Influenza, or the “flu,” is a viral respiratory infection that commonly affects the nose, throat, and lungs. Some symptoms of flu infection include fever, muscle ache, headache, dry cough, shortness of breath, general malaise, and more. Most healthy people with active flu infections can fight off the infection with their immune systems, however, certain high-risk groups may be prone to developing complications, such as children under 2 years old, adults over 65 years old, those that are pregnant, those with weakened immune systems, those with chronic illnesses, and those with a body mass index of 40 or higher.
The influenza vaccine is a preventative vaccine that reduces the chances of a patient having severe complications from the virus. Even after preventative measures such as the influenza vaccine, some adults remain at high risk for hospitalization following an infection. That is where flu antiviral drugs come in; antiviral drugs are medications that assist your body in fighting viruses.
The most common antiviral for the flu is Tamiflu, generically known as oseltamivir. Oseltamivir is a neuraminidase inhibitor and was approved by the United States Food and Drug Administration in 1999. When oseltamivir is started within two days of flu symptoms and confirmed flu infection, it can shorten length of illness along with a decrease in overall symptoms. This is especially useful in high-risk populations who may be able to prevent a hospitalization after taking oseltamivir.
However, there is considerable emerging data about the actual efficacy of oseltamivir. One study published in the Indian Journal of Pharmacology in 2015 notes issues raised by the Cochrane Team that claims the randomized controlled trials were not precise, nor did they have high-quality data. They claim that these trials were poorly designed.
More recently, a study released in the Journal of the American Medical Association in 2023, showed that oseltamivir was not associated with a reduced risk of hospitalization for the infected population, and was not associated with a reduced incidence of hospitalization in older populations or in patients at greater risk. Unfortunately, on the other hand, it was associated with increased nausea and vomiting in patients taking it.
Emily McDonald, MD, MSc, the Principal Investigator in this trial and a medical doctor, said in an interview with MedPage Today that she “wouldn’t prescribe it to an otherwise healthy person.” Additionally, she argues that current treatment guidelines for oseltamivir need to be reviewed, stating that overprescribing is a big problem especially when it comes to antibiotic medications and antiviral medications.
While antiviral medications like oseltamivir (Tamiflu) have been widely used as a treatment option, recent studies have raised questions about their true effectiveness and potential side effects. As further research and analysis continue, it is essential for healthcare professionals to carefully evaluate the benefits and risks of antiviral treatments for each patient, ensuring appropriate and informed decision-making.