Bird Flu Treatment and Bangladesh

Use
· For Treatment -
In order for Oseltamivir to be effective as treatment for avian influenza infection, the medication must be administered as early as possible, within 48 hours of symptom onset.
· For Prophylaxis -
Chemoprophylaxis or prophylaxis is the administration of a drug to prevent disease from developing in someone who has been exposed but is not yet ill. Therapy should begin as soon as possible within 2 days of exposure or for those persons who will go for curling of chickens.

Oseltamivir Oral Formulations
· Capsules 75 mg each
– 10 capsules per box
– Manufacturer: Roche/Beximco/Eskayef
– Brand name—Tamiflu®/Ossiflu®/SKflu®
– Store at room temperature (15 - 300C)

· Liquid Suspension ( not available in Bangladesh yet)
– White powder mixed with 23 mL of drinking water
– Fruit flavored
– Refrigeration required
– Use within 10 daysOral dispenser included

Oseltamivir Treatment Regimen
• Adults: 75 mg two times a day for 5 days
• Not approved for children less than 1 year of age
• Children > 1 year old:
<15> 40 kg 75 mg twice daily

Oseltamivir Chemoprophylaxis Doses

Patient Age Prophylactic Dose
i) > 13 years 1 capsule (75 mg) once a day
ii) 1 to 12 years
<> 40 kg: 75 mg once a day
Duration of prophylaxis depends on epidemiologic setting. Post-exposure use is typically for 7 to 10 days.

Oseltamivir Side Effects
• Headache (20%)
• Nausea (10%)
• Vomiting (9%)
• Fatigue (8%)
• Diarrhea (7%)
• Cough (6%)
• Bronchitis, abdominal pain, dizziness (2%)
• Insomnia, vertigo (1%)

Contraindications & Precautions

• Pregnant or breastfeeding mothers

No recognized birth defects in pre-clinical testing

No human clinical studies demonstrating safety or efficacy

Use if benefit outweighs risk

• Liver diseases

Safety and efficacy not yet evaluated

• Kidney diseases

Decrease dose based on creatinine clearance