Is Tamiflu Safe to Take During Pregnancy?

Getting the flu when you’re pregnant can be scary. You may be wondering if it’s safe to take prescription flu medications to ease your symptoms and get you feeling better faster. 

Tamiflu (oseltamivir) is one antiviral medication used for the treatment of seasonal influenza (the flu). It’s considered safe and effective for treating the flu during pregnancy. It’s also the first-choice medication to prevent the flu if you’re exposed to it while pregnant. Still, there are some things to consider about taking Tamiflu while you’re pregnant.

What’s important to know about influenza in pregnancy?

Many changes happen to the body during pregnancy. One example is that your immune system may not work as well as it usually does. Other changes involve the heart and lungs. Because of these changes, pregnant women have a higher risk of severe illness if they contract the flu. This risk can continue until up to 2 weeks after birth. Flu during pregnancy also increases the risk of preterm birth (giving birth earlier than expected). And the fever that usually comes with the flu can increase the risk of developmental issues for your baby.

The American College of Obstetricians and Gynecologists recommends that all pregnant people receive the flu vaccine every year. This is the best way to prevent getting the flu and lower the risk of flu-related complications. In fact, a 2017 study showed that the flu vaccine decreased hospitalizations in pregnant women by 40%. The flu vaccine also helps protect your baby from the flu during their first few months of life.

What about taking Tamiflu if you’re pregnant and have the flu?

Sometimes, even if you’ve been vaccinated, you may still get the flu. If you’re pregnant and have the flu, it’s important to start Tamiflu as soon as possible. Taking Tamiflu at the first sign of symptoms can lower your risk of needing to go to the intensive care unit if you are hospitalized. It can also help shorten hospital stays and lower your risk of dying from flu-related complications.

To get the most benefit, Tamiflu should be started within 48 hours of your first flu symptoms.

You don't need to wait to have a positive flu test to start treatment with Tamiflu. You can begin taking it right away. Some of the early symptoms of the flu can include:

• Fever

• Chills

• Cough

• Sore throat

• Runny/stuffy nose

• Headache

• Body aches

• Tiredness

Contact your healthcare provider at the first sign of flu symptoms. This will help ensure you can receive a prescription for Tamiflu as soon as possible. 

Tamiflu is also recommended to prevent the flu in certain pregnant women after exposure. This type of treatment is called post-exposure prophylaxis (PEP). If you’re pregnant and also have other medical conditions, or have been unable to get a flu vaccine, you likely qualify for Tamiflu PEP. Be sure to contact your healthcare provider if you’re pregnant and someone you’ve been in close contact with gets the flu — even if you don’t have symptoms. Your healthcare provider will help decide if Tamiflu prophylaxis is needed.

How Tamiflu works

Tamiflu is an antiviral neuraminidase inhibitor. Neuraminidase is an enzyme (protein) that allows the flu virus to copy itself. These copies spread throughout the body and make you sick. By blocking neuraminidase, Tamiflu prevents the flu virus from copying and spreading throughout your body — which makes you feel better faster.

Does Tamiflu cross the placenta?

Yes, Tamiflu does cross the placenta. This means that small levels of Tamiflu can be detected in the baby when the mother takes it. Even though these small amounts of Tamiflu cross to the baby, studies haven’t shown any risk of birth defects from it. In fact, Tamiflu is considered the first-choice antiviral medication for the flu during pregnancy because it has the most studies available to show it is safe and effective.

What is the dose of Tamiflu when you’re pregnant?

The standard treatment dosage of Tamiflu for adults is 75 mg orally twice daily for 5 days. This is the same as the dosage for adults who are not pregnant. In certain cases, the dose may need to be increased. Your healthcare provider will determine which dose is best for you.

The dose is different if you’re taking Tamiflu to prevent getting the flu after being exposed. In this case, the dosage is 75 mg orally once daily for 7 days. It’s important to note that in this case, taking Tamiflu lowers the risk of getting the flu, but does not prevent it completely. This protection also only lasts for the 7 days you are taking it. So if you develop any signs or symptoms of the flu during or after taking Tamiflu, you should contact your healthcare provider right away.

What are the side effects of Tamiflu?

The most common side effects of Tamiflu are nausea and vomiting. These side effects are not usually serious, but they may be bothersome. Some people also have nausea and vomiting when they have the flu. But these flu symptoms are usually more common in children.

You can take Tamiflu with or without food. But taking it with food may help prevent nausea. If you vomit after taking Tamiflu, contact your healthcare provider about next steps. The need for an extra dose of Tamiflu depends on a number of different factors.

Other more serious side effects of Tamiflu happen less than 1% of the time. These include severe skin reactions, shortness of breath, and severe or bloody diarrhea. If you develop symptoms of a serious side effect contact your healthcare provider right away.

Quiz: Test your knowledge about Tamiflu

What other medication can you take with Tamiflu for flu symptoms when pregnant?

Depending on your symptoms, you may decide to take other over-the-counter (OTC) medications to lessen your flu symptoms. They won't treat the flu, but it may make the symptoms more bearable. And you can take them while you’re taking Tamiflu. But which ones are safest during pregnancy? 

Generally, it’s best to try non-medicated options to treat flu symptoms when pregnant. This is especially true during the first trimester. Humidifiers/vaporizers, saline nasal spray, and non-medicated throat lozenges can all help manage flu symptoms. Hydration is also extremely important.

If your symptoms are more severe, OTC medications may be considered. But only certain OTC cough and cold medications are safe to use during pregnancy. Some examples include:

• Acetaminophen (Tylenol) for fever and aches/pains (including sore throat)

• Chlorpheniramine (an antihistamine) for runny nose and cough from post-nasal drip

• Fluticasone (Flonase) nasal spray for nasal congestion or runny nose

These OTC medications may not always be the best option when pregnant. And sometimes, other OTC medications may be recommended. It’s best to always speak to your healthcare provider or pharmacist before taking any medications during pregnancy. This includes OTC medications. 

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Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She was a full-time clinical professor in the pharmacy practice department at D’Youville School of Pharmacy before subsequently joining the faculty of the pharmacy practice department at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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