Tamiflu for children: instructions for use. Preparation of Tamiflu suspension from powder. Treatment studies in pediatric practice

Instructions for use

Mode of application

Dosage

Tamiflu is taken by mouth, with or without food. In some patients, the tolerability of the drug improves if it is taken with food.

Standard dosing regimen

Treatment should begin on the first or second day of flu symptoms.

Adults and teenagers? 12 years old. The recommended dosing regimen for Tamiflu is 1 capsule 75 mg 2 times a day orally for 5 days or 75 mg suspension 2 times a day orally for 5 days. Increasing the dose of more than 150 mg / day does not increase the effect.

Children > 40 kg or? 8 year olds who can swallow capsules can also be treated with one 75 mg capsule twice daily as an alternative to the recommended dose of Tamiflu Suspension (see below).

Prevention

Adults and teenagers? 12 years

75 mg once a day orally for at least 10 days after contact with an infected person. The drug should be started no later than the first 2 days after contact. During a seasonal influenza epidemic - 75 mg 1 time per day; within 6 weeks. The prophylactic effect lasts as long as the drug is taken.

Children > 40 kg

Children who can swallow the capsules may also receive preventive therapy by taking one 75 mg capsule once daily as an alternative to the recommended dose of Tamiflu Suspension (see below).

Overdose

Currently, no cases of overdose have been described, however, the expected symptoms of acute overdose will be nausea with or without vomiting. single doses Tamiflu up to 1000 mg was well tolerated, except for nausea and vomiting.

Treatment of influenza in adults and children over the age of 1 year. Influenza prophylaxis in adults and adolescents over 12 years of age in groups increased risk virus infection (in military units and large production teams, in debilitated patients). Prevention of influenza in children older than 1 year.

Contraindications Tamiflu capsules 75mg

Hypersensitivity to oseltamivir phosphate or any component of the drug. End-stage renal disease (creatinine clearance

Method of application and dosage Tamiflu capsules 75mg

Inside, during meals or regardless of the meal. Tolerability of the drug can be improved if taken with food. Adults, teenagers, or children who cannot swallow a capsule may also receive drug treatment at dosage form powder for suspension for oral administration. In cases where the drug in the dosage form "powder for oral suspension" is not available, or if there are signs of "aging" of the 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 (chocolate syrup with or without sugar content, honey, light brown sugar or table sugar dissolved in water, sweet dessert, sweetened condensed milk, applesauce or yogurt) 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. Detailed recommendations are given in the subsection "Ex-temporal preparation of Tamiflu suspension". Standard dosing regimen. Treatment. The drug should be started no later than 2 days after the onset of symptoms of the disease. Adults and adolescents aged >12 years. 75 mg 2 times a day orally for 5 days. Increasing the dose of more than 150 mg / day does not increase the effect. Children weighing >40 kg or aged >8 years. Children who can swallow capsules can also be treated with one 75 mg capsule twice daily. Children aged >1 year. Recommended powder for oral suspension 12 mg / ml or capsules 30 and 45 mg (for children over 2 years old). Prevention. The drug should be started no later than 2 days after contact with patients. Adults and adolescents aged >12 years: 75 mg once a day by mouth for at least 10 days after contact with the patient. During a seasonal influenza epidemic - 75 mg 1 time per day for 6 weeks. The prophylactic effect lasts as long as the drug is taken. Children weighing >40 kg or aged >8 years. Children who can swallow the capsules may also receive preventive therapy by taking one 75 mg capsule once daily. Children aged >1 year. Recommended powder for suspension for oral administration 12 mg / ml or capsules 30 and 45 mg. Dosing in special cases. Patients with kidney damage. Treatment. Patients with a creatinine clearance of more than 60 ml / min dose adjustment is not required. In patients with creatinine clearance from 30 to 60 ml / min, the dose of the drug should be reduced to 30 mg twice a day for 5 days. In patients with creatinine clearance between 10 and 30 ml/min, the dose should be reduced to 30 mg once daily for 5 days. For patients on permanent hemodialysis, the initial dose of 30 mg may be taken prior to dialysis if flu symptoms appear within 48 hours between dialysis sessions. To maintain plasma concentrations at a therapeutic level, the drug should be taken at 30 mg after each dialysis session. Patients on peritoneal dialysis should take the drug at an initial dose of 30 mg before dialysis, then 30 mg every 5 days. In this regard, there are no recommendations for dosing in this group of patients. Prevention. Patients with a creatinine clearance of more than 60 ml / min dose adjustment is not required. In patients with creatinine clearance from 30 to 60 ml / min, the dose of the drug should be reduced to 30 mg once a day. In patients with creatinine clearance from 10 to 30 ml/min, it is recommended to reduce the dose to 30 mg every other day. For patients on permanent hemodialysis, the initial dose of 30 mg can be taken prior to the start of dialysis (“1st session”). To maintain plasma concentrations at a therapeutic level, the drug should be taken at 30 mg after each subsequent odd dialysis session. Patients on peritoneal dialysis should take the drug at an initial dose of 30 mg before dialysis, then 30 mg every 7 days. The pharmacokinetics of oseltamivir in patients with terminal stage renal failure (with a creatinine clearance of 1 year - within 12 weeks, dose adjustment is not required. Children. The drug in this dosage form should not be prescribed to children under 1 year old. Extemporaneous preparation of a suspension of Tamiflu. In cases where adults, adolescents and children have problems with swallowing capsules, and the drug in the dosage form "powder for oral suspension" is not available or if there are signs of "aging" of the 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 for to mask 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 75mg, the following instructions should be followed: 1. Holding one 75mg capsule over a small container, carefully open the capsule and pour the powder into a container 2. Add a small amount (no more than 1 teaspoon) of a suitable sweetened food (to cover the bitter taste) and mix well. 3. Thoroughly mix the mixture and drink it immediately after preparation. If a small amount of the mixture remains in the container, then 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 should be followed for correct dosing: 1. Holding one 75 mg capsule over a small container, carefully open the capsule and pour the powder into the container. 2. Add 5 ml of water to the powder using a syringe with marks indicating the amount of liquid collected. Mix thoroughly for 2 minutes. 3. Draw up the required amount of the mixture from the container into the syringe: There is no need to take the undissolved white powder, since it is an inactive filler. By pressing the plunger of the syringe, inject all its contents into the second container. The remaining unused mixture must be discarded. 4. In the second container, add a small amount (no more than 1 teaspoon) of a suitable sweetened food item to cover the bitter taste and mix well. 5. Thoroughly mix the mixture 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. repeat this procedure before each dose of the drug.

The antiviral drug is Tamiflu. Instructions for use for children and adult patients recommend taking a suspension and tablets for the treatment and prevention of influenza.

Forms of release and composition

Powder for suspension for oral administration (children's form of the drug).
Capsules 30 mg, 45 mg and 75 mg (sometimes erroneously called tablets).

One capsule contains 30, 45 or 75 mg of the active ingredient oseltamivir (oseltamivir phosphate). One bottle of the drug contains 30 mg of the active substance oseltamivir phosphate. After preparation of the suspension, the content of oseltamivir is 12 mg per milliliter.

The suspension bottle comes with a plastic adapter and a dosing syringe with a measuring cup. The powder itself is white or slightly yellowish color, has a specific pleasant fruity smell and taste. After mixing with water, an opaque suspension of white or yellow color is formed.

Pharmacological properties

Oseltamivir - active ingredient"Tamiflu" - refers to prodrugs. Oseltamivir carboxylate, which is its active metabolite, is a selective inhibitor of influenza A and B neuraminidase.

This enzyme, which activates the release of viruses from cells affected by them, provokes the reproduction and spread of harmful microorganisms throughout the body, including the epithelial layer. respiratory tract. When using oseltamivir, the processes of virus replication are inhibited, and their pathogenicity is reduced.

