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Three antiviral drugs (amantadine, rimantadine, and oseltamivir)
are approved and commercially available for use in preventing flu.
All of these medications are prescription drugs, and a
doctor should be consulted before the drugs are used. When
used for prevention, they are about 70% to 90% effective
for preventing illness in healthy adults.
Four antiviral drugs (amantadine, rimantadine, zanamavir
and oseltamivir) have been approved for treatment of the
flu. If taken within 2 days of getting sick, these drugs
can reduce the symptoms of the flu and shorten the time you
are sick by 1 or 2 days. They also can make you less contagious
to others. All of these drugs must be prescribed by a doctor
and taken for 5 days. Antiviral drugs are effective only
against influenza viruses. They will not help the symptoms
associated with the common cold or many other flu-like illnesses
caused by viruses that circulate in the winter.
All of the antiviral drugs are different in terms of who
can take them, how they are given, any dosing changes based
on age or medical conditions, and side
effects. Your doctors
will help decide whether you should get antivirals and which
one you should get.
Use of Antivirals
Antiviral drugs are most often used to control flu outbreaks
in institutions, for example in nursing homes, or in hospital
wards, where people at high risk (see below) for complications
from flu are in close contact with each other. Antivirals
also have been used on cruise ships or similar settings
to control outbreaks of the flu.
In the event of an outbreak, public health practice is to
combine the use of flu vaccine and antivirals. In a nursing
home during an outbreak, for example, residents and staff
are given the flu vaccine and antivirals to prevent flu until
the vaccine takes effect (about 2 weeks). This practice continues
as long as influenza is occurring in that setting.
Doctors also can prescribe antivirals for flu to people
not living in institutional settings, but treatment must
begin within 2 days of the onset of symptoms for it to be
effective. Also, while all antivirals lessen the symptoms
of illness and shorten the duration of illness, only 1 (oseltamivir)
has been shown in a study to reduce some complications requiring
antibiotics.
When considering antivirals, it’s important to remember
that most healthy people recover from the flu without complications.
Who Should Get Antiviral Drugs
People who are at high risk of serious complications from influenza may benefit most from antiviral medications. This includes: people 65 years of age and older, children 6-23 months of age, people with chronic medical conditions (for example, heart or lung disease, diabetes) and pregnant women. (Note that none of the antivirals are approved for use in children less than 1 year of age.) While CDC has provided interim guidance for health-care professionals on the use of antiviral drugs this season, your doctor will decide whether you should get antiviral drugs this season.
For Treatment:
If you get sick with flu-like symptoms this season, your
doctor first may give you a test to find out whether you
have influenza. (Symptoms of flu include: fever (usually
high), headache, tiredness, a sore throat and dry cough,
nasal congestion, and body aches.) Your doctor also will
consider a number of things before making a treatment decision,
such as your risk for complications from flu.
For Prevention: In the event of a flu outbreak
in a home, institution, or community, your doctor may choose
to give antivirals to you as a preventive measure, especially
if you are at high risk for complications from the flu. Also,
if you are in close contact with someone who is considered
at high risk for complications from flu, you may be given
antiviral drugs to prevent passing flu to the high-risk person.
For more information, see the following:
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