Wednesday, January 16, 2013
What about Tamiflu? Should you take it?
So if you GET the flu, should you take Tamiflu? Or less known, Relenza?
Ah, that's the million dollar question...literally, since Tamiflu and Relenza are the only drugs FDA approved and indicated for this year's flu. These drugs are flying off the shelves as the flu season kicks into full gear, and we are desperate to get over the flu as fast as possible. Much is being debated these days about the efficacy of these anti-viral drugs. What do we know?
We know that antiviral treatment typically shortens the symptoms of the flu by at least twenty-four hours. We know treatment is recommended for those with weakened immune systems or those with severe enough symptoms to be hospitalized. We know starting these medications when you have already had symptoms for more than two days is NOT helpful. We know that taking Tamiflu can help prevent getting the flu if you are definitely exposed to someone with the flu.
What else do we know? We know that there are no independent studies of the drug (meaning that the manufacturer of the drug has at least partially funded all the studies). That does not mean the studies are invalid, but certainly it calls bias into question.
Tamiflu and Relenza are not without side effects. In my own clinical experience, I have had patients who took one of these drugs because their family member was diagnosed with the flu, and the side effects of the drug were "as bad as the flu"- particularly nausea. That being said, I have also had patients who had zero side effects and happily did not get the flu despite obvious exposure.
What do I do clinically? If I diagnose you with the flu, and you've had symptoms for more than two days, I will not prescribe an antiviral. If you have a very sensitive stomach, I am unlikely to prescribe an antiviral. If you are a college student living in a dorm (translation, exposing a zillion other kids to your flu), I am likely going to encourage you to take an antiviral. So, it depends...on YOU and your symptoms and your risk factors.
BOTTOM LINE: If you have true flu symptoms, get in to see your doctor ASAP...and then have a DISCUSSION about whether or not an antiviral medicine is likely to help you (or your roommates.)