Oseltamivir

Background

Mechanism of Action

• Inhibits viral neuraminidase, which is required for virion release after budding

Dose

Adults

• Influenza (treatment): 75 mg PO bid for 5 days, started within 48 hours of illness onset
• Influenza (prophylaxis): 75 mg PO daily

Renal Dosing

Indication	CrCl >60	CrCl >30 to 60 mL/min	CrCl >10 to 30 mL/min	IHD	CAPD	CRRT
Influenza (treatment)	Usual dose	30 mg PO bid	30 mg PO daily	30 (low-flux) to 75 (high-flux) mg PO after dialysis	30 mg PO once	30 mg once daily
Influenza (prophylaxis)	Usual dose	30 mg PO daily	30 mg PO every other day	30 mg PO after every other dialysis	30 mg PO weekly	Unclear

Hepatic Dosing

• No dose adjustment needed

Pediatric

• Influenza (treatment):
  • Infants ≤8 months: 3 mg/kg/dose PO bid
  • Infants ≥9 months: 3.5 mg/kg/dose PO bid
  • Children ≤15 kg: 30 mg PO bid
  • Children >15 to 23 kg: 45 mg PO bid
  • Children >23 to 40 kg: 60 mg PO bid
  • Children & adolescents >40 kg: 75 mg PO bid (adult dose)
  • Duration 5 days, started within 48 hours of illness onset
• Influenza (prophylaxis):
  • Same doses as above, used once daily instead of bid