Let’s talk about Tamiflu

Yes, it can make a difference if you have the flu. No, it doesn’t treat or prevent the coronavirus.
September 27, 2021
a woman rests on a couch. She uses a kleenix to blow her nose. Photo: Getty Images.
Tamiflu is prescribed after a flu diagnosis. The antiviral medication does not work for coronavirus. Photo: Getty Images

Flu season is upon us, and public health officials are bracing for a rough one. Last year’s mild flu season, they fear, may have weakened our collective resistance to the flu.

The most important thing you can do to protect yourself is to get a flu shot. But if you end up with the flu, and you get it diagnosed quickly, there are antiviral treatments that have been shown to help with symptoms and, if taken soon after symptom onset, shorten the flu’s length by a day or two. The best-known of them is Tamiflu (or, as a generic, oseltamivir phosphate). The U.S. Food and Drug Administration approved the Roche-developed drug, which is taken in pill or liquid form, back in 1999.

How does Tamiflu work?

Tamiflu – which, like other antivirals, is available only with a prescription – hinders the flu virus’s ability to replicate and multiply. Fewer viruses can mean lesser symptoms and a shorter duration of disease. That’s especially important for those who are older or immunocompromised who are at a much higher risk of developing pneumonia and ending up hospitalized, says Dr. Michelle Barron, UCHealth’s infectious-disease specialist. Further, the CDC notes studies that have reported early antiviral treatment to reduce the risk of death among such patients.

When do you take Tamiflu?

As soon as possible after diagnosis, ideally within 48 to 72 hours of symptom onset.

Does Tamiflu work for the coronavirus?

No. Different viruses have unique characteristics that different antivirals target. Taking Tamiflu for a COVID-19 infection would be like using a bear trap to catch a shark.

Is the coronavirus pandemic complicating the prescription of Tamiflu?

Yes, Barron says. Prior to the pandemic, doctors could prescribe Tamiflu with a high degree of confidence to high-risk patients who called in to report flu-like symptoms. With the coronavirus, they need to be tested, which can delay treatment and Tamiflu’s ultimate effectiveness, she says.

What other flu treatments are out there?

According to the U.S. Centers for Disease Control and Prevention, there are four approved flu antivirals: Tamiflu, zanamivir (trade name Relenza), peramivir (trade name Rapivab), and baloxavir marboxil (trade name Xofluza). Zanamivir is a powder that’s inhaled and, like Tamiflu is typically taken for five days. Peramivir is given once intravenously. Baloxavir is a single-pill dose.

Dr. Michelle Barron, the top infectious disease expert in Colorado.
Dr. Michelle Barron takes a moment to reflect on the pandemic that has consumed her life for the last six months. Unfortunately, she knows the pandemic is far from over. She’s already planning for the next wave.

Are there equivalents to Tamiflu for the coronavirus?

Not in a form that can be taken orally – at least not yet. UCHealth providers are prescribing Regeron’s REGEN-COV to outpatients who have tested positive for COVID-19 and have symptoms. It is, however, delivered as an infusion. Pills could emerge in the coming months, depending on the clinical trial results for experimental coronavirus antivirals.

Does UCHealth’s top infectious disease physician have parting words to share regarding Tamiflu?

Yes: avoid it as best you can. There’s a good way to do that.

“I just encourage everybody to get their flu shot,” Barron says. “The value of getting a flu shot is that you probably won’t need Tamiflu and you don’t have to come in and get tested.”

To schedule your flu shot, click here.

About the author

Todd Neff has written hundreds of stories for University of Colorado Hospital and UCHealth. He covered science and the environment for the Daily Camera in Boulder, Colorado, and has taught narrative nonfiction at the University of Colorado, where he was a Ted Scripps Fellowship recipient in Environmental Journalism. He is author of “A Beard Cut Short,” a biography of a remarkable professor; “The Laser That’s Changing the World,” a history of lidar; and “From Jars to the Stars,” a history of Ball Aerospace.