Dosing: Adult Influenza prophylaxis: Oral: 75 mg once daily; initiate prophylaxis within 48 hours of contact with an infected individual; duration of prophylaxis: 10 days. During community outbreaks, duration of protection lasts for length of dosing period; safety and efficacy have been demonstrated for use up to 6 weeks in immunocompetent patients and safety has been demonstrated for use up to 12 weeks in patients who are immunocompromised.
Prophylaxis (institutional outbreak, CDC 2011 recommendations): Continue for ≥2 weeks and until ~10 days after identification of illness onset in the last patient
Influenza treatment:Treatment of influenza: Oral: 75 mg twice daily initiated within 48 hours of onset of symptoms; duration of treatment: 5 days
Note: Hospitalized patients with severe influenza infection may require longer (eg, ≥10 days) treatment courses. Some experts also recommend empirically doubling the treatment dose. Initiate as early as possible in any hospitalized patient with suspected/confirmed influenza (CDC, 2011); may be administered via naso- or orogastric tube in mechanically-ventilated patients (Taylor, 2008).
Dosing: PediatricInfluenza prophylaxis: Oral: Initiate prophylaxis within 48 hours of contact with an infected individual; duration of prophylaxis: 10 days:
Prophylaxis (institutional outbreak, CDC 2011 recommendations): Continue for ≥2 weeks and until ~10 days after identification of illness onset in the last patient
Children <1 year (unlabeled dosing, CDC 2011): Note: Prophylaxis is not recommended for infants <3 months of age unless clinically critical; weight-based dosing recommendations are not intended for premature neonates:
<12 months: 3 mg/kg/dose once daily
Alternate dosing based on age (use only if weight not available) (unlabeled dosing; AAP, 2010): 3-5 months: 20 mg once daily
6-11 months: 25 mg once daily
Children: 1-12 years: During community outbreaks, prophylaxis may be used for up to 6 weeks.
≤15 kg: 30 mg once daily
>15 kg to ≤23 kg: 45 mg once daily
>23 kg to ≤40 kg: 60 mg once daily
>40 kg: 75 mg once daily
Adolescents ≥13 years: Refer to adult dosing.
Influenza treatment: Oral: Initiate treatment within 48 hours of contact with an infected individual; duration of treatment: 5 days
Note: Hospitalized patients with severe influenza infection may require longer (eg, ≥10 days) treatment courses. Some experts also recommend empirically doubling the treatment dose. Doubling the dose in adult outpatients was not associated with increased adverse events. As no double dose studies have been published in children, use caution. Initiate as early as possible in any hospitalized patient with suspected/confirmed influenza (CDC, 2011); may be administered via naso- or orogastric tube in mechanically-ventilated patients (Taylor, 2008).
Treatment of influenza:
Children <1 year (unlabeled dosing, CDC 2011):
Note: Weight-based dosing recommendations are not intended for premature neonates:
<12 months: 3 mg/kg/dose twice daily
Alternate dosing based on age (use only if weight not available) (unlabeled dosing; AAP, 2010):<3 months: 12 mg twice daily
3-5 months: 20 mg twice daily
6-11 months: 25 mg twice daily
Children: 1-12 years:
≤15 kg: 30 mg twice daily
>15 kg to ≤23 kg: 45 mg twice daily
>23 kg to ≤40 kg: 60 mg twice daily
>40 kg: 75 mg twice daily
Adolescents ≥13 years: Refer to adult dosing.
Dosing: Geriatric Refer to adult dosing.
Dosing: Renal Impairment Clcr 10-30 mL/minute: Adults:
Treatment: Reduce dose to 75 mg once daily for 5 days
High-dose treatment (unlabeled [eg, severely-ill hospitalized patients with 2009 H1N1 influenza]): Currently no data are available; consider 150 mg once daily
Prophylaxis: Administer 75 mg every other day or 30 mg once daily.
CAPD (unlabeled dose): Adults: 30 mg once weekly (Robson, 2006)
Hemodialysis:
Children >1 year (unlabeled dose; Schreuder, 2010):
≤15 kg: 7.5 mg after each hemodialysis session
>15 kg to ≤23 kg: 10 mg after each hemodialysis session
>23 kg to ≤40 kg: 15 mg after each hemodialysis session
>40 kg: 30 mg after each hemodialysis session
Adults (unlabeled dose; Robson, 2006): 30 mg after every other session
Dosing: Hepatic Impairment Mild-to-moderate impairment: No adjustment necessary
Severe impairment: Pharmacokinetics and safety have not been evaluated.