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HWN Suggests

If you're healthy, Tamiflu probably won't help you

I had been reporting on the Tamiflu controversy for several years when the question of whether to take the drug became personal.

For those who haven’t been nerding out on this fascinating scientific saga, the short summary is this: Tamiflu, a pill, is one of two first-line drugs approved to both prevent and treat influenza. (The other is an inhaler, Relenza.) About a decade ago, these flu medicines came under attack, as researchers began to dig into the evidence behind them and reveal holes, inconsistencies, and missing data. The antivirals, they argued, didn’t seem to be as effective as health officials around the world (and the manufacturers)…

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 Can our stockpiles of Tamiflu protect against a bird flu pandemic?

Oseltamivir has a controversial past. Governments around the world have spent billions of dollars to stockpile the drug since the early 2000s based on evidence that it reduced the risk of serious complications such as pneumonia for people with seasonal flu. But as revealed in The BMJ’s open data campaign, and by reporting by The Guardian and other outlets, scientists asserted that the drug’s manufacturer, Roche, had withheld unfavorable data. Evidence of the drug’s benefit, they say, hinged on cherry-picked, mostly unpublished trials funded by Roche.

 Tamiflu and Relenza: getting the full evidence picture

The review confirms small benefits on symptom relief, namely shortening duration of symptoms by half a day on average. However, there is little evidence to support any belief that use of NIs reduces hospital admission or the risk of developing confirmed pneumonia. The evidence also suggests that there are insufficient grounds to support the use of NIs in preventing the person-to-person spread of influenza.

 Tamiflu as a treatment for influenza

In April 2014, the Cochrane review on neuraminidase inhibitors was published alongside BMJ summary reviews. The review found that while Oseltamivir and zanamivir have small, non‐specific effects on reducing the time to alleviation of influenza symptoms, oseltamivir increases the risk of adverse effects, such as nausea, vomiting, psychiatric effects and renal events in adults and vomiting in children, and both drugs do not reduce the important outcomes such as pneumonia and hospitalisations.

 What the Tamiflu saga tells us about drug trials and big pharma

We now know the government's Tamiflu stockpile wouldn't have done us much good in the event of a flu epidemic. But the secrecy surrounding clinical trials means there's a lot we don't know about other medicines we take.

Articles of Interest

'Tamiflu Is No Better Than Tylenol'

Analysis of clinical trial data released by the manufacturers, Roche and GlaxoSmithKline, after a five year battle to keep them secret, reveal that it cuts the duration of flu symptoms by just a single day. The analysis by the Cochrane Acute Respiratory Infections Group, led by Dr Tom Jefferson, also warned that oseltamivir, the active ingredient in both medicines, causes nausea and vomiting and increases the risk of headaches and renal and psychiatric syndromes.

Does Tamiflu work and what are the side effects?

As an individual and as a member of a human herd, I will continue to get yearly flu vaccines and nudge my dear ones to do the same. If I wake up feeling like I got hit by a truck and then nanobots have attacked my mucous membranes with sandpaper I will probably take one of the anti-flu drugs (but maybe zanamivir since it is cheaper and probably won’t make me jump off a balcony). These are decisions, though, that individual patients should make after being fully informed of both effectiveness and potential side effects.

Effectiveness of Tamiflu and Relenza questioned

Most experts would agree that the modest benefits of Tamiflu and Relenza, as reported by the review, do not justify the increased adverse risks, let alone the money spent on them by the UK.

Hallucinations After Taking Tamiflu: How Much Is Real Versus Not Real?

Whoa, Morpheus. Can Tamiflu (otherwise known as oseltamivir) really affect your perception of reality that much? Tamiflu is a neuraminidase inhibitor, a class of drugs that can inhibit the reproduction of the influenza virus and thus, when taken early enough, may possibly potentially reduce the severity of flu symptoms. (Possibly potentially because there is still debate on how effective neuraminidase inhibitors such as Tamiflu and Relenza really are.)