It also inhibits the activity of excretion and spread of pathological agents from the body of the carrier of the disease. "Tamiflu", instructions for use confirms this, facilitates the course of the disease and reduces its duration, reducing the risk of complications such as otitis media, sinusitis, bronchitis or pneumonia. Clinical studies have shown that in children under 12 years of age, the duration of the disease is reduced by an average of 2 days.

When taken for prophylaxis by persons in contact with infected patients, the patient's family members are reduced by 92% of the likelihood of getting sick with any type of influenza. No clinically significant effect of the drug on the intensity of the body's response to the penetration of the virus into it was found, antibodies are produced in the same way as without the use of the drug. Confirmed cases of the formation of resistance to the drug are not registered.

Suspension, Tamiflu tablets: what does the medicine help with

The drug is prescribed for the prevention and treatment of influenza. For the treatment of influenza, the drug can be used by persons from one year old. In the event of a pandemic, it is possible to use the remedy in children 6-12 months old.

The drug showed the greatest effectiveness when taken within two days after infection and the onset of the first symptoms. Also, "Tamiflu" can be used as prophylactic after contact with infected persons in epidemics and pandemics in persons older than one year.

It should be noted that taking the drug does not replace vaccination against the influenza virus. Before using the product, especially in children from 6 to 12 months, you should consult your doctor.

Instructions for use

Tamiflu is taken orally, with or without food. Tolerability of the drug can be improved if taken with food. Adults, teenagers, or children who cannot swallow a capsule can also take Tamiflu in the form of a suspension, which is prepared from a powder.

In cases where the powder is not available, or if the capsules show signs of “aging”, open the capsule and pour its contents into a small amount (maximum 1 teaspoon) of a suitable sweetened food in order to mask 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.

"Tamiflu": instructions for use for adults and children in the treatment of influenza

The drug should be started no later than 2 days from the onset of flu symptoms.

Children aged 8 years and older or weighing over 40 kg who can swallow capsules can also be given Tamiflu 75 mg capsules (1 capsule 75 mg, or 1 capsule 30 mg + 1 capsule 45 mg) 2 times a day.

For adults and adolescents aged 12 years and older, the drug is prescribed 75 mg (1 capsule 75 mg, or 1 capsule 30 mg + 1 capsule 45 mg, or suspension) 2 times a day for 5 days. Increasing the dose of more than 150 mg per day does not increase the effect.

Dosing regimen "Tamiflu" in the form of capsules 30 mg and 35 mg or suspension for children, depending on the body weight of the child:

up to 15 kg - 30 mg 2 times a day;
more than 15-23 kg - 45 mg 2 times a day;
more than 23-40 kg - 60 mg 2 times a day;
more than 40 kg - 75 mg 2 times a day.

Prevention

Taking the drug "Tamiflu" should be started no later than 2 days after contact with the patient.

For children aged 8 years and older or weighing more than 40 kg who can swallow capsules, the drug can also be prescribed for the purpose of prophylaxis at 75 mg (1 capsule 75 mg, or 1 capsule 30 mg + 1 capsule 45 mg) 1 time per day. day.

For adults and adolescents aged 12 years and older, Tamiflu is prescribed 75 mg (1 capsule 75 mg, or 1 capsule 30 mg + 1 capsule 45 mg, or suspension) 1 time per day orally for at least 10 days after contact with sick. During a seasonal influenza epidemic - 75 mg 1 time per day for 6 weeks. The prophylactic effect lasts as long as the drug is taken.

For children aged 1 year and older, the drug in the form of a suspension or capsules of 30 mg and 45 mg is prescribed for the purpose of prevention in the following doses:

up to 15 kg - 30 mg 1 time per day;
more than 15-23 kg - 45 mg 1 time per day;
more than 23-40 kg - 60 mg 1 time per day;
more than 40 kg - 75 mg 1 time per day.

