Oseltamivir
- Atc Codes:J05AH02
- CAS Codes:196618-13-0#204255-11-8
- PHARMGKB ID:196618-13-0#204255-11-8
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Tamiflu; Belgium: Tamiflu; Bulgaria: Tamiflu; Cyprus: Tamiflu; Czech Republic: Tamiflu; Denmark: Tamiflu; Estonia: Tamiflu; Finland: Tamiflu; France: Tamiflu; Germany: Tamiflu; Greece: Tamiflu; Hungary: Tamiflu; Ireland: Tamiflu; Italy: Tamiflu; Latvia: Tamiflu; Lithuania: Tamiflu; Luxembourg: Tamiflu; Malta: Tamiflu; Netherlands: Tamiflu; Poland: Tamiflu; Portugal: Tamiflu; Romania: Tamiflu; Slovakia: Tamiflu; Slovenia: Tamiflu; Spain: Tamiflu; Sweden: Tamiflu; UK: Tamiflu.
North America
Canada: Tamiflu; USA: Tamiflu.
Latin America
Argentina: Agucort, Tamiflu; Brazil: Tamiflu. Mexico: Tamiflu.
Asia
Japan: Agucort, Tamiflu.
Drug combinations
Chemistry
Oseltamivir: C~16~H~28~N~2~O~4~. Mw: 312.40. Ethyl (3R,4R,5S)-4-acetamido-5-amino-3-(1-ethylpropoxy)-1-cyclohexene-1-carboxylate. CAS-196618-13-0.
Oseltamivir Phosphate: C~16~H~28~N~2~O~4~ H~3~PO~4~. Mw: 410.40. [3R-(3α,4β,5α)]-Ethyl 4-(acetylamino)-5-amino-3-(1-ethylpropoxy)-1-cyclohexene-1-carboxylate phosphate (1:1)). CAS-204255-11-8 (1998).
Pharmacologic Category
Antivirals; Neuraminidase Inhibitors. (ATC-Code: J05AH02).
Mechanism of action
Oseltamivir phosphate is an inactive prodrug until hydrolyzed by hepatic esterases to oseltamivir carboxylate, active metabolite. Oseltamivir carboxylate is a potent selective competitive inhibitor of influenza virus neuraminidase, enzyme essential for viral replication. Active against influenza A and B viruses (including amantadine- and rimantadine-resistant isolates). Active in vitro and in vivo in animal studies against some avian influenza A viruses (some strains of H5N1, H7N2, H9N2); active against influenza A (H5N1) isolated from patients in Vietnam and Thailand during 2004, and in Mexico in 2009 (H1N1).
Therapeutic use
Uncomplicated acute illness due to influenza (A or B) infection in children ≥1 year of age and adults who have been symptomatic for no more than 2 days. Prophylaxis against influenza (A or B) infection in children ≥1 year of age and adults.
Pregnancy and lactiation implications
There are no adequate studies to determine risk to pregnant woman or developing fetus. Studies evaluating the effects on embryo-fetal development in rats and rabbits showed dose-dependent increase in rates of minor skeleton abnormalities in exposed offspring. Enters breast milk (not recommended in nursing women).
Unlabeled use
Contraindications
Hypersensitivity to oseltamivir or any component of the formulation.
Warnings and precautions
Rare but severe hypersensitivity reactions (anaphylaxis, severe dermatologic reactions) associated with use. Rare occurrences of neuropsychiatric events (including confusion, delirium, hallucinations, and/or self-injury) reported from postmarketing surveillance. Use with caution in chronic cardiac disease, in severe hepatic impairment, in renal impairment (creatinine clearance <30 mL/minute), in respiratory disease, and in immunocompromised patients. Oseltamivir not a substitute for influenza virus vaccine. Consider primary or concomitant bacterial infections.