Influenza has hit the United States particularly hard this winter. Centers for Disease Control and Prevention It is estimated that 15 million people have become ill and 180,000 people have been hospitalized so far this season.
But antiviral drugs such as Tamiflu remain an effective weapon in shortening the duration of symptoms in people with seasonal influenza, even as a variant known as subclade K increases cases across the United States.
“There is nothing about this (variant) that affects the activity of antiviral drugs,” he said. Brandon DionneClinical Associate Professor of Pharmacy and Health Systems Sciences at Northeastern University.
Experts say the key is to take the medication as soon as possible. And for that you need to get a prescription.
Typical Tamiflu
Tamiflu, whose generic name is oseltamivir, is a readily available oral treatment that is typically prescribed twice a day for five days, Dionne said. “That’s the go-to for most people.”
Tamiflu works against both influenza A and influenza B by inhibiting the neuraminidase enzyme (the “N” in influenza viruses such as H1N1 and H3N2), which releases new virus particles from host cell membranes, Dionne said.
“Oseltamivir binds directly to neuraminidase, inhibiting it rather than preventing production of the enzyme,” he said.
The drug shortens the duration of flu symptoms by about 12 to 24 hours on average, Dionne said, and could provide significant relief for people suffering from body aches, chills, fever, cough and nausea.
Other options include Xofluza, or baloxavir marboxil, which is expensive because it’s still on patent, is more likely to develop resistance than Tamiflu, and is a one-time oral dose, Dionne said.
The American College of Obstetricians and Gynecologists said the following about Xofluza: Not recommended For pregnant people “as efficacy and safety data do not exist in this population.”
Importantly, antiviral flu drugs must be taken quickly, within 48 hours of flu symptoms to be effective, Dionne said. “The sooner you take it, the more effective it is.”
Receiving a prescription
Because influenza antivirals are prescription drugs, getting tested in a timely manner is the first challenge for people seeking relief from flu symptoms.
Dionne said more states are now allowing pharmacists to “test and treat.” “If you get tested for influenza and get a positive result, you can be prescribed oseltamivir.”
States participating in testing and treatment include California, Colorado, Idaho, Illinois, Michigan, Minnesota, Montana, Nebraska, South Dakota, Tennessee, Washington, Wisconsin and Wyoming, CVS spokeswoman Roslyn Guarino said.
“Additionally, MinuteClinic offers symptomatic patient visits, where patients can be tested for influenza, COVID-19 and strep throat if eligible,” Guarino said. He said CVS has seen an increase in demand for Tamiflu and other flu-related drugs, but “there is not a widespread shortage.”
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Influenza test you can do at home
Some people use at-home flu tests to determine whether antiviral drugs are needed, but the cost typically ranges from $12 to $30.
A short-lived federal program called Test2Treat that offered free COVID-19 and influenza testing is no longer available, but people can still purchase a 3-in-1 test for COVID-19 and influenza A and B at pharmacies or online.
Dionne said the tests can be covered through flexible spending or health savings accounts, but typically come in two-packs. He said a second test may be needed if the influenza virus load is too low to be detected in the first test.
Dionne said some at-home tests also check for respiratory syncytial virus. “This makes sense because these symptoms overlap. Even if your flu test is negative, you could still be infected with COVID-19 or RSV.”
People who test positive for the flu can share that information with their health care provider or telehealth provider to get a prescription for antiviral treatment.
Antiviral drugs for the most vulnerable people
“Tamiflu is most important for patients who are at highest risk.” Jason ParenteClinical Professor and Program Director of the Physician Assistant Program in the School of Health Medicine at Northeastern University Bouvet College of Health Sciences.
of Recommended by CDC Prompt treatment with antiviral drugs should be given to people who have influenza or suspected influenza and who are at high risk for serious complications, such as pregnant women and people with asthma, chronic lung disease, diabetes, or heart disease.
Parente said Tamiflu could also be used as a preventive measure for certain populations exposed to the flu, such as nursing home residents.
jason lancasterThe dean of Northeastern University’s College of Pharmacy and Health Systems Sciences said there is strong evidence that prophylactic use of oseltamivir prevents influenza.
“One meta-analysis demonstrated up to a 55% reduction in progression to symptomatic influenza,” he said.
The CDC also recommends antiviral treatment for people who are hospitalized with the flu or who are seriously ill with the flu. The antiviral drug peramivir, also known as rapivab, is given through an intravenous drip and is helpful for people who cannot swallow, while zanamivir, also known as Relenza, is given through an inhaler and is not recommended for asthma patients.
There’s still time for vaccinations
The increase in influenza activity will continue for several weeks, according to the CDC. Health experts in the Northeast say it’s not too late to get vaccinated.
Although this year’s vaccines are less compatible with the main variants currently circulating, it is possible that vaccination could reduce the severity of symptoms.
Lancaster said that in addition to vaccination, prevention includes proper hand washing, covering your mouth and nose when coughing or sneezing, wearing a mask if you have symptoms, and staying home if you are sick to minimize your contact with others.