National shortage of Tamiflu (oseltamivir)
Pharmacies are experiencing a national shortage of oseltamivir suspension and capsules and very few doses remain available.
Oseltamivir can be used for the treatment or chemoprophylaxis of influenza in both adult and pediatric patients. The suspension formulation is routinely utilized in pediatric patients and adults with enteral tubes.
The duration of the shortage is uncertain, according to the ASHP Drug Shortages Bulletin (ASHP Drug Shortage Detail: Oseltamivir Oral Suspension and Capsules). Conservation of the current remaining supply should be prioritized for patients hospitalized due to influenza and outpatients with a positive influenza test and recent symptoms who are at high risk for influenza complications. Oseltamivir is most effective if therapy is started within 48 hours of symptom onset, patients presenting later will have less benefit in symptom reduction.
Due to limited supply, routine chemoprophylaxis in institutional outbreaks is not recommended during the shortage. For inpatients that have improved enough for discharge prior to completion of therapy, oseltamivir can be stopped at discharge. As an alternative to the suspension formulation, oseltamivir capsules can be opened and administered through enteral tubes if needed. Alternative treatment options include oral baloxavir, inhaled zanamivir, and IV peramivir, all of which are also in short supply.
For more information, see guidance from the UNMC Antimicrobial Stewardship Program on influenza treatment and chemoprophylaxis recommendations and alternative treatment options at the following link:
A list of manufacturers of oseltamivir and contact information can be found at: Influenza 2022-2034 (fda.gov)
Update provided by: Jenna Preusker, Pharm.D., BCPS – Nebraska ASAP Pharmacy Program Coordinator