Antimicrobials
Oseltamivir

Oseltamivir

C difficile risk
None
Oral Bioavailability
Excellent
Cost
See below under General Info

Dosing

Standard Dosing 75mg PO BID x 5 days

Critically Ill, Severely Immunocompromised or in Intensive Care Unit 75-150mg PO BID x 5 days or longer (double dosing or prolonged duration of therapy is based on expert opinion only)

Prophylaxis 75mg PO daily x 10 days for those exposed, or for duration of outbreak

eGFR = 30 to 59 ml/mineGFR = 10 to 29 ml/minTreatment: 30mg PO BID x 5 days; certain resources also support 75mg PO daily x 5 days

Prophylaxis: 30mg PO daily x 10 days for exposures or for duration of outbreak Treatment: 30mg PO daily x 5 days

Prophylaxis: 30mg PO every OTHER day x 10 days for exposures or for duration of outbreak

Treatment: 75mg PO load then 75mg PO after each HD session for 5 day period

Prophylaxis: 30mg PO load then 30mg PO after each HD session x 10 days for exposures or for duration of outbreak

Treatment: 30mg PO daily x 5 days

Prophylaxis: 30mg PO daily x 10 days for exposures or for duration of outbreak

General Information

Hospital Formulary Status Yes (PO solid, PO power for susp)

In-Hospital Cost will be updated

PharmaCare Formulary Status Yes (PO solid, PO susp)

Special Authority Yes (PO solid, PO susp) (See below under Restricted Use Criteria)

PharmaCare Coverage 30mg PO - $1.6986/cap 45mg PO - $2.6139/cap 75mg PO - $3.3674/cap 6mg/ml PO susp recon - $0.3570/ml 15mg/ml (30ml) - $1.2816/ml 15mg/ml (40ml) - $1.1717/ml 15mg/ml (50ml) - $1.1058/ml

Outpatient Cost 30mg PO - $1.79-2.42/cap 45mg PO - $2.91/cap 75mg PO - $3.40-4.25/cap 6mg/ml PO susp recon - $0.36-0.39/ml

Treatment and prophylaxis of influenza

Special Authority Status: Yes (PO solid, PO susp)

Special Authority Category: Limited Coverage Drugs

Special Authority Criteria: For the treatment and prophylaxis of influenza A and B during an outbreak situation among permanent residents of licensed residential care facilities (PharmaCare Plan B)

OR

For the treatment of patients at high risk* with influenza infection within 48 hrs of symptom onset, who have either:

  • laboratory-confirmed influenza A or B sensitive to oseltamivir OR

  • signs and symptoms of influenza A or B only when influenza is confirmed to be circulating in the local community and sensitive to oseltamivir, as per BC CDC influenza bulletin

*Please refer to the BC Special Authority Program Website for more info

Special Authority Approval Period: 5-day treatment course during influenza season

Special Authority Practitioner Exemptions: None

Special Authority Special Notes:

  • prescribers do not need to submit a Special Authority Request for this coverage

  • prescribers should write “Submit as zero cost to PharmaCare” when writing a prescription for patients who do not meet the criteria

  • when submitting a claim for a prescription with this note, pharmacists should use the intervention code DE Adjudicate to $0.00 as requested (this ensures appropriate PharmaCare coverage)

  • refer to the BC Special Authority Program Website for more info

Gastritis (PO)

  • sx: nausea and vomiting

  • adults: up to 15%

  • usually mild and limited to the first 1-2 days of treatment

Neuropsychiatric effects (PO)

  • rare

  • sx: delirium, hallucinations, confusion, abnormal behavior, convulsions, and encephalitis

  • usually abrupt onset and rapid resolution

Severe skin reactions (PO)

  • rare

  • includes toxic epidermal necrolysis, SJS, and erythema multiforme

  • usually abrupt onset and rapid resolution

No significant

Antimicrobial class: Antiviral, Neuraminidase Inhibitor

Pregnancy category: C

Higher doses have not been shown to be superior but may be considered in critically ill or obese patients i.e. 150mg PO BID

Average serum half life: 2.0 hr

Lung penetration: Therapeutic