3 Reasons To Avoid Tamiflu And 1 Compelling Reason When It Could Work

Tamiflu has been the rage for many years. The CDC recommends it in a number of situations and doctors prescribe it very often for patients who present with flu-like symptoms.

A number of articles make statements encouraging you to see your doctor if you have symptoms of the flu, because there could be a medication that can help. Unfortunately, most people don’t really know the truth about Tamiflu.

Personally, I think Tamiflu is misused and given out too freely for most people who actually have the flu – and for many that don’t. It has some side effects like nausea, vomiting, and even nose bleeds that are unnecessary if the drug doesn’t offer great benefit in the first place.

And there is even evidence supporting the fact that it does not significantly decrease the amount of time you are sick. This evidence comes from a Cochrane review, considered by many to be the best evidence available regarding the topic. Even the World Health Organization (WHO) recently downgraded Tamiflu because it has not been found to be effective.

How does Tamiflu work? Theoretically, Tamiflu should stop a virus from reproducing because the drug blocks the virus from leaving a cell. If it cannot leave the cell, then it cannot enter other cells to make more virus. And if the virus cannot make more virus, then it should decrease the length of the illness by allowing our own immune systems to fight off influenza. But timing is everything as you will learn as you continue to read.

3 Reasons To Avoid Tamiflu

#1 – It does not greatly decrease the length of the illness

Ideally, Tamiflu should be given within 48 hours of the onset of symptoms. Even if started within this time period, the evidence shows that symptoms will only resolve 16.8 hours earlier. That’s 16.8 hours earlier for a virus that lasts 1-2 weeks. That’s really not very much time saved.

If I’m going to take a medication, I want something that’s going to make me better quickly. Tamiflu is not your drug of choice based on these studies – especially with the added side effects like nausea and vomiting.

#2 – It does not decrease complications

What’s more? Taking Tamiflu did not show any decrease in complications that can arise from influenza, like pneumonia.

So if it doesn’t help decrease the course of the virus and it doesn’t stop other complications, why take it?

Well, in the very young, elderly, or those that have other serious conditions, the CDC recommends taking Tamiflu in the slight chance that it CAN prevent any of the complications. Basically the CDC thinks the benefits of taking the medication may outweigh the risks of side effects. These conditions include:

• Those with worsening or prolonged illness, or those who develop pneumonia
• Children younger than 2 and adults older than 65
• American Indians/Alaska natives
• Pregnant women or within 2 weeks of giving birth
• People with lower immune systems
• Obesity (BMI 40 and above)
• Patients living in long-term care facilities like nursing homes
• Patients younger than 19 on long-term aspirin therapy
• Patients with chronic disease including lung, heart, or neurological conditions

For others without any of the criteria above, Tamiflu is not indicated.

#3 – Tamiflu has many side effects

Why take a medication when it is unlikely to help, especially given the large amount of side effects. In my experience, nausea and vomiting is certainly the most common. But there are a number of others that can occur as well including:

• Diarrhea
• Dizziness
• Headache
• Nosebleed
• Eye redness or discomfort
• Sleep problems
• Cough or other respiratory symptoms
• Mood changes

So for the ordinary patient without the health conditions listed above, Tamiflu has the potential to cause marked discomfort without much benefit. That brings us to the last part of this article and perhaps THE reason you might consider taking the medication.

The Compelling Reason To Take Tamiflu

If you know you’ve been exposed to Influenza – and I mean a friend, colleague, or family member has had the flu (usually known because it was confirmed by a test) – then I believe starting Tamiflu early either as prophylaxis before symptoms start or early after symptoms start could be beneficial.

I have no evidence to support this claim and I’m certainly not trying to get more people to go to their doctor. But in my own anecdotal experience, I believe if you start Tamiflu immediately after symptoms start, it may help. When I say immediately, I mean within 12-24 hours after symptoms start or even earlier.

If you think about it, the earlier you stop viral replication, the less virus there is in the body, and the easier it is to fight off. I think that 48 hours is too long. By this time, the virus has fully replicated and you’re stuck with a high viral load in the body.

Even if you stop the virus from reproducing, there’s too much influenza in the system already, and it still takes the same amount of time to fight off.

There’s really no way to know whether you actually have the flu when it has only been 12 hours or less, and most people don’t make it into the doctor this quickly anyway. Why would they? They have no idea if it’s going to get worse and they’re probably right to stay home and wait it out. This is why many people present near or after the 48-hour mark and then Tamiflu certainly will not work.

So what’s the best choice? Should you see your doctor quickly after symptoms start or wait it out at home? If you go by the evidence, it’s unlikely that Tamiflu will help and it’s probably unlikely that a doctor is going to want to prescribe Tamiflu if you don’t look too sick, because how do they know whether you have the flu or not?

In my own practice, I follow the CDC guidelines above. If patients fall outside of the time window or do not meet criteria, then I generally do not prescribe Tamiflu. However, if the patient has been exposed to influenza, and presents early in their course, within 12-24 hours or less, then I’m very likely to prescribe Tamiflu.

So if you know others around you that have confirmed influenza and you can get to the doctor early, perhaps Tamiflu can be the super drug it was touted to be.

Have you had a good or bad experience with Tamiflu? Do you think it works if it is taken early in the course of the illness? Comment below.