For dosing the suspension, use the enclosed syringe labeled 30 mg, 45 mg and 60 mg. Required amount suspensions are taken from the vial with a dosing syringe, transferred to a measuring cup and taken orally.

Obtaining a suspension from capsules

In cases where adults, adolescents and children have a problem with swallowing capsules, and there is no Tamiflu in the form of a powder for oral suspension, or if there are signs of “aging” of the capsules, it is necessary to open the capsule and pour out its contents in a small amount ( 1 teaspoon maximum) of a suitable sweetened food to cover 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.

How to prepare a suspension of "Tamiflu" from powder

Gently tap the closed vial with your finger several times so that the powder is distributed at the bottom of the vial.
Measure out 52 ml of water using the measuring cup, filling it to the indicated level.
Add 52 ml of water to the vial, close the cap and shake well for 15 seconds.
Remove the cap and insert the adapter into the bottle neck.
Screw the bottle tightly with a cap to ensure correct location adapter.

On the vial label, indicate the expiration date of the prepared suspension. Before use, the vial with the prepared suspension must be shaken. For dosing the suspension, a dosing syringe is supplied with labels indicating dose levels of 30 mg, 45 mg and 60 mg.

Side effects

According to the instructions, the use of Tamiflu can cause the following side reactions:

Respiratory system: cough, pain and sore throat, nasal congestion.
Digestive system: attacks of nausea, vomiting (in the first days of therapy or when taking the drug in high doses); rarely - abdominal pain, diarrhea.
Central nervous system: headache, dizziness, insomnia.
Other: general weakness feeling tired.

Overdose symptoms: nausea, vomiting.

Contraindications

chronic insufficiency of kidney function;
children under 1 year of age (since the safety and efficacy of the drug in children under 1 year of age have not been established);
increased individual sensitivity to any ingredient of the drug.

"Tamiflu" is prescribed with caution to pregnant and lactating women, as well as patients with severely impaired liver function.

Analogues of the drug "Tamiflu"

Full analogues for the active element:

Flustop.
Oseltamivir.

For the treatment and prevention of influenza, drugs can be prescribed:

Agrippal S1.
Begrivak.
Influvac.
IRS 19.
AnGriCaps maxim.
Sodium oxodihydroacridinyl acetate.
Gypsy.
Cytovir-3.
Ergoferon.
Ingavirin.
Araglin D.
Antigrippin-maximum.
Neovir.
Relenza.
TheraFlu for flu and colds.

Price and holiday conditions

The average price of Tamiflu in pharmacies (Moscow) is 1254 rubles for 10 Swiss-made capsules of 75 mg. In Minsk, the cost of the drug reaches 48 - 66 bel. rubles. The price in Kyiv and Kazakhstan is 385 hryvnia and 7780 tenge, respectively. The drug is dispensed by prescription.

Tamiflu is antiviral drug, active against influenza viruses type B and A. Tamiflu contains oseltamivir, a prodrug that is metabolized in the body to oseltamivir carboxylate.

Oseltamivir phosphate is a pro-drug of a potent selective inhibitor of influenza virus neuraminidase enzymes. Viral neuraminidase is very important for the release of new viral particles from infected cells and further spread of the virus in the body.

Tamiflu greatly facilitates the course of the disease, reduces the time it takes, reduces the likelihood of bronchitis, sinusitis, otitis or pneumonia.

Timely drug therapy allows not only to shorten the duration of the disease and reduce the intensity pathological symptoms, but also to avoid the development of such formidable complications as meningitis, pneumonia, pleurisy, myocarditis, etc.

Tamiflu Capsule Photo

In children aged 1 to 12 years, Tamiflu significantly reduces the duration of the disease (by 35.8 hours), the frequency of acute otitis media. Recovery and return to normal activity occurs almost 2 days earlier.

Tamiflu is available in the following forms:

1. Capsules used for therapy and prevention viral diseases in adolescents and older people. They contain oseltamivir 30, 45 or 75 mg (1 capsule).