The Truth About Tamiflu

There are a couple of take-home messages here. One is pretty obvious: Tamiflu may not be doing much good for patients with the flu who take it, and it might be causing harm. The more important issue, however, involves the need for trust in science and medicine.

When Is Tamiflu Worth Taking?

“Medications like antivirals aren’t always the answer,” he says. “They’re an answer in a specific time duration,” and for certain people, but they’re not a magic, flu-dissipating bullet—and whether they’re right for you depends on your own unique circumstances.

Armed With New Data, Researchers Again Challenge Effectiveness of Antiflu Drug

Tamiflu can make flu symptoms disappear a little sooner than they would otherwise, the authors say, but there is no evidence that it can prevent serious complications from flu, or keep people out of the hospital.

Big Pharma Plays Hide-the-Ball With Data

What Cochrane uncovered was more than 70 Tamiflu trials and well over 100,000 pages of unpublished reports. Among them were many trials where the results were negative or inconclusive.

Controversies in medicine: the rise and fall of the challenge to Tamiflu

One of the biggest recent controversies in medicine involves the effectiveness – or otherwise – of the antiviral drug Tamiflu. Governments around the world have stockpiled the drug for use in severe influenza pandemics, but many have raised doubts about its effectiveness.

Don't give Tamiflu or Relenza to under-12s, warn researchers

Government stresses 'safety first' approach for severe symptoms.

Is the Neuraminidase Inhibitor Tamiflu Effective in the Treatment of Influenza?

Influenza is a disease that has caused the deaths of tens of millions people in the last century alone. The influenza neuraminidase protein is essential in the mechanism infection. It enables the virus to leave the infected cell and proliferate. Antiviral neuraminidase inhibitor drugs can be used for treatment. The drug Tamiflu is the standard of care for both treatment and prophylaxis of influenza. The Cochrane reports of 2009 and 2014 conclude that evidence is lacking to support this. Numerous bodies disagree. Cochrane also question the accuracy and credibility of many studies and agencies in support of Tamiflu.

Should you take an antiviral drug when you get the flu?

You might be a candidate for an antiviral if you have a positive lab test for influenza and if you are at a higher risk for flu complications because you are age 65 or older; you have a chronic illness such as heart, lung, or kidney disease; or you have a compromised immune system.

Study Questions Tamiflu's Effectiveness Against Pandemics

Evidence from the trials reviewed showed Tamiflu and Relenza alleviated flulike symptoms in adults about half a day faster than in those taking a placebo. Using either drug as a preventative medicine also reduced the risk of developing symptomatic flu. But there was insufficient evidence that Tamiflu stopped people with the flu virus from spreading it; no evidence that Tamiflu reduced hospitalizations; and no evidence that either drug reduced complications like pneumonia, inflammation of the sinuses or middle-ear infections in adults, the report found.

Tamiflu and Relenza for treatment and prevention of influenza

The Cochrane Collaboration published an evidence review of Tamiflu (the antiviral drug oseltamivir) and Relenza (zanamivir) trials, reporting that Tamiflu shortens symptoms of influenza but other claims made for the drugs were not well supported by evidence from clinical study reports.

Tamiflu For All? Evidence Of Morbidity In CDC’s Antiviral Guidelines

While CDC states that oseltamivir can prevent serious complications and even death, by contrast, potential harms are not consistently highlighted alongside promotions of the drug...

Tamiflu helps, newest study in long-running debate says

Others suggest that the new report doesn’t change much about our understanding of Tamiflu, though they praise Roche for supporting it and agree with its finding that the drug reduces hospitalizations.

Tamiflu is stockpiled globally as a defence against pandemic influenza … but does it work?

