Tamiflu Side Effects To Watch for and the Simple Trick That Eases Symptoms Fast
The antiviral medication can speed recovery during this year's brutal flu season
Fever, chills, sore throat, cough… the list of common flu symptoms goes on. Fortunately, the antiviral drug Tamiflu (oseltamivir) has been shown to shorten the duration of illness and ease symptoms. But what are the side effects of Tamiflu itself? Here, a leading infectious disease specialist explains the most common one, offers an easy remedy and sets the record straight on a major myth about the treatment.
How does Tamiflu work?
“Think of Tamiflu as an antiviral, somewhat like how antibiotics work against bacteria,” explains William Schaffner, MD, Professor of Preventive Medicine with a primary appointment in the Department of Health Policy and Professor of Medicine in the Division of Infectious Diseases at Vanderbilt University School of Medicine.
As Dr. Schaffner colorfully puts it: “The drug gets absorbed into the virus and bollixes up the mechanism it needs to multiply.” That’s important because if the virus can’t replicate in your body, it can’t keep making you sick.
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Timing is key for treating the flu virus
That mechanism is also why the sooner you start the antiviral medication, the more effective it is. “This makes sense, because if treatment is delayed, the virus has already had a head start multiplying in the body,” Dr. Schaffner explains. “Studies clearly show that the medication is most effective when started within the first 48 hours, or the first two days, after symptoms begin.”
That said, perhaps the biggest myth about Tamiflu is that it has no effect if administered after that 48-hour window has closed, says Dr. Schaffner, who notes that though its potency is diminished, it still can help tame symptoms.
2 Tamiflu side effects to watch for
Though it’s effective at shortening the duration of flu symptoms by about a day and a half and decreasing the risk of complications, Tamiflu can cause side effects. Here, Dr. Schaffner notes two common side effects:
Nausea or diarrhea
“Some people even vomit,” he notes, which is why he advises drinking milk when taking Tamiflu to help coat the stomach and ease digestion. (Discover more simple ways to ease nausea here.)
Excitability
Excitability is a rare side effect marked by unusual restlessness, increased energy or agitation. But it’s important to point out that this neuroexcitatory phenomenon is seen most prominently in kids—and in a rather specific context, at that.
“This side effect was observed in one Japanese study where Tamiflu was administered to children in higher doses for longer periods of time, about five days,” explains Dr. Schaffner. He emphasizes that the longer duration of treatment was a key variable, adding that this side effect of unusual behavior is rare in the U.S.—and no reason to avoid treating children with Tamiflu.
“We have a strong policy in our children’s hospital here that if [a child] is admitted with influenza or suspected influenza, if they’re that sick, they have to be given an antiviral,” he adds.
Is there an alternative to Tamiflu?
The antiviral drug Baloxavir can be used instead of Tamiflu to help speed recovery from the influenza virus, and its biggest selling point is that it’s a single dose, says Dr. Schaffner. Its cons, however, include a higher risk of gastrointestinal side effects.
“There are two concerns with Baloxavir: one is that it’s much more frequently associated with diarrhea,” he reveals. “The other is that it tends to make the flu strain resistant to it—this happens about 10 percent of the time.” For severe cases, intravenous antivirals are also an option, he adds.
Who should take Tamiflu?
In short, anyone experiencing flu symptoms, especially those over 65, when waning immunity increases the chance of more severe illness. Other high-risk groups include people with a chronic health condition like diabetes, heart disease or lung disease, and pregnant women.
Indeed, it’s important to gauge how vulnerable you may be to developing severe illness, as “flu is dominant right now—hugely dominant,” observes Dr Schaffner.
How to tell flu from COVID this season
While flu cases are increasing across the country, “COVID is also starting to stick its nose up a bit,” warns Dr. Schaffner.
To distinguish between these two diseases—which are treated with different medications but affect the same high-risk groups—testing is usually recommended first, he advises. “However, during a large flu outbreak, it can sometimes be easier to start antiviral treatment right away. Some doctors take that approach and ‘play the odds,’ since at the moment, it’s much more likely to be flu than anything else.”
The best way to prevent the flu
Of course, an ounce of prevention is worth a pound of cure, and as you might have guessed, the best way to ward off the flu is by getting vaccinated, urges Dr. Schaffner.
“It’s not too late to get vaccinated, even though we’re already partway through the season,” he says. “This flu season is expected to extend into March, so if you haven’t gotten your shot yet, don’t wait—head to your nearest pharmacy or healthcare provider.”
The flu vaccine is designed to work best at keeping people out of the hospital, he adds. “It’s less effective at preventing milder cases, but year after year it has been proven to prevent countless hospitalizations, ICU admissions and even deaths.”
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