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Should You Take Antiviral Drugs If You Catch the Flu?

Are you worried about the coronavirus? The headlines are scary. But what about influenza? You are far more likely to catch the flu this season. What to do?
Should You Take Antiviral Drugs If You Catch the Flu?
Sick young Caucasian woman lying on sofa and trembles, wrapped in coverlet and scarf, tries to warm herself ,having flu symptoms, feels cold, indoors/Cold, virus, sickness concept/Flu season

The Chinese coronavirus is capturing headlines around the world and for good reason. This infection is spreading very fast in China and people are dying. It has also been identified in several other countries. As worrisome as the coronavirus is, let’s not forget that we are also in the middle of flu season. You are more likely to catch the flu over the next two months than you are to catch the coronavirus. The latest data we have from the CDC states

“CDC estimates that so far this season there have been at least 15 million flu illnesses, 140,000 hospitalizations and 8,200 deaths from flu.”

As of this writing, the number of cases of coronavirus identified in China is under 3,000 and the number of deaths reported from China is under 100. That’s scary and likely to climb rapidly over the next several days and weeks.

Will You Catch the Flu?

Compared to influenza, however, coronavirus is currently less worrisome in the United States. The chances that you will catch the flu are far greater. Every state has reported high rates of influenza infection.

Public health officials focus primarily on getting people vaccinated, starting in September. But this year it appears that the influenza B strain circulating in many communities is not identical to the one in the flu shot. The virus that is making people sick is B/Victoria V1A.3.

The influenza B vaccine protects against B/Victoria V1A.1 As a result of this mismatch, many people, especially children, may catch the flu even if they have been immunized.

There is also significant influenza A starting to circulate. The predominant strain is H1N1 but H3N2 is also out there. We won’t know how well the influenza A vaccine works for several more weeks. Some experts have already questioned the match, since the H3N2 “Aussie flu” hit late in the southern hemisphere. It was not included in this year’s shot.

If You Catch the Flu, What To Do?

Here is what the CDC has to say about antiviral medications if you catch the flu: 

“Flu vaccine effectiveness estimates are not available yet this season, but vaccination is always the best way to prevent flu and its potentially serious complications.

“Antiviral medications are an important adjunct to flu vaccine in the control of influenza. Almost all (>99%) of the influenza viruses tested this season are susceptible to the four FDA-approved influenza antiviral medications recommended for use in the U.S. this season.”

Do You Know About Antiviral Flu Drugs?

Antiviral flu drugs have been available for decades, but they are still not widely used. Amantadine (Symmetrel) was the first such medication. It was followed by rimantadine (Flumadine). Neither got much love from the medical profession.

You can learn more about the pros and cons of these old drugs at this link.

Why Don’t More Doctors Prescribe Pills for Influenza?
Antiviral drugs for influenza can speed recovery and reduce the severity of complications

Newer Antiviral Meds if You Catch the Flu:

More recent antiviral medications have received more recognition. They include oseltamivir (Tamiflu) which comes as a capsule and zanamivir (Relenza) which is a powder for inhalation.

An injectable flu medicine was approved by the FDA in 2014. It is called peramivir (Rapivab). A little over a year ago, the FDA approved baloxavir (Xofluza). This oral medicine has the advantage of only requiring a single dose.

All these flu medications must be taken within the first day or two of symptoms to be maximally effective. Some are also helpful for preventing illness. Tamiflu and Relenza are approved for prophylaxis. That means if someone in the household has come down with the flu, others can be protected by taking such drugs. They are roughly 70 to 90 percent effective when used for prevention.

Are Antivirals Worth the Trouble?

Once you get symptoms, however, antiviral drugs only shorten the duration of the illness by a day or two on average. As a result, some doctors don’t feel they are worth using. One, writing in Emergency Medicine News (April 2017), called Tamiflu:

“a dud of a drug.” 

However, a meta-analysis of 78 studies concluded that this type of medicine can save lives. Oseltamivir and zanamivir are neuraminidase inhibitors. The researchers wrote:

“Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk” (Lancet Respiratory Medicine, May 2014).

Starting the drug early is more effective. Consequently, they concluded:

“We advocate early instigation of neuraminidase inhibitor treatment in adults admitted to hospital with suspected or proven influenza infection.”

A more recent study confirms this conclusion. Investigators analyzed data from 70 clinical centers involving more than 18,000 patients (Journal of Infectious Diseases, Jan. 14, 2020).  They found that administering antiviral drugs as soon as patients were admitted to the hospital with suspected influenza shortened hospital stays.

It isn’t just people in the hospital who benefit from antiviral drugs. In another study of more than 3,000 people with confirmed or suspected influenza A, treatment with neuraminidase inhibitors:

“significantly reduced the likelihood of requiring hospital admission” (Clinical Infectious Diseases, May 15, 2017).

Antiviral Drug Side Effects:

These flu medicines do have side effects. Tamiflu can cause nausea, vomiting and headaches. Here is a link to:

The Inside Story of Tamiflu: Side Effects & Benefits
What is the bottom line on Tamiflu (oseltamivir) and Xofluza (baloxavir) for influenza? How well do they work? Are there side effects you should know about?

Xofluza appears less likely to cause these symptoms, although it can cause some digestive upset and occasionally serious allergic reactions. Relenza, the inhaled medicine, can cause airways to constrict and should probably not be used by people with asthma or COPD.

Take Precautions: Don’t Catch the Flu!

We hope you can avoid the flu this season. Here are two links you may find helpful:

Some Steamy Strategies to Prevent Influenza
Flu is here! It will spread. What can you do to prevent influenza besides get a flu shot? You may be intrigued to learn how humidity fights flu

Then There is the face mask question:

Will Wearing a Face Mask Protect Against the Flu?
Have you ever worn a surgical mask to avoid the flu? If not, why not? Do you wash your hands? Wearing a face mask AND washing your hands is your best protection

What If Someone Catches the Flu?

If someone in your family gets sick, you may want to ask your doctor about an antiviral medication. There are rapid flu tests that can confirm whether you have influenza or not. And if you are really suffering, antiviral medicine may help keep you out of the hospital.

What do you think? Share your thoughts about influenza, vaccines and antiviral medications in the comment section below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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