2. Powder for the preparation of a suspension for children. 1 g of powder contains oseltamivir 30 mg as oseltamivir phosphate 39.4 mg.
1 ml finished suspension contains 6 mg of oseltamivir in the form of oseltamivir phosphate 7.88 mg. The kit comes with a plastic adapter and a dosing syringe with a measuring cup.

The instructions for use of Tamiflu indicate that the antiviral agent facilitates such negative manifestations viral diseases such as:

– high fever,
– Aches in joints, bones and muscles,
- Migraine pains
– Phenomena nasal congestion,
- Cough,
- Weakness, dizziness, vision disorders,
- Feeling of itching in the throat.

Indications for the use of Tamiflu

Flu treatment.

For adults and children over 1 year of age who have flu-like symptoms while the influenza virus is circulating.

The effectiveness of the drug has been demonstrated at the beginning of treatment within 2 days after the onset of symptoms. This indication is based on clinical research influenza with the predominant distribution of type A influenza.

Treatment of children aged 6 to 12 months during an influenza pandemic.

As a prophylactic, Tamiflu is prescribed to patients who have been in contact with patients who are clinically diagnosed with influenza during the circulation of the influenza virus.

According to doctors, Tamiflu does not replace the flu vaccination. Influenza vaccinated children older than 1 year and adults Tamiflu may be prescribed in the event of a discrepancy between the circulating influenza virus and the virus against which the vaccination was carried out.

Instructions for use Tamiflu, dosage

Suspension and capsules are taken regardless of the meal. The dose of oseltamivir and the duration of therapy are determined by the doctor.

The standard dosage of Tamiflu is 75 mg per day, it can be divided into 2 parts, one 30 mg capsule and one 45 mg.

It is better to start treatment with the drug in the first days of the disease, that is, immediately after the first signs appear.

The course of treatment is 10 days. It is strictly forbidden to increase the dosage on your own! expressed healing effect It will not be possible to achieve, but the manifestation of adverse reactions is possible.

Instructions Tamiflu for children

children whose body weight is less than 15 kilograms should take 30 mg / 1 time per day;
from 15 to 23 kilograms - you should use the medicine within 45 mg / 1 r. in a day;
from 23 to 40 kilograms - it is permissible to increase the dose to 60 mg / 1 time per day;
from 41 kilograms - the medicine is prescribed according to the same scheme as for adults.

During a seasonal epidemic of viral diseases, Tamiflu should be taken as a prophylactic course - in age dosage once a day for a week.

For children over 12 years of age and adults, it is enough to drink one capsule per day.

Application features

Oseltamivir is effective only against diseases caused by influenza viruses. There are no data on the effectiveness of oseltamivir in any diseases caused by pathogens other than influenza viruses.

Oseltamivir should be combined with caution with substances such as phenylbutazone, chlorpropamide, and methotrexate, because they are excreted in the same way, as a result of which, while taking these drugs, the excretion process may slow down.

It is undesirable to combine alcoholic drinks and Tamiflu.

Side effects and contraindications of Tamiflu

The most common side effect of this medicine is nausea and liquid stool. As a rule, such reactions are manifested mainly in children.

In addition, the following negative reactions from the body are possible:

dyspepsia,
Nausea and vomiting,
Pain in the epigastric region
Cough,
mucous discharge from the nose,
Migraine,
Dizziness,
Bleeding from the nasal passages
allergic manifestations.

Typically, the data unwanted effects develop at the beginning of therapy, pass independently and do not require discontinuation of oseltamivir.

Overdose

Adverse reactions reported with overdose were by nature and types similar topics observed with therapeutic doses of Tamiflu.

Nausea, dizziness, and vomiting may occur. In case of an overdose, it is necessary to stop taking the drug and carry out symptomatic treatment.

The medicine has no specific antidote.

