP10SS forms and Antiviral Authorisation
Vouchers during the H1N1 (swine flu) pandemic in England. 21
September 2009. Accessed via
http://www.dh.gov.uk/en/AdvanceSearchResult/index.htm?searchT
erms=12596 on 28 September 2009.
23) Summary of Product Characteristics – Tamiflu® 12mg/mL powder
for oral suspension (oseltamivir) Roche Products Limited. Last
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revision of text 9 September 2009 Accessed via
http://emc.medicines.org.uk on 24 September 2009
24) Pharmaceutical Services Negotiating Committee. General News:
Influenza A. Background and Guidance for Pharmacists: Supply of
oseltamivir liquid 15mg/mL. Accessed via:
http://www.psnc.org.uk/news.php/481/influenza_a_h1n1_guidance
_updated_15 on 22 July 2009.
25) Internal communication between NHS Direct and East and South
East England Specialist Pharmacy Services 22 July 2009.
Quality Assurance
Search Strategy
Standard In house resources and communications
Prepared by
Wynn Pevreal
Principal Pharmacist
London Medicines Information Service
Contact
Med.info @nwlh.nhs.uk
Checked by
Alexandra Denby
Regional MI Manager
London Medicines Information Service
Updated by
Wynn Pevreal
(Paediatric doses – in line with reference 22)
Update Checked by
Helen Rowlandson
Northwick Park Medicines Information Service
Date last updated: 28 Sep 09 Review due: 31 Aug 2010
Version: 4.3