Overview
11 DESCRIPTION Oseltamivir phosphate capsules, USP an influenza neuraminidase inhibitor (NAI), is available as: • Capsules containing 30 mg, 45 mg, or 75 mg oseltamivir for oral use, in the form of oseltamivir phosphate USP. In addition to the active ingredient, each capsule contains croscarmellose sodium, isopropyl alcohol, povidone, pregelatinised starch, sodium stearyl fumarate and talc.
Mechanism of Action
12 CLINICAL PHARMACOLOGY 12.1 Mechanism of Action Oseltamivir is an antiviral drug with activity against influenza virus [see Microbiology ( 12.4 )]. 12.3 Pharmacokinetics Absorption and Bioavailability Oseltamivir is absorbed from the gastrointestinal tract after oral administration of oseltamivir phosphate and is extensively converted predominantly by hepatic esterases to oseltamivir carboxylate. At least 75% of an oral dose reaches the systemic circulation as oseltamivir carboxylate and less than 5% of the oral dose reaches the systemic circulation as oseltamivir (see Table 6).
Indications
- 1 INDICATIONS & USAGE Oseltamivir phosphate capsules USP, is an influenza neuraminidase inhibitor (NAI) indicated for: • Treatment of acute, uncomplicated influenza A and B in patients 2 weeks of age and older who have been symptomatic for no more than 48 hours. ( 1.1 ) • Prophylaxis of influenza A and B in patients 1 year and older. ( 1.2 ) Limitations of Use: • Not a substitute for annual influenza vaccination. ( 1.3 ) • Consider available information on influenza drug susceptibility patterns and treatment effects when deciding whether to use. ( 1.
Common Doses
- 75 mg
- 3 mg
- 60 mL
- 30 mg
Dosage
2 DOSAGE & ADMINISTRATION Treatment of influenza ( 2.2 ) • Adults and adolescents (13 years and older): 75 mg twice daily for 5 days • Pediatric patients 1 to 12 years of age: Based on weight twice daily for 5 days • Pediatric patients 2 weeks to less than 1 year of age: 3mg/kg twice daily for 5 days • Renally impaired adult patients (creatinine clearance >30-60 mL/min): Reduce to 30 mg twice daily for 5 days ( 2.4 ) • Renally impaired adult patients (creatinine clearance >10-30 mL/min): Reduce to 30 mg once daily for 5 days ( 2.
Contraindications
- 4 CONTRAINDICATIONS Oseltamivir phosphate capsules are contraindicated in patients with known serious hypersensitivity to oseltamivir or any component of the product. Severe allergic reactions have included anaphylaxis and serious skin reactions including toxic epidermal necrolysis, Stevens-Johnson Syndrome, and erythema multiforme [see Warnings and Precautions ( 5.1 )] . Patients with known serious hypersensitivity to oseltamivir or any of the components of oseltamivir phosphate capsules ( 4 )
Side Effects
- 6 ADVERSE REACTIONS The following serious adverse reactions are discussed below and elsewhere in the labeling: • Serious skin and hypersensitivity reactions [ see Warnings and Precautions ( 5.1 ) ] • Neuropsychiatric events [ see Warnings and Precautions ( 5.2 ) ] Most common adverse reactions (>1% and more common than with placebo): • Treatment studies – Nausea, vomiting, headache. ( 6.1 ) • Prophylaxis studies – Nausea, vomiting, headache, pain. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Macleods Pharma USA, Inc. at 1-888-943-3210 or FDA at 1-800-FDA-1088 or www.fda.
Interactions
- 7 DRUG INTERACTIONS Live attenuated influenza vaccine (LAIV), intranasal: Avoid administration of LAIV within 2 weeks before or 48 hours after oseltamivir phosphate capsules use, unless medically indicated. ( 7 ) 7.1 Influenza Vaccines Live Attenuated Influenza Vaccine The concurrent use of oseltamivir phosphate capsules with live attenuated influenza vaccine (LAIV) intranasal has not been evaluated. However, because of the potential for oseltamivir phosphate capsules to inhibit replication of live vaccine virus and possibly reduce the efficacy of LAIV, avoid administration of LAIV within 2...