Questions and Answers about Children and Tamiflu

October 28, 2009

As the H1N1 flu virus continues to spread, CDC is working with physicians and other health care providers to make sure Americans who get sick can get the medicine they need, when they need it.  In the spring when the H1N1 flu virus first hit this country, the federal government released approximately 11 million doses of antiviral medication to the states.  This consisted mostly of oseltamivir (Tamiflu^®) and represented approximately 25 percent in the Strategic National Stockpile.  Since then, we have replenished the stockpile. In October, Secretary Sebelius released an additional 300,000 doses of liquid pediatric Tamiflu from the stockpile to send to the states.

Two main forms of Tamiflu are produced by the manufacturer: capsules and an oral powder that is made into a liquid suspension at the pharmacy. The capsules come in adult and pediatric sizes. Both forms, capsules and the oral suspension, can be used to treat children who become ill with the flu.  Here are some questions and answers about treating children with Tamiflu^®, and information about what to do if the liquid form is not readily available in your community:

Questions & Answers

Is there a shortage of oral suspension (liquid) Tamiflu^®?

The Food and Drug Administration (FDA) and the maker of Tamiflu^® (Roche PDF ) have said that available supplies of liquid Tamiflu^® for children are limited.

What is being done about this?

A pharmacist can make a Tamiflu^® suspension (liquid) using available Tamiflu^® adult capsules, which are not in short supply.  CDC is alerting pharmacists about this option and providing instructions on how to prepare a suspension using adult capsules. Some pharmacies, including some chains, can do this already, others are not yet prepared. Children’s doses of Tamiflu^® are also available in capsules.

What can I do if my child cannot swallow capsules?

If your doctor prescribes Tamiflu^® capsules for your child and your child cannot swallow capsules, the prescribed capsules may be opened and mixed with a sweet thick liquid and given that way. 

What liquids can I use?

A thick and sweet liquid, such as regular or sugar-free chocolate syrup, that masks the flavor of the medicine can be mixed with the contents of the Tamiflu^® capsule. Sugar-free sweet liquids are available. The child should consume the liquid mixture entirely.

If my child can’t swallow capsules, how do I open Tamiflu capsules and mix the medicine?

Pour a small amount (about a spoonful) of sweet, thick liquid into a cup or bowl.  Carefully open the Tamiflu^® capsule prescribed by your doctor and pour out all of the powder inside the capsule and mix it into the liquid. The exact amount of liquid used doesn’t matter, as long as the powder inside the capsule is mixed in well.  (All of the medicine may not dissolve. Just be sure it is all well mixed.) Use only the prescribed dose.

What will I need to do this?

You will need

• The prescribed Tamiflu^® capsule
•  A small bowl or cup and a spoon
• 1-2 Teaspoons of sweetened liquid

How do I mix the ingredients?

• Pour a small amount (about a spoonful) of a sweet thick liquid into a cup or bowl.
• Holding one capsule over a small bowl, carefully pull the capsule open and pour the complete contents of the capsule into the bowl.
• Stir the mixture and give the entire dose to the child with a spoon.

Should my child take all of the mixture?

Yes, make sure your child takes all of the medicine mixture.