Thread by @Drug_Evidence

THREAD: Tamiflu for #influenza prevention – the evidence

1/6 In 2019 21,000 BC citizens were prescribed Tamiflu (oseltamivir), many to prevent the flu. Flu prevention guidelines. AMMI Canada ammi.ca/?ID=171

Systematic review of Tamiflu safety: pubmed.ncbi.nlm.nih.gov/27246259/

2/6 Tamiflu for prevention ↘️ symptomatic flu (by 3%, NNT=33) with uncertain effect on asymptomatic flu.

One likely explanation is that Tamiflu has a central symptom lowering effect but may not ↘️ viral transmission.
pubmed.ncbi.nlm.nih.gov/27246259

#influenza #flu #tamiflu

3/6 Tamiflu doesn't reduce risk of developing flu-like illness though it can make people feel better (i.e. fewer self-reported symptoms) & reduces fever.

There is not enough evidence to say it prevents death, hospitalizations, or flu complications
pubmed.ncbi.nlm.nih.gov/27246259/

4/6 Tamiflu ↗️ risk of harm when used for flu prevention

It ↗️ the risk of nausea & headache (Number Needed to Harm about 20-25). Increased psychiatric harms (NNH 94) include confusion, depression, aggression. pubmed.ncbi.nlm.nih.gov/27246259/

#influenza #medsafety #ptsafety

5/6 Tamiflu product monograph: “Patients with influenza should be closely monitored for signs of abnormal behaviour.”

If a patient develops psychiatric harm, ask whether it started soon after taking Tamiflu
rochecanada.com/PMs/Tamiflu/Ta…

#medsafety #ptsafety #tamiflu

6/6 Tamiflu presentation by @AMTejani:

A safety net with many holes: Oseltamivir and influenza prophylaxis tinyurl.com/y25mobwo

#medsafety #ptsafety #prescribing #influenza

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