Contraindications:

allergies to Tamiflu ingredients;
the age of infants up to six months (Tamiflu in the form of a suspension in pediatric practice can only be used to treat children older than 6 months);
chronic kidney failure, with Cl creatinine less than 10 ml per minute.

Caution should be exercised in pregnant and lactating women, children from 6 to 12 months.

Tamiflu analogues, list of drugs

Structural analogues according to active substance:

oseltamivir,
flustop,

In the seasonal prevention of influenza and the treatment of acute respiratory viral infections, analogues of Tamiflu are actively used (list):

Theraflu,
Cycloferon,
Ribavarin,
Ergoferon,
acyclovir,
Viferon,
Remantadin.

All analogues of Tamiflu are antiviral agents with different efficiencies. It is important to understand that the instructions for the use of Tamiflu, the price and reviews of analogues do not apply and cannot be used as a guide to the use or prescription of other drugs, even similar ones. For any replacement of Tamiflu with an analogue or other changes, a doctor's consultation is necessary.

Note that the need for the use of drugs, the appointment of a treatment regimen, methods and doses of the drug is determined solely by the attending physician. Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication.

In this article, you can read the instructions for use medicinal product Tamiflu. Reviews of site visitors - consumers are presented this medicine, as well as the opinions of medical specialists on the use of Tamiflu in their practice. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications were observed and side effects, possibly not declared by the manufacturer in the annotation. Tamiflu analogues, if available structural analogues. Use for the treatment and prevention of influenza in adults, children, as well as during pregnancy and lactation.

Tamiflu- an antiviral drug. Oseltamivir phosphate (the active ingredient of Tamiflu) is a prodrug, its active metabolite oseltamivir carboxylate (OK) is an effective and selective inhibitor of neuraminidase of influenza A and B viruses, an enzyme that catalyzes the release of newly formed viral particles from infected cells, their penetration into respiratory epithelial cells ways and further spread of the virus in the body.

It inhibits the growth of the influenza virus and suppresses the replication of the virus and its pathogenicity, reduces the release of influenza A and B viruses from the body.

Pharmacokinetics

Tamiflu is readily absorbed from the gastrointestinal tract and is highly converted to the active metabolite by hepatic and intestinal esterases. At least 75% of an oral dose is absorbed into systemic circulation in the form of an active metabolite, less than 5% - in the form of the parent drug. Plasma concentrations of both the prodrug and the active metabolite are dose-proportional and independent of food intake. According to animal studies, after oral administration of oseltamivir phosphate, its active metabolite was found in all major foci of infection (lungs, bronchial washings, nasal mucosa, middle ear and trachea) at concentrations that provide an antiviral effect. It is excreted (> 90%) as an active metabolite, mainly by the kidneys. The active metabolite does not undergo further transformation and is excreted by the kidneys (> 99%) by glomerular filtration and tubular secretion.

Indications

treatment of influenza in adults and children over the age of 1 year;
influenza prevention in adults and adolescents over the age of 12 who are at high risk of infection with the virus (in military units and large production teams, in debilitated patients);
influenza prevention in children older than 1 year.

Release forms

Capsules 30 mg, 45 mg and 75 mg (sometimes erroneously called tablets).

Powder for suspension for oral administration (children's form of the drug).

Instructions for use and dosage

The drug is taken orally, with or without food. Tolerability of the drug can be improved if taken with food.

Adults, adolescents, or children who cannot swallow a capsule may also receive Tamiflu treatment in powder form for oral suspension.

In cases where Tamiflu in the form of powder for oral suspension is not available, or if there are signs of "aging" of the 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 (chocolate syrup with normal sugary or unsweetened, honey, light brown sugar or table sugar dissolved in water, sweet dessert, sweetened condensed milk, applesauce or yogurt) to cover 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.

Treatment

The drug should be started no later than 2 days from the onset of flu symptoms.

Children aged 8 years and older or weighing more than 40 kg who can swallow capsules can also be given Tamiflu 75 mg capsules (1 capsule 75 mg, or 1 capsule 30 mg + 1 capsule 45 mg) 2 times a day. day.

less than or equal to 15 kg - 30 mg 2 times a day;
more than 15-23 kg - 45 mg 2 times a day;
more than 23-40 kg - 60 mg 2 times a day;
more than 40 kg - 75 mg 2 times a day.

Prevention

The drug should be started no later than 2 days after contact with the patient.

For adults and adolescents aged 12 years and older, Tamiflu is prescribed 75 mg (1 capsule 75 mg, or 1 capsule 30 mg + 1 capsule 45 mg, or suspension) 1 time per day orally for at least 10 days after contact with the patient. During a seasonal influenza epidemic - 75 mg 1 time per day for 6 weeks. The prophylactic effect lasts as long as the drug is taken.

For children aged 1 year and older, the drug in the form of a suspension or capsules of 30 mg and 45 mg is prescribed for the purpose of prevention in the following doses:

less than or equal to 15 kg - 30 mg 1 time per day;
more than 15-23 kg - 45 mg 1 time per day;
more than 23-40 kg - 60 mg 1 time per day;
more than 40 kg - 75 mg 1 time per day.

For dosing the suspension, use the enclosed syringe labeled 30 mg, 45 mg and 60 mg. The required amount of suspension is taken from the vial with a dosing syringe, transferred to a measuring cup and taken orally.

Preparation of Tamiflu suspension from powder

1. Gently tap the closed vial with your finger several times so that the powder is distributed at the bottom of the vial.

2. Measure out 52 ml of water using the measuring cup, filling it to the indicated level.

3. Add 52 ml of water to the bottle, close the cap and shake well for 15 seconds.

4. Remove the cap and insert the adapter into the bottle neck.

5. Screw the vial tightly with the cap to ensure the correct position of the adapter.

Extemporaneous preparation of Tamiflu suspension from capsules

In cases where adults, adolescents and children have a problem with swallowing capsules, and Tamiflu in the form of a powder for oral suspension is not available or if there are signs of "aging" of the capsules, it is necessary to open the capsule and pour its contents into a small amount (maximum 1 teaspoon) of a suitable sweetened food (as above) to cover 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.

Side effect

nausea and vomiting;
diarrhea;
bronchitis;
stomach ache;
gastrointestinal bleeding;
dizziness;
headache;
cough;
sleep disorders;
weakness;
pains of various localization;
rhinorrhea;
upper respiratory infections;
asthma (including exacerbation);
acute otitis media;
pneumonia;
sinusitis;
dermatitis;
lymphadenopathy;
dermatitis;
skin rash;
eczema;
hives;
erythema multiforme;
Stevens-Johnson syndrome;
anaphylactic and anaphylactoid reactions;
angioedema;
hepatitis;
convulsions;
delirium (including symptoms such as impaired consciousness, disorientation in time and space, abnormal behavior, delusions, hallucinations, agitation, anxiety, nightmares).

Contraindications

chronic renal failure ( permanent hemodialysis, chronic peritoneal dialysis, CC less than 10 ml / min);
hypersensitivity to the components of the drug.

Use during pregnancy and lactation

In studies on reproductive toxicity in animals (rats, rabbits), no teratogenic effect was observed. In studies on rats, no negative effects of oseltamivir on fertility were found. The exposure in the fetus was 15-20% of that in the mother.

During preclinical studies, Tamiflu and the active metabolite were excreted into the milk of lactating rats. Whether oseltamivir or the active metabolite is excreted in human milk is not known, but breast milk can be 0.01 mg per day and 0.3 mg per day, respectively.

Because data on the use of the drug in pregnant women is not enough, Tamiflu should be prescribed during pregnancy or nursing mothers only if possible benefits from its use to the mother outweigh the potential risk to the fetus or infant.

Use in children

Tamiflu should not be given to children under 1 year of age.

special instructions

Convulsions and delirium-like neuropsychiatric disorders have been reported in patients (mainly children and adolescents) taking Tamiflu for the treatment of influenza. These cases were rarely accompanied by life-threatening activities. The role of Tamiflu in the development of these phenomena is unknown. Similar neuropsychiatric disorders have also been noted in patients with influenza who did not receive Tamiflu.

There are no data on the effectiveness of Tamiflu in any diseases caused by pathogens other than influenza A and B viruses.

In the treatment and prevention of influenza in patients with CC from 10 to 30 ml / min, dose adjustment of the drug Tamiflu is required. There are no recommendations for dose adjustment in patients receiving hemodialysis, peritoneal dialysis and in patients with CC ≤ 10 ml / min.

One vial of Tamiflu (30 g powder for oral suspension) contains 25.713 g of sorbitol. When taking Tamiflu at a dose of 45 mg 2 times a day, 2.6 g of sorbitol enters the body. In patients with congenital intolerance fructose, this amount exceeds daily allowance sorbitol.

drug interaction

According to pharmacological and pharmacokinetic studies, clinically significant drug interaction unlikely.

Oseltamivir phosphate is highly converted to the active metabolite by esterases, mainly found in the liver. Drug interaction due to competition and binding to the active centers of esterases that convert oseltamivir phosphate to active substance, not presented. The low degree of protein binding of oseltamivir and the active metabolite does not suggest the presence of a displacement-related interaction. medicines from association with proteins.

In vitro, oseltamivir phosphate and the active metabolite are not the preferred substrate for polyfunctional oxidases of the cytochrome P450 system or for glucuronyltransferases. There are no grounds for interaction with oral contraceptives.

Cimetidine, a non-specific inhibitor of isoenzymes of the cytochrome P450 system and competing in the process of tubular secretion with alkaline-type drugs and cations, does not affect the plasma concentrations of oseltamivir and its active metabolite.

Unlikely clinically significant drug interaction due to competition for tubular secretion, given the margin of safety for most similar drugs, routes of excretion of the active metabolite of oseltamivir ( glomerular filtration and anionic tubular secretion), as well as the excretory capacity of each of the pathways.

Probenecid leads to an increase in the AUC of the active metabolite of oseltamivir by about 2 times (due to a decrease in active tubular secretion in the kidneys). However, dose adjustment is not required when co-administered with probenecid, given the safety margin of the active metabolite.

Simultaneous administration with amoxicillin does not affect the plasma concentrations of oseltamivir and its components, demonstrating weak competition for excretion by anionic tubular secretion.

Simultaneous administration with paracetamol does not affect the plasma concentrations of oseltamivir and its active metabolite or paracetamol.

Pharmacokinetic interaction between oseltamivir, its main metabolite was not found when taken simultaneously with paracetamol, acetylsalicylic acid, cimetidine or antacids (magnesium and aluminum hydroxide, calcium carbonate).

In phase 3 clinical studies, Tamiflu was administered with commonly used drugs such as ACE inhibitors(enalapril, captopril), thiazide diuretics (bendroflumethiazide), antibiotics (penicillin, cephalosporins, azithromycin, erythromycin and doxycycline), histamine H2 receptor blockers (ranitidine, cimetidine), beta-blockers (propranolol), xanthines (theophylline), sympathomimetics ( pseudoephedrine), opioid receptor agonists (codeine), corticosteroids, inhaled bronchodilators, acetylsalicylic acid, ibuprofen, paracetamol. Changes in the nature or frequency of adverse events were not observed.

Analogues of the drug Tamiflu

Structural analogues for the active substance:

Oseltamivir;
Flustop.

Analogues for anti-influenza action:

Agrippal S1;
AnGriCaps maxima;
Antigrippin-maximum;
Araglin D;
Begrivak;
Ingavirin;
Influvac;
IRS 19;
Neovir;
Sodium oxodihydroacridinyl acetate;
Relenza;
TeraFlu for flu and colds;
Cytovir-3;
Gypsy;
Ergoferon.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.