Doubling Down on Flu Medication

Tamiflu double doses for influenza show same results as single doses

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Most cases of the flu don’t lead to more than a few days home from work, or sometimes a hospital stay. In some cases, however, the flu can cause major respiratory problems and even death.

An antiviral medication called oseltamivir (Tamiflu) is a common treatment given to flu patients. Some treatment guidelines for healthcare workers suggest giving patients with severe influenza a double dose of this medication.

When testing this recommendation, the authors of a new study in Southeast Asia found no difference between the health of patients with severe influenza given a double dose and those given a single dose of oseltamivir.

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The study was performed by researchers from the South East Asian Infectious Disease Clinical Research Network. The data was gathered at 13 different hospitals in Indonesia, Singapore, Thailand and Vietnam between April 2007 and February 2010.

The study included 326 patients admitted to the hospital for severe influenza, some with the H1N1 flu. Most of the participants (75.5 percent) were children under the age of 15 years.

Half of the patients were given a double dose of oseltamivir (150 mg twice a day or the equivalent pediatric dose) while the other patients were given the standard dose (75 mg twice a day or the pediatric equivalent).

After five days of treatment, the researchers tested for influenza by testing nasal and throat swabs for viral RNA. Results were similar in both groups.

Of the double dose patients, 72.3 percent did not test positive for the viral RNA, and the same was true for 68.2 percent of the standard dose patients, a difference of 4.2 percent.

The authors also found no major differences in the rates of serious health events or death between the two groups. In total, 21 patients died – 7.3 percent of the double dose group and 5.6 percent of the standard dose group.

The authors concluded that while the double dose of oseltamivir was well tolerated by patients, it did not give them any additional benefits over the standard dose.

It is important to note that most of the participants were children and the study was performed only in Southeast Asia. More research is needed to confirm these findings in a more diverse population.

According to the authors, determining proper influenza treatment guidelines is important.

“These findings have implications for both clinical management and pandemic preparedness including during the current H7N9 epidemic,” the authors wrote.

The study was published by BMJ on May 30.

The South East Asia Infectious Diseases Clinical Research Network received support for this study from the National Institute of Allergy and Infectious Diseases and the Wellcome Trust of Great Britain.

Reviewed by: 
Review Date: 
May 30, 2013
Last Updated:
August 8, 2013