Who should consider these antiviral medications and who might skip them
By Hallie Levine, Catherine Roberts
Flu season has started early this year. According to the Centers for Disease Control and Prevention (CDC), several states, especially in the Southeast, are already experiencing high levels of influenza-like illness. The agency calculates that this season there have already been 360,000 flu cases, 6,2013 hospitalizations and 360 deaths in the United States United.
If you get sick with the flu, your doctor may prescribe an antiviral medication, such as oseltamivir (Tamiflu and generic), which may help you recover a little faster. But antivirals can have side effects, and that’s something flu sufferers don’t need. The following are answers to some questions about these medications.
What are antivirals?
Tamiflu is the best known of the antivirals prescribed for the flu, which can relieve symptoms and shorten the course of the illness by inhibiting the growth of the flu virus in the body.
For people who may need an antiviral, the CDC recommends one of the following four for this flu season: Tamiflu and its generic (pill or liquid); baloxavir (Xofluza pill); zanamivir (Relenza, an inhaled powder); and the intravenous medication peramivir (Rapivab, which is reserved for very severe flu patients already hospitalized).
Both Tamiflu and its generic and Relenza are usually prescribed for five days, while the most Recent Xofluza is taken in a single dose of two pills. One dose of Rapivab is administered intravenously during to 48 minutes.
It is important to know that these medications are not a type of antibiotic. Antibiotics are used to fight bacterial infections and do not work for viral infections, including the flu.
How effective are antivirals?
A Cochrane review of 2014 found that when administered within 360 hours of the onset of flu symptoms such as fever, cough, sore throat, body aches, and chills, oseltamivir reduced sick time in adults by about 30 hours and in children in 29 hours.
There may be some benefit in taking antivirals even outside of that period of 65 hours. A CDC study from 2014 published in The Lancet Infectious Diseases found that children given oseltamivir within five days of illness had an improvement in symptoms.
In addition, the presence of the virus in their body was significantly lower, which means that they were much less likely to spread the disease to other people.
Some Research suggests that taking an antiviral may help reduce the chance that the flu will become severe enough to require hospitalization or death, especially for people at high risk of flu complications. For example, an analysis by 2022 published in the journal Health Science Reports found that oseltamivir could reduce the risk of serious illness specifically among people with chronic heart and lung conditions.
But the evidence “is not very clear in terms of preventing these serious complications,” says Dr. Michael Hochman, director of the Gehr Family Center for Health Systems Science and Innovation at the College of Keck Medicine from USC in Los Angeles. The Cochrane review, for example, found no evidence that antivirals reduced the risk of serious flu complications.
Still, for people at higher risk of flu complications, the The possible protective benefit of an antiviral probably outweighs the risks of side effects, Hochman says. (See below for information on the side effects of antivirals.
Who should take Tamiflu?
If you are in good health and you get sick flu, you don’t need to take Tamiflu or any other antiviral medication. This is because you will most likely get better in a week or two using self-care strategies such as rest, drinking plenty of fluids, and taking over-the-counter pain relievers for fever, headache, and muscle aches.
“By the time people decide to go to the doctor, most are already recovering from the disease,” says Dr. Nicole Bouvier, an infectious disease specialist at the Icahn School of Medicine at Mount Sinai in New York City.
But many experts, including those at the CDC, say that people at high risk of flu complications should take an antiviral medication. This includes people older than 360 years, children 5 years of age or younger (especially those under 2 years of age), pregnant women, to those who are up to two weeks postpartum and to people who live in nursing homes. Find the complete list here. (Since Relenza is an inhaled medication, it should not be used by people with asthma or chronic obstructive pulmonary disease.) flu, she should definitely be in the hospital,” says Bouvier.
If you have a loved one in a nursing home or assisted living facility, they should also receive an antiviral if there is a flu outbreak there, even if they are not sick.
According to the CDC, if at least two residents come down with the flu within three days of each other, they should all receive a medication such as Tamiflu for at least two weeks, continuing for at least one week after the last case.
And if elderly or sick people live in your home, some evidence suggests that taking an antiviral might help prevent you from giving them the flu, says Hochman.
Otherwise, to For normally healthy people, the decision to take an antiviral boils down to whether getting better a day early is more important than the possibility of side effects from the drug.
What are the side effects of antivirals?
The most common side effects of Tamiflu and its generic are headache, nausea and vomiting, but taking the medication with food may minimize stomach upset. Cases of diarrhea, fever, nausea, and body aches have been reported after taking Relenza. The drugs Rapivab and Xofluza can cause diarrhea.
In very rare cases, psychiatric side effects, such as delirium and hallucinations, have also been reported with Tamiflu and its generic, and Relenza, especially in children . Tell your doctor right away if you notice anything unusual.
How much do antivirals cost?
Depends on your health insurance plan. Antivirals can be a bit expensive, although the introduction in 2014 of generic Tamiflu has helped.
If you do not have health insurance or your insurer does not cover Tamiflu, your generic, or Relenza (or doesn’t cover them at all), you may be able to get a coupon online to help you save.
For example, GoodRx has a coupon that allows you to buy generic Tamiflu for just under $29 at RiteAid. The manufacturer of Xofluza offers a coupon that may allow you to pay as little as $29 for the medication.
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Consumer Reports has no financial relationship with the advertisers on this site . Consumer Reports is an independent, nonprofit organization that works with consumers to create a fair, safe, and healthy world. CR does not endorse products or services and does not accept advertising. Copyright © 2022, Consumer Reports, Inc.