We’re still not sure Tamiflu is effective for the complications of influenza. It looks to us as if it is reasonably effective at reducing symptoms – a little bit – but that in itself isn’t reason enough to have nations around the world stockpile billions of dollars worth of the drug as had happened. In terms of its effectiveness in reducing symptoms, when you start thinking of a disease that gets better by itself, the difference between being less ill (“cured”) and feeling less ill is theoretical.

Tamiflu Made My Kid Hallucinate. I Think the Flu is Preferable to Delirium

It turns out that hallucinations, odd behavior and nightmares aren’t unusual for kids taking Tamiflu. “Reports of neuropsychiatric adverse events were the category most frequently reported in pediatric patients,” wrote FDA spokeswoman Stephanie Yao in an email.

Tamiflu's Widespread Use, Effectiveness Is Questioned

In a study that drew criticism from some health officials and the drug maker Roche Holding AG, a group of researchers has concluded that Tamiflu and similar antiviral drugs shouldn't be used widely during the regular flu season because they aren't likely to help many patients with flu-like symptoms. The authors also said they found no "credible evidence" that Tamiflu works against avian flu.

Tamiflu: Millions wasted on flu drug, claims major report

Hundreds of millions of pounds may have been wasted on a drug for flu that works no better than paracetamol, a landmark analysis has said.

Tamiflu: Myth and Misconception

In its ads to physicians, the company claimed that Tamiflu cuts hospital admissions by 61 percent and reduces complications such as bronchitis, pneumonia, and sinusitis by 67 percent. In at least one press release, the company even claimed that the drug reduces flu deaths. The drug does none of the above.

The Tamiflu Spin

The specific complaint at issue is whether or not oseltamivir prevents secondary complications of influenza like hospitalization and pneumonia. Although you wouldn’t guess that was at issue from the reporting.

The Top 4 Flu Treatments That Do Not Work (And 2 That Do)

Flu season is upon us, and your local pharmacy may feature special displays with products claiming to cure or treat the flu (which is caused by the influenza virus). The array of products, and the claims featured on their packaging, can be bewildering. Which of them should you buy? Here is a quick guide. (Spoiler: if you want to know what really works, skip to the end.)

To Tamiflu or Not to Tamiflu?

If you have the flu, there are several prescription medications available including: oral oseltamivir (Tamiflu), inhaled zanamivir (Relenza), or the intravenous drug peramivir (Rapivab). However, studies show that these medications only help you recover one day faster from the flu. Rather than going to the doctor’s office to get examined and get a prescription, you might prefer to stay home and rest and drink plenty of fluids. Over the counter (OTC) medications don’t cure the flu but they can help you feel better by treating symptoms such as aches, coughs, and sore throats.

What the Tamiflu saga tells us about drug trials and big pharma

We now know the government's Tamiflu stockpile wouldn't have done us much good in the event of a flu epidemic. But the secrecy surrounding clinical trials means there's a lot we don't know about other medicines we take.

You Asked: Can Tamiflu prevent the flu?

Tamiflu is not without its drawbacks, but it may be the difference between a relatively mild illness and a trip to the hospital for some

Resources

Tamiflu (Oseltamivir)

Tamiflu (oseltamivir) works well to treat the flu, but you have to take your first dose within 48 hours of the start of your flu symptoms. It can also help prevent the flu if you've recently been in close contact with someone who has the flu. Kids as young as 2 weeks old can take Tamiflu (oseltamivir), but keep in mind that the pediatric dosing is different than adult dosing. It's only available with a prescription (not available over the counter), so don't wait to see your provider if you start feeling sick. This medication comes as a brand or generic capsule or fruit-flavored liquid. Tamiflu (oseltamivir) can cause side effects like nausea and vomiting.

MedlinePlus

You should know that people, especially children and teenagers, who have the flu may become confused, agitated, or anxious, and may behave strangely, have seizures or hallucinate (see things or hear voices that do not exist), or harm or kill themselves. You or your child may develop these symptoms whether or not you or your child uses oseltamivir, and the symptoms may begin shortly after starting treatment if you do use the medication.