Confusing Tamiflu Dosing Instructions May Pose Risk to Young H1N1 Flu Sufferers, Physicians Warn

Confusion over the proper dose of the flu drug Tamiflu to give children who develop the H1N1 influenza virus could result in toxic overdoses or ineffective underdoses of the medication, a group of prominent scientists is warning.

Officials from Northwestern University Feinberg School of Medicine in Chicago, Emory University in Atlanta, and Weill Cornell School of Medicine in New York City voiced their concerns about Tamiflu dosing confusion in a letter posted online this week in the New England Journal of Medicine, according to a HealthDay News article.

The letter points out a potential problem with how the proper dosage of Tamiflu is spelled out on the drug’s labeling and urges doctors and pharmacists to help parents determine the proper dose to give children to avoid problems.

Tamiflu is considered the first line of defense against H1N1 flu, which has already infected millions of people worldwide and health officials fear may infect millions more Americans this fall.

Inconsistent Dosing Instructions Blamed for Confusion

The problem is that the dosing instructions on the Tamiflu labeling does not always coincide with the measurement markings on the plastic syringe included with the drug to deliver the liquid medication, the officials said. For example, Tamiflu Oral Suspension tells users to give children three-fourths of a teaspoon of the medicine twice a day, but the syringe provided is marked in milligrams (not teaspoons), the scientists said.

In one case, the parents of a six-year-old girl struggled to determine the proper dose of Tamiflu Oral Suspension, given the differences in how the measurements are listed on the packaging and syringe. The parents are both health professionals and were able to figure out the proper dose to give their daughter, but most parents would have been unable to do so, