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Tamiflu Dosing Reminder

Tamiflu (Oseltamivir) Dosing Reminder

Reminder per UMC Medication Management Team, Clinical IT

Upon review of the EHR dose-range checking alerts, there are still a significant amount of alerts firing in the EHR surrounding dose-range checking for Oseltamivir:

Per manufacturer and pharmacy recommendations, Tamiflu should be adjusted for renal impairment.

Flu Season is upon us and with so many providers prescribing Tamiflu, it is important to remember that this drug needs to be renally dosed.

Influenza Treatment

  •  Adults with renal impairment (Moderate, CrCl greater than 30 up to 60 mL/min): 30 mg orally twice daily for 5 days
  • Adults with renal impairment (Severe, CrCl greater than 10 up to 30 mL/min): 30 mg orally once daily for 5 days
  • Adults with ESRD on hemodialysis (CrCl 10 mL/min or less): 30 mg orally immediately, then 30 mg after every hemodialysis cycle; treatment duration not to exceed 5 days from the time of the initial dose 
  • Adults with ESRD on continuous ambulatory peritoneal dialysis (CrCl 10 mL/min or less): Single 30-mg oral dose immediately 
  • Adults with ESRD not on dialysis, influenza treatment: Use not recommended

Influenza Prophylaxis

  • Adults with renal impairment (Moderate, CrCl greater than 30 up to 60 mL/min): 30 mg orally once daily 
  • Adults with renal impairment (Severe, CrCl greater than 10 up to 30 mL/min): 30 mg orally every other day
  • Adults with ESRD on hemodialysis (CrCl 10 mL/min or less): 30 mg orally immediately, then 30 mg after alternate hemodialysis cycles 
  • Adults with ESRD on continuous ambulatory peritoneal dialysis (CrCl 10 mL/min or less): 30 mg orally immediately, then 30 once weekly 
  • Adults with ESRD not on dialysis, influenza prophylaxis: Use not recommended
Source: Micromedex
(Disclaimer: These are recommendations set forth by Micromedex and the manufacturers of Oseltamivir only; double check and use clinical judgment as it applies)