Is Tamiflu the Best Flu Med? What Are My Options?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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This year’s flu vaccine was disappointing in its coverage of the influenza strains making folks sick. Because of this, we may have to rely instead on the antiviral medications used to treat influenza. Influenza medications are moderately effective for reducing the duration and severity of influenza when started at the onset of symptoms. These antiviral meds also help reduce the duration of viral shedding, important for limiting spread from person to person.

Meet your three choices of influenza medications aka the neuraminidase inhibitors: Relenza (zanamivir), Tamiflu (oseltamivir), and Rapivab (peramivir).

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Which one is the best?

There aren’t many comparison studies but Rapivab was compared to Tamiflu and found to be “non-inferior” meaning they both work about the same to limit duration of symptoms. Remember, Relenza can’t be used in anyone with asthma. Tamiflu can also cause nausea and vomiting, and diarrhea is a common adverse effect reported in patients receiving Rapivab. One really isn’t better than the other so look at delivery method (inhaler, pill, IV), cost, and side effect profile with your doctor to make the decision.

Can the influenza virus be resistant to these medications?

Not yet. Since September 2009, 99 percent of influenza virus isolates tested in the United States have been susceptible to neuraminidase inhibitors (Tamiflu, Relenza and Rapivab). That’s good news.

Dr O.

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