Along with its needed effects, oseltamivir (the active ingredient contained in Tamiflu) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
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General
The most common side effects are nausea and vomiting.
The most common side effects reported in patients receiving oseltamivir (the active ingredient contained in Tamiflu) during studies for the treatment of influenza were nausea, vomiting, bronchitis, insomnia, and vertigo. Nausea and vomiting were generally mild to moderate in severity and usually occurred on the first 2 days of treatment. Less than 1% of patients discontinued oseltamivir early due to nausea and vomiting.
Side effects in prophylaxis studies were similar to those in treatment studies. Side effects that occurred more frequently than in treatment studies were aches and pains, rhinorrhea, dyspepsia, and upper respiratory tract infections.
Gastrointestinal
Gastrointestinal side effects have been the most commonly reported and have included nausea (without vomiting;
up to 10%), vomiting (
up to 9%), diarrhea (up to 7%), abdominal pain (2%), and pseudomembranous colitis (less than 1%). Gastrointestinal bleeding and hemorrhagic colitis have been reported during postmarketing experience.
Respiratory
Respiratory side effects have included cough (up to 5%) and bronchitis (up to 2%). The incidences were similar or higher among placebo patients and may represent symptoms of underlying influenza infection. Pneumonia has been reported (less than 1%) and may also be a symptom of underlying disease. Nasopharyngitis, congestion, rhinitis, and dry, sore throat have also been reported.
Nervous system
Nervous system side effects have included headache (
up to 18%), dizziness (up to 2%), insomnia (1%), and vertigo (up to 1%). The incidences were similar or higher among placebo patients and may represent symptoms of underlying influenza infection. Seizure has been reported during postmarketing experience.
Psychiatric
Psychiatric side effects have included abnormal behavior and delirium (including symptoms such as altered level of consciousness, confusion, delusions, hallucinations, agitation, anxiety, nightmares) during postmarketing experience. Mania has been reported.
Delirium and abnormal behavior leading to injury, with fatal outcomes in some cases, in influenza patients receiving oseltamivir have been reported during postmarketing experience (mostly in Japan). Although frequency is unknown, based on oseltamivir usage, these events appear to be uncommon. These events were primarily reported in pediatric patients and often had an abrupt onset and rapid resolution. Since influenza may be associated with a variety of neurologic and behavioral symptoms (including hallucinations, delirium, and abnormal behavior, with fatal outcomes in some cases) and may occur with encephalitis or encephalopathy but can occur without obvious severe disease, oseltamivir's contribution to these effects has not been established.
Other
Other side effects have included fatigue (
up to 8%), humerus fracture (less than 1%), pyrexia (less than 1%), and peritonsillar abscess (less than 1%). Drowsiness and malaise have been reported; however, causality has not been established. Hypothermia has been reported during postmarketing experience.
Hematologic
Hematologic side effects have included anemia (less than 1%). Pancytopenia has been reported; however, causality has not been established.
Hypersensitivity
Hypersensitivity side effects have included allergy, anaphylactic/anaphylactoid reactions, and swelling of the face or tongue during postmarketing experience.
Dermatologic
Dermatologic side effects have included rash, dermatitis, urticaria, eczema, and serious skin reactions (including toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme) during postmarketing experience.
Hepatic
Hepatic side effects have included hepatitis and abnormal liver function tests during postmarketing experience. Hepatic failure has been reported; however, causality has not been established.
Cardiovascular
Cardiovascular side effects have included unstable angina (less than 1%). Sudden cardiopulmonary arrest has been reported; however, causality has not been established. Arrhythmia has been reported during postmarketing experience.
Metabolic
Metabolic side effects have included aggravation of diabetes during postmarketing experience. Hyperglycemia has been reported; however, causality has not been established.
Immunologic
Immunologic side effects have included sepsis; however, causality has not been established.
Musculoskeletal
Musculoskeletal side effects have included arthralgia in at least one patient.
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