The flu epidemic is coming, do you need to stock up on oseltamivir? Reminder: There are risks in abusing drugs

Recently, influenza outbreaks in many places have attracted the attention of many friends. Many people around us, especially children after school, have been increasingly infected with influenza. According to the weekly influenza report released by the CDC, the weekly influenza-like case monitoring data of national influenza sentinel hospitals show that the proportion of influenza cases has increased for five consecutive weeks.

Facing the fierce influenza epidemic, everyone knows that Oseltamivir is a "special medicine" to fight influenza. Of course, some careless friends have made mistakes in the name of the medicine, which has embarrassed themselves... Let me emphasize again that it is Oseltamivir ! The medicine with a similar name is used for weight loss, so don't make a mistake.

So, should we stock up on oseltamivir at home? Regarding this question, my personal suggestion is that in order to cope with the possibility of influenza virus infection, it is certainly okay to keep some oseltamivir at home, but there is really no need to "stock up", and we should not use the drug indiscriminately. Compared with stocking up drugs, it is more important to understand the characteristics of this drug and the safety precautions for using it. Today's popular science article will introduce you to the anti-influenza drug oseltamivir.

How Oseltamivir “eliminates” influenza viruses

Oseltamivir is indeed a very effective drug for fighting influenza infection. From the perspective of drug classification, oseltamivir belongs to the class of neuraminidase inhibitors. Neuraminidase, also known as sialidase, is a protein that can catalyze the hydrolysis of sialic acid. Neuraminidase is distributed on the back membrane of influenza viruses. Its function is to help influenza viruses escape from host cells and infect new cells. In other words, after influenza viruses infect the human body, they need the participation of neuraminidase to complete their replication and reproduction.

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Oseltamivir is a prodrug. After entering the human body, it will be converted into an active ingredient with medicinal effect. The converted active ingredient can inhibit the activity of neuraminidase, thereby inhibiting the replication and reproduction of the virus. The virus replication and infection of new cells are blocked, and it will eventually be "killed" by the body's immune cells. This is the antiviral action mechanism of oseltamivir.

Studies have shown that oseltamivir has a good inhibitory effect on different types of neuraminidase of influenza A and B viruses. It is also a very effective therapeutic drug for the currently prevalent influenza A.

Oseltamivir is effective, but don't use it indiscriminately

Oseltamivir is a symptomatic and effective drug for fighting influenza A. However, for home use, we still need to remind everyone not to abuse it.

The typical symptoms of influenza A are fever, body aches, sore throat, cough, etc., but COVID-19 infection or infections caused by other pathogens (such as pneumococcus, etc.) may also cause similar symptoms. If it is an influenza A infection, there is certainly no problem with the symptomatic use of oseltamivir, but if it is an infection caused by other pathogens, taking oseltamivir will have no therapeutic effect and may also bring about problems with the safety of the medication.

The most common adverse reactions to the use of oseltamivir are gastrointestinal adverse reactions. Nausea, vomiting, abdominal pain, etc. are all common problems, especially in children. In addition, taking oseltamivir may also cause adverse reactions of the respiratory system, including bronchitis, cough, etc., and central nervous system adverse reactions include dizziness, headache, insomnia, fatigue, etc. If we use it symptomatically to fight against the influenza virus, it is the solution to the main contradiction, and most people can tolerate the potential side effects. But if we abuse oseltamivir regardless of whether it is influenza A or not, the disease will not be treated, but instead there is a risk of many side effects, which is really not worth the loss.

Therefore, for oseltamivir, when taking drugs to treat influenza, it should be used as much as possible under the premise of a clear diagnosis of influenza virus infection. Currently, many medical institutions can conduct nucleic acid tests for influenza A, and there are also influenza antigen detection kits that can be used for self-testing at home. If the drug can be used after the infection is confirmed, the efficacy and safety of the drug can be better guaranteed.

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In addition to this reminder of symptomatic medication, there are a few more things I would like to remind you:

1. If it is confirmed to be influenza A, medication should be taken as soon as possible. The best time to take medication is within 36 hours of infection. The earlier it is taken, the greater the benefit. Of course, during the medication process, you still need to pay attention to monitoring the adverse reactions of the drug.

2. Some children have poor compliance with taking oseltamivir and are prone to vomiting or unwillingness to take the medicine. A more convenient way is to use oseltamivir granules suitable for children.

3. The dosage for children is different from that for adults. The dosage should be reasonably selected based on body weight, and oseltamivir should be used according to the actual situation. The course of treatment for oseltamivir is generally 5 days. For patients who really need to take the medicine, they should try to take it according to the dosage and course of treatment to avoid recurrence of the disease.

4. Although oseltamivir is indicated for preventing influenza, it is generally recommended for people at risk of severe illness. For most people, it is completely unnecessary to take oseltamivir to prevent influenza. The best way to prevent influenza is to get a flu vaccine in time before the flu season arrives each year. At the same time, pay attention to avoiding gatherings during the peak of the flu season, and maintain good hygiene habits such as washing hands frequently and opening windows for ventilation.

Finally, I have to emphasize that many of my friends are now getting the flu vaccine, but for the live attenuated influenza vaccine, it is usually recommended not to take oseltamivir within 2 weeks of vaccination. Conversely, within 48 hours of taking oseltamivir, you should not get this type of vaccine to avoid affecting the effect. If you are unclear about this, you can consult a doctor during the consultation or vaccination.

In short, oseltamivir is not a miracle drug, and there is no need to over-glorify it. If you are confirmed to have influenza infection, you can use the drug reasonably to fight the virus. For families, there is no need to stock up in large quantities, and do not abuse the drug. For us, the best way to fight influenza is still to make an appointment for a flu shot in time every autumn.

Author: Li Jin, Deputy Director and Pharmacist, Medical Committee Member, China Science Writers Association

Review｜Liu Guiyang, Chief Pharmacist, Fourth Medical Center, PLA General Hospital

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