Tamiflu ® (marchio registrato) (oseltamivir)

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Tamiflu ® (marchio registrato) (oseltamivir) is an antiviral drug that is used in the treatment and prophylaxis of both Influenza virus A and Influenza virus B.

Oseltamivir is a neuraminidase inhibitor. It acts as a transition-state analogue inhibitor of influenza neuraminidase, preventing progeny virions from emerging from infected cells. Patient leaflet.

(3R,4R,5S)-4-acetylamino-5-amino-3-(1-ethylpropoxy)-1-cyclohexene-1-carboxylic acid ethyl ester

Oseltamivir was the first orally active neuraminidase inhibitor commercially developed. It is a prodrug, which is hydrolysed hepatically to the active metabolite, the free carboxylate of oseltamivir (GS4071).

Adverse effects

Common adverse drug reactions associated with oseltamivir therapy include: nausea, vomiting, diarrhea, abdominal pain, and headache. Rare ADRs include: hepatitis and elevated liver enzymes, rash, allergic reactions including anaphylaxis, and Stevens-Johnson syndrome.

Various other ADRs have been reported in postmarketing surveillance including: toxic epidermal necrolysis, cardiac arrhythmia, seizure, confusion, aggravation of diabetes, and haemorrhagic colitis.

In November 2006, the United States Food and Drug Administration (FDA) amending the warning label to include the possible side effects of delirium, hallucinations, or other related behavior. This went further than the FDA's previous pronouncement, from a year before, that there was insufficient evidence to claim a causal link between oseltamivir use and the deaths of 12 Japanese children (only two were from neurological problems, although more have died since then). The change to a more cautionary stance was attributed to 103 new reports that the FDA received of delirium, hallucinations and other unusual psychiatric behavior, mostly involving Japanese patients, received between August 29, 2005 and July 6, 2006. This was an increase from the 126 similar cases logged between the drug's approval in 1999 and August 2005.

In March 2007, the European Medicines Agency said that the benefits of oseltamivir outweighed the costs, but that it would closely monitor reports from Japan.

In April 2007, South Korea issued a safety warning against prescribing Tamiflu ® (marchio registrato) to teenagers except in special cases.

For further information it is necessary to talk to your physician.

H. Shuji; S. Norio; I. Mutsumi; Y. Masahiko; I. Masataka; K. Kazuhiro; K. Maki; S. Hideaki; K. Chiharu; K. Kazuhiko; M. Keiko; K. Yoshihiro. 2007. Emergence of Influenza B Viruses With Reduced Sensitivity to Neuraminidase Inhibitors. JAMA. 297:1435-1442.
Links to Tamiflu ® (marchio registrato)-Related Incidents in The Japan Times
Kiso M, Mitamura K, Sakai-Tagawa Y, Shiraishi K, Kawakami C, Kimura K, et al. Resistant influenza A viruses in children treated with oseltamivir: descriptive study. Lancet 2004;364(9436):759-65. PMID 15337401
Flu Drug Tamiflu ® (marchio registrato) May Cause Odd Behavior in Children, Forbes
PMID 16371632 (full text)
http://www.rocheusa.com/products/Tamiflu ® (marchio registrato)/pi.pdf
J. Org. Chem. 2001, 66, 2044-2051. Synthesis of Tamiflu ® (marchio registrato).

External Links

www.Tamiflu ® (marchio registrato).com
FDA information page on oseltamivir
Journal Response – Oseltamivir
Reto U. Schneider: The race to develop GS4104 - A comprehensive feature story about the development of Tamiflu ® (marchio registrato) published in January 2004 in NZZ-Folio, the magazine of the daily Neue Zürcher Zeitung in Switzerland (translated from German). 
MedlinePlus Drug Information: oseltamivir (systemic)
Pharmasquare – Tamiflu ® (marchio registrato) Mode of Action
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