girl with cold, this year's flu, coming flu season, flu worse

The influenza epidemic that is sweeping North America has a lot of people freaked out. And with good reason. Headlines have reported “Killer flu.” There is a growing tally of deaths from this year’s influenza epidemic. First, we were told that children were vulnerable. More recently baby boomers were told that they, too, could succumb to the H3N2 virus. That got the attention of millions of people. Then we have been told that the vaccine is not all that effective. What’s left? Oseltamivir. This oral drug has been quite controversial. Some people have reported that Tamiflu did not work. Why not?

Q. You have written that Tamiflu can help people recover more quickly from influenza. I don’t think it works.

I came down with the flu and called my doctor’s office. It took a week for them to fit me into the schedule. The doctor did a test and confirmed I had influenza. He gave me a prescription for Tamiflu, but it didn’t do anything for me. It took another week before I felt better. Why all the hype for a drug that doesn’t work?

Why Tamiflu Did Not Work:

A. Oseltamivir (Tamiflu) is an oral antiviral medication for influenza. It works by blocking an enzyme (neuraminidase or NA) the virus uses to spread throughout the body.

Think of this drug a bit like glue. It firmly attaches itself to neuraminidase and makes the enzyme less active. Without fully functional NA, the virus cannot escape the infected cell. If the flu virus cannot escape, it cannot move on to infect other cells. The immune system is then in better shape to help the body recover faster.

The Window of Opportunity:

To be maximally effective, Tamiflu should be taken within 48 hours of the first symptoms. It may still be somewhat helpful taken up to four days after flu symptoms begin. In your case, though, too much time had passed for Tamiflu to provide decent benefit. Tamiflu did not work because too many virus particles managed to escape and multiply.

Even under the best of circumstances, clinical trials show that Tamiflu shortens flu symptoms by a day or two. The drug may, however, reduce the chance of complications (Medical Letter, Jan 1, 2018). That can make a difference for people who would otherwise become extremely ill.

Learn more about Tamiflu at this link:

The Inside Story of Tamiflu: Side Effects & Benefits

The Tamiflu Naysayers:

Many health professionals downplay the effectiveness of oseltamivir. By the way, the drug is now available generically at slightly lower cost. Tamiflu (10 pills) can cost $160 to $180 if your insurance company won’t pay. The generic oseltamivir (with a GoodRx coupon) could run between $51 and $93. Still pricey, but a bit more affordable.

A Reader (Lee from Oregon) shares her doctor’s negativity:

My primary care physician is an infectious diseases specialist. He teaches at OHSU [Oregon Health & Science University] and stays current on the latest information available to physicians. He used to prescribe Tamiflu to me but no longer does (even though I am very high risk, immune compromised, COPD ) because it does not have a verifiable effect. It is really effective at garnering massive profit, because patients insist on it. My advice; wash your hands, eat healthily and get plenty of rest.”

Is It True that Tamiflu Did Not Work?

So, what’s the straight and skinny on oseltamivir?

Tamiflu is not a magic bullet against the flu. It won’t eliminate all symptoms within 24 hours. On the other hand, there is solid scientific evidence that it does make a difference. Here is Canadian “systematic review of systematic reviews” (Journal of Antimicrobial Chemotherapy, Nov. 1, 2017). In other words, they reviewed other SR/MAs [systematic reviews and meta-analyses] of most of the available data. Here is what they found:

We identified 27…of 3723 articles reviewed. NI [neuraminidase inhibitors] (n = 2) or oseltamivir (n = 1) versus no treatment were consistently associated with a decrease in mortality odds among the hospitalized, general population. Oseltamivir versus no treatment was associated with a decrease in hospitalization and pneumonia risk/odds in 2/4 SR/MAs. Oseltamivir (n = 4) and zanamivir (n = 3) were consistently associated with a 0.5 - 1 day decrease in symptom duration.”

“NI treatment is likely to be effective at reducing mortality among hospitalized patients, and symptom duration by up to 1 day in the general population. Oseltamivir or zanamivir prophylaxis are likely to be effective at reducing secondary symptomatic influenza transmission. Increased nausea and vomiting are likely associated with oseltamivir use…Among hospitalized patients, NI administration seems warranted to reduce mortality risk.”

Norwegian researchers reported on the experience with oseltamivir (Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH); 2005). Here are their conclusions:

Oseltamivir reduces the duration of illness with 1-2 days in previously healthy adults and children with clinical influenza. Severity of illness was significantly reduced by oseltamivir in previously healthy adults, and the frequency and duration of fever was significantly reduced in previously healthy adults and children. Oseltamivir treatment reduces lower respiratory tract complications, antibiotic use, and hospitalization in both healthy and at risk adults (age ≥ 65 years, individuals with underlying chronic respiratory or cardiovascular problems).

“Oseltamivir reduces the duration of cough, fever, time to resolution of illness and frequency of hospitalization in both previously healthy adults, children and at risk adults. The frequencies of secondary complications like bronchitis, sinusitis, otitis media, pneumonia, in addition to antibiotic use, were also reduced in most patients. Use of oseltamivir for prophylaxis for periods of five days to six weeks provides a protective effect of 58-89 % against clinical influenza in healthy adults. Prophylaxis for six weeks in a vaccinated frail, elderly population gave a protective effect of 92 %. Children given post exposure prophylaxis for 10 days achieved a protective effect of 55-80 %.

Stories from Readers:

What does all that statistical talk mean in real terms? We have no doubt that Tamiflu did not work for some people. But the Norwegian data suggest that the drug is probably working better than this year’s influenza vaccine for a significant number of individuals. Here is what some of our readers have to say:

J. in Pennsylvania reported some benefit from Tamiflu:

I took tamiflu for the first time for an influenza A infection. It did cut my symptoms off after just a few days. My last bout with influenza was about 10 years ago, and I was extremely sick for about 10 days compared to about 5 days with the Tamiflu. My only complaints are an increased headache about 30 minutes after every dose and awful insomnia. No sleep for 3 days. I was so wired I was shaking. I had to stop taking it on day 3 because of the insomnia.”

Anita says “I love Tamiflu!”

I had the flu last year and was so ill, I went to the health clinic. My doctor put me on Tamiflu, and I started feeling better within 24 hours. I am taking it now, as I was just diagnosed with the flu. I started it a little over 2 days ago, but I so believe in the effectiveness of this medicine. And, thank The Lord, no side effects! Feeling stronger and better each day.”

MOL in New Jersey was also pleased:

Last year, I had flu symptoms including fever for several days before going to doctor. Doctor prescribed Tamiflu & I was pleasantly surprised at the relief in a short time. I’m a believer of the effectiveness of Tamiflu.”

People’s Pharmacy Perspective:

To repeat, Tamiflu is not a miracle medicine. But some people do seem to get benefit. The data also suggest that the severity of the symptoms is lessened. If the drug can prevent hospitalizations that is a blessing. Tamiflu side effects include nausea and vomiting, so it is not benign. Headache is another complication. For more details visit:

The Inside Story of Tamiflu: Side Effects & Benefits

Share your own Tamiflu story below. If Tamiflu did not work for you we want to hear about it. If it made a difference in your recovery, let others know about it.

Bottom line: We need far better vaccines and antiviral medicine so we are not overwhelmed by the next influenza epidemic.

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  1. angel
    vt
    Reply

    Tamiflu was not helpful at all. treated with Tamiflu in 24hrs and long behold 7 days later still tested positive for the flu. Was told at the e.r that I was contagious for 5 days until I finished the Tamiflu. Its hogwash im still contagious and very much still have the flu. All doctors can say is rest. iv slept for 7 days any more rest and I wouldn’t have a pulse!!! all the medical advances and we still cant cure the simple flu virsus……

  2. Betty
    Alabama
    Reply

    I have never had a flu shot, and no upper respiratory infections in over 10 years. I make sure to keep my immune system healthy, and at the first sign of being sick, take oscillococcinum. This stuff works! I worked in a school for years where I was exposed to everything.

  3. Rebecca
    Baltimore
    Reply

    For me it has been a magic bullet on three different occasions. Twice when my husband came down with the flu the doctor prescribed Tamiflu for me and said if I started to develop symptoms to take it. Both times I started to develop a fever, fatigue, aches, etc and took one pill and felt completely well the next day even though I did finish out the prescription. One time I took it prophylactically when my daughter got the flu and I never had symptoms. So maybe it was the magic bullet that time too or I did not actually need it. For me, because of my personal history with Tamiflu I laugh when I read that it is not a magic bullet. For me, it definitely has! I did not have side effects either. In my book, Tamiflu is a winner.

  4. Cindy B
    Seattle, WA
    Reply

    I’d like to say I’ve never had the flu, despite no flu shots. And maybe I haven’t! But just last week, I suddenly began to feel horribly tired, achy all over, and FREEZING COLD with goosebumps all over, despite having 2 heavy coats and 3 pairs of fleece pants, and Ugg boots on, by a roaring fire. I had a temp of 101.8. Uh-oh.

    Fortunately I had some of that “Oscillococcinum” (sp?) on hand because I’d been reading about how good it was, but you had to take it at the first sign of illness. I did! The NEXT day, the fever was gone and I felt better. The SECOND day, it was like it never happened. Gone!! I hate to give stuff free “plugs,” but that Oscillococcinum is something everyone should have in their home, and take it instantly if you start feeling ill. The stuff works!

  5. Sue B.
    PA
    Reply

    I developed a sore throat, chills, fever- 102.5, and cough. Also really bad body aches. I went to a 24 hr clinic, I tested negative for the flu! Due to my symptoms they ordered Tamiflu. Within 24 hours I did feel better. I still was sick for another 5 days, but I was grateful I was given the Tamiflu and that it worked for me.

  6. Rosalie
    Utah
    Reply

    I coughed all night, ached all over, had a fever, and as soon as I could the next morning visited instacare and was given a prescription for Tamiflu. Cough and aching went away rapidly, and over the next day my fever subsided. I got better and better and was over it in a few days. I’d certainly take Tamiflu right away if I got the flu again. I always get a flu shot because the flu is miserable.

    • Chris
      nj
      Reply

      Did you start the Tamiflu within 48 hours of the first symptom? I have the same scenario and because of the negative test started it later.

  7. Virginia
    Georgia
    Reply

    As some have written getting into a doctor soon enough to get Tamaflu is a big issue. Fortunately we have many more urgent care clinics now without waiting for your own doctor to see you. As has been mentioned, get the flu shot and get Tamiflu ASAP to reduce your symptoms at least some and perhaps slow up possible complications. Something is better than nothing!!

  8. dzrlib
    Reply

    I don’t understand why people don’t take Vitamin C and Cod Liver Oil both as a preventive and with increased dosage if symptoms occur. They work for my family.

  9. cate
    Bethlehem PA
    Reply

    You know, Boiron makes a remedy called oscillococcinum that you can buy for about $20. It is made from goose liver, homeopathic, works like a charm for the flu, no adverse effects at all.

  10. Ron
    SoCal
    Reply

    So many things that are a bit dangerous can be purchased without a prescription that it seems logical that Tamiflu should be included. Since it is only effective at the early stages, there is really no use in waiting until you are sick. When I come down with the flu, I’m far too ill to even think about going to a doctor or pharmacy. So going to a doctor/clinic, getting seen tested and maybe getting a prescription is ludicrous.

  11. Conrad
    Reply

    Just to add to my last post. If Tamiflu scares you it’s probably best not to take it. The mind is a powerful thing. Probably preventative measures are the best thing like frequent hand washing and staying away from crowded areas as much as possible during the flu season. Live and eat healthy in mind, body and spirit.

  12. Conrad
    Reply

    If you think you have the flu go to the nearest urgent care facility ASAP, especially youngsters and the elderly. Don’t forget to cover your face. Tamiflu may help. I had the flu in 2014 and it was really bad. Never been sicker.I am old and lucked out and survived.

  13. Carole
    Washington
    Reply

    I went right in to get tamiflu within 48 hours of coming down with the flu after I saw the positive remarks about it on your website. I tested positive for influenza A. I was pretty sick for about 4 days and had the cough for a month where I then came down with post nasal drip. I am not sure it helped or not. I have only had the flu once before many years ago.

  14. Lynnea
    South Carolina
    Reply

    We were in the middle of a cruise when our 23-year old daughter came down with symptoms warranting a visit to the sickbay. She was swabbed; she had the flu. Doctor onboard gave her Tamiflu to take and she was confined to her own small cabin for the last two days of the trip. Meanwhile, husband started to have symptoms about that time. By the time we left the ship, she was feeling much better, while he was starting to feel very ill. Daughter took far less time to recover, husband took several weeks and ended up having to take antibiotics for probable sinus infection as well. None of us had a flu shot this year; so far, I haven’t gotten sick.

  15. Val
    Florida
    Reply

    I took Tamiflu as a preventive the day after being exposed to the flu. I did not come down with the flu, but the side effects were just as bad. It increased my blood pressure unacceptably and gave me nausea, headache, and horrible vertigo for several days (and even now, two and a half weeks later I’m still having slight instances of vertigo).

  16. Tom M
    Mi
    Reply

    I have never used Tamiflu. One thing that made sense was that this drug is supposed to enable the immune system to get stronger and overcome the flu. Why not reinforce the immune system to begin with? I’m happy that this drug has helped some people, but I doubt I would ever take it. Any more with big Pharma it’s why not let everyone get sick and then we’ll treat them with drugs. Perhaps a serious article about strengthening our immune systems might be of help.

  17. Judith
    Gheen Minnesota
    Reply

    I’m a baby boomer who got the flu while traveling home by car. It is not a good time to have the flu! I needed something that would help fast, no time for a stop to pick up Tamiflu. Having two more days to go on the road and running to the bathroom for the 3rd time, had to look for something in the travel bag to help. This flu bug hit my gut hard and with pain I’ve never felt before with any flu. I should say I haven’t had the flu but a few times in my life. I found in my travel bag some OTC dual-action probiotics. Took the two pills, and in ten min. things started getting better. One more trip to the bathroom and everthing, I mean everthing came out.
    I did get the flu shot back in Sept. Very glad I did. I do believe that helped too. But for me I can’t say enough about the probiotics I took. If you get the flu, have it on hand.

  18. Marty
    Houston, TX
    Reply

    Tamiflu seems to work better as a preventative than as a treatment. I was thoroughly exposed to a toddler with confirmed influenza. The toddler’s mother, and grandmother (me), and infant sibling all took Tamiflu before having any symptoms. We were told not to wait until we had symptoms. The three of us had no influenza symptoms at all. The toddler’s father did not take Tamiflu and he was flat on his back for four days with all the usual symptoms. Tamiflu does work but it works better if taken as soon as you are exposed to a confirmed case and not after you already have symptoms. We had no side effects from Tamiflu. We took it with meals which is supposed to minimize the most typical side effects.

  19. Brian
    NJ
    Reply

    Re your use of individual’s stories as ‘evidence’ pro or con:
    This makes interesting reading, but it is worth keeping in mind the wise adage, “The plural of anecdote is not data.” – an M.D.

    • Joe Graedon
      Reply

      Dr. Brian,

      You are oh so right! And yet humans learn from stories. Just check out the Bible. Physicians have presented case histories and reports for decades/centuries. If you ever watch television you know that pharmaceutical manufacturers spend hundreds of thousands of dollars on direct to consumer prescription drug ads in which they feature a “vignette” of a patient benefitting from one of their pricey prescription products.

      You may detest anecdotes, but that is the world we live in. If you look at our article carefully you will see that we are very careful to also cite research and analyses that have been published in peer reviewed medical journals. You may also wish to review the CDC position on oseltamivir.

      You seem like a physician who values data. Do you not find it amazing that virtually ALL the talking heads promoting the influenza vaccine maintain that getting a flu shot will lessen the severity of the flu. As far as we can tell, there is no good evidence to support that position. Yet it has been repeated hundreds of times this flu season as a mantra. You may wish to read an article we wrote on that topic:

      https://www.peoplespharmacy.com/2018/01/18/will-the-influenza-vaccine-protect-you-from-flus-complications/

      We welcome your response.

  20. Lisa
    Raleigh
    Reply

    19 year old so got the flu on the day before Christmas and we got him to Minute Clinic before they closed. He was prescribed Tamiflu and his fever went from 103 to 99 in two days. He felt almost fine on the fifth. He didn’t have any side effects other than it slashing the number of days he was ill.

  21. Renee
    Euless TX
    Reply

    I’ve had influenza 3 times as an adult. The 3rd time was the only one in which I was prescribed Tamiflu – it was the swine flu a few years ago. I experienced about one month of insomnia that I was convinced came from taking Tamiflu. I’m unsure of how effective it was on my symptoms; the most memorable thing was the awful insomnia afterwards. I tried different prescribed sleep aids with no relief. It just finally resolved on its own. (I’ve never had insomnia before or since.)

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