Antivirals for Flu Season!

Julie Weber Trending Topics

The weather is getting colder, leaves are falling, and the days are getting shorter. The fall season is here and for many that means it’s time to head to the pharmacy or doctor’s office for their annual flu vaccine. The CDC recommends that everyone get their flu shot, it is especially important this year due to the COVID-19 pandemic. But whether or not you have received your flu shot, it is important to be educated on what the flu is, how it affects you, and what treatment is available. The Missouri Poison Center is here to make sure this flu season you and your family stay protected and informed!

WHAT IS THE FLU?

The flu or influenza is caused by influenza viruses that can infect the nose, throat, and lungs. Influenza viruses can circulate all year but are typically most active during “flu season” that peaks around December to February and can continue as late as May. Like most viruses, influenza is contagious, especially within the first 3-4 days after their illness begins. The virus spreads to others up to 6 feet away mainly through droplets produced when people cough, sneeze, or talk. Although less likely, the flu can also spread by touching infected surfaces and then touching your own mouth, nose, or eyes. Children younger than 18 years old are most likely to get sick from the virus, but there are still thousands of infections that happen in people of any age every year. Everyone should take the right precautions, no matter their age. It is also important to remember that while getting an influenza vaccine is the BEST protection against contracting the flu, it is not a guarantee.

WHAT ARE THE SYMPTOMS?

Symptoms generally start two days after exposure and last for about 5-7 days. In some cases, a few symptoms (e.g., cough) may take up to two weeks or longer to resolve. Symptoms can range from mild to severe, or even lead to death. Common symptoms include:

  • Cough 
  • Possible Fever 
  • Sore throat
  • Runny or stuffy nose 
  • Fatigue 
  • Headaches 
  • Vomiting
  • Diarrhea 

The flu may also cause complications such as sinus or ear infections, bacterial pneumonia, or worsen chronic medical conditions. Follow up with your physician if symptoms persist or become severe.

HOW CAN I PREVENT GETTING AND SPREADING THE FLU?

An annual Influenza vaccination is highly recommended as the most effective way to prevent getting the flu. To reduce the spread, avoid close contact with others if you are sick and limit contact with those who are sick. Cover your cough or sneeze with a tissue and throw it away after using. Wash your hands with soap and water often, avoid touching your eyes, nose, and mouth, and disinfect surfaces or objects that may be contaminated with germs.

WHAT SHOULD I DO IF I GET THE FLU?

If you get the flu, stay home and avoid contact with others. If your condition starts to worsen beyond minor symptoms, seek medical attention. High risk patients are at a greater risk of developing serious complications from the flu. This includes patients over the age of 65, young children, cancer patients, pregnant woman, and patients with chronic health conditions.  Typically, these patients should receive antiviral therapy as soon as possible once infected with the flu. Your physician will help determine if you need an antiviral medication. Antivirals may be prescribed for treatment or prevention of the flu after an exposure, depending on the type (see below).

WHAT ARE ANTIVIRALS?

Antivirals are exactly what they sound like! They are medications that work against a virus. They are different from antibiotics, which only treat bacterial infections. You CANNOT treat a viral infection with an antibiotic. Influenza antivirals are specifically used to either prevent or treat influenza (or sometimes both!). Antivirals work by reducing the duration of flu symptoms by 24-48 hours and prevent further complications. At this time, there are four FDA approved antivirals for influenza.

The information in the table below may vary based on individual patient risk and medical history. For more information on the flu or the antiviral medications, check out the CDC website here.

WHAT AGE IS IT USED FOR? WHAT IS THE USUAL DOSE AND LENGTH OF THERAPY? ARE THERE ANY SIDE EFFECTS?
Oseltamivir phosphate (Tamiflu®)
Oral capsule & solution
Treatment: All Ages

Prevention: 1 year & older

Treatment: 75mg twice daily for 5 days

  • Considered longer duration in patients that are severely ill or those with compromised immune systems.

Prevention: 75mg once daily

  • Continue for one-week post exposure if previously vaccinated; or two weeks if unvaccinated (administer vaccine).
  • Diarrhea, nausea, vomiting
  • Headache
  • Rare reports of serious skin reactions and abnormal or unusual behavior
Zanamivir (Relenza®)
Aerosol powder for inhalation

Treatment: 7 years & older

Prevention: 5 years & older

Treatment: Two inhalations (10 mg) twice daily for 5 days.

  • A longer duration can be considered in severely ill or immunocompromised patients.

Prevention: Two inhalations once daily for 7 days after last known exposure.

  • Diarrhea, nausea, vomiting
  • Stuffy nose, sore throat
  • Headache
  • Constriction of the airways in the lungs
Baloxavir marboxil (Xofluza®)
Oral tablet

Treatment: 12 years & older

Not used for prevention

Varies based on weight: 40 mg or 80 mg as a single dose within 48 hours of onset of symptoms.

  • Diarrhea, nausea
  • Common cold symptoms
  • Throat irritation
  • Headache
Peramivir (Rapivab®)
IV Solution

Treatment: 2 years & older

Not used for prevention

IV ONLY

600mg as a single dose within 48 hours of onset of symptoms. May be dosed daily for 5-10 days in hospitalized, high-risk individuals.

  • Diarrhea, constipation, vomiting
  • Rare reports of confusion, behavioral changes, tremors, and seizures

For any questions or concerns you may have about the flu vaccine or antivirals, call the Poison Help line at 1-800-222-1222. Specially trained nurses and pharmacists are available 24/7/365 to answer your questions. The service is free and confidential.

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