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Pandemic Planning Toolkit A resource to assist your organization in preparing for pandemic influenza

TAMIFLU® (oseltamivir phosphate) has been studied only in strains of influenza that were circulating at the time. The magnitude of effect of TAMIFLU in treating and preventing novel strains of influenza, such as those that may be involved in a pandemic, cannot be predicted.

 
Step Step 1 Step 2 Step 3 Step 4 Step 5 Step 6 Step 7
 
Calculate quantity of antivirals needed
Once your organization has determined the number of individuals to protect, it must decide 'For what purpose should TAMIFLU be used?' Follow these steps to assist you in calculating an order quantity for your organization.
 
STEP 2A: Determine course of therapy: Treatments vs. Prevention
  • Treatment - Adults (13 years and older) should take 75 mg twice daily for 5 days for treatment. Therapy should begin within 2 days of symptom onset. This equates to 1 pack of capsules.
  • Prevention - Adults (13 years and older) should take 75 mg once daily for 10 days following known or suspected exposure. Therapy should begin within 2 days of exposure. Adults (13 years and older) can also take 75 mg once daily for up to 6 weeks when influenza is known to be circulating in the community. Duration of protection lasts for as long as dosing is continued.
    • NOTE: For use in children aged 1-12 years (e.g., when purchased for family members of employees), see dosing guidelines provided in the accompanying complete prescribing information.
 
STEP 2B: Determine proper dosing
  • Dosage may vary for seasonal vs. pandemic flu depending on the strain of influenza that is circulating
  • Current recommendations for dosing are consistent with treatment and prevention dosage for seasonal influenza (Refer to www.cdc.gov for current guidance on pandemic dosing)
 
STEP 2C: Assess how many pandemic waves to cover
  • Past pandemics have spread globally in two and sometimes three waves
  • The organization may want to consider purchasing antivirals that protect employees for more than one wave of a pandemic
 
STEP 2D: Calculate the order quantity.
Determine:
  • The total number of individuals to protect from Step 1
  • The # of courses of therapy per individual (1 treatment course = 1 pack capsules, 1 prevention course = 1 pack of 10 capsules)
  • The dosage level
  • The # of waves

  •  
    TAMIFLU Order Quantity (# of packs) = a x b x c x d
 
Sample calculation:
Company XYZ employs 1,000 individuals and employees have on average 3 immediate family members (4,000 individuals) and are covering 40% of this population
  • a = 40% x 4,000 individuals = 1,600. The company assumes that each individual will be provided 2 treatment courses (2 packs) and 2 prevention courses (2 packs)
  • b = 4
  • The company assumes that the seasonal dosage will be used c =1
  • The company assumes that there will be two waves of a pandemic d =2

  •  
    TAMIFLU Order Quantity (# of packs)= a x b x c x d = 1,600 x 4 x 1 x 2 = 12,800
 
ORDER QUANTITY = 12,800 Packs of TAMIFLU
 
Step Step 1 Step 2 Step 3 Step 4 Step 5 Step 6 Step 7
 

 
Guidelines
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Indications and Important Safety Information

 

Indications

TAMIFLU is indicated for the treatment of uncomplicated influenza caused by viruses types A and B in patients 1 year and older who have been symptomatic for no more than 2 days.

TAMIFLU is also indicated for the prophylaxis of influenza in patients 1 year and older.

TAMIFLU is not a substitute for early and annual vaccination as recommended by the Centers for Disease Control's Advisory Committee on Immunization Practices (ACIP).

Prescribers should consider available information on influenza drug susceptibility patterns and treatment effects when deciding whether to use TAMIFLU.

Safety Information

There is no evidence for efficacy against any illness caused by agents other than influenza types A and B.

Treatment efficacy in subjects with chronic cardiac and/or respiratory disease has not been established. No difference in the incidence of complications was observed between the treatment and placebo groups in this population.

No information is available regarding treatment of influenza in patients at imminent risk of requiring hospitalization.

Efficacy of TAMIFLU has not been established in immunocompromised patients.

Safety and efficacy of repeated treatment or prophylaxis courses have not been studied.

Influenza can be associated with a variety of neurologic and behavioral symptoms, which can include events such as hallucinations, delirium and abnormal behavior, in some cases resulting in fatal outcomes. These events may occur in the setting of encephalitis or encephalopathy but can occur without obvious severe disease. There have been postmarketing reports (mostly from Japan) of delirium and abnormal behavior leading to injury, and in some cases resulting in fatal outcomes, in patients with influenza who were receiving TAMIFLU. Because these events were reported voluntarily during clinical practice, estimates of frequency cannot be made but they appear to be uncommon based on TAMIFLU usage data. These events were reported primarily among pediatric patients and often had an abrupt onset and rapid resolution. The contribution of TAMIFLU to these events has not been established. Patients with influenza should be closely monitored for signs of abnormal behavior. If neuropsychiatric symptoms occur, the risks and benefits of continuing treatment should be evaluated for each patient.

In postmarketing experience, rare cases of anaphylaxis and serious skin reactions, including toxic epidermal necrolysis, Stevens-Johnson syndrome and erythema multiforme, have been reported with TAMIFLU.

The most common adverse events reported >1% of patients treated with TAMIFLU and more commonly than in patients treated with placebo are:

  • Treatment of adult and pediatric patients - nausea, vomiting.
  • Prophylaxis of adult and pediatric patients - nausea, vomiting, abdominal pain.

Vaccination is considered the first line of defense against influenza.

Please see TAMIFLU full Prescribing Information for additional safety information.

 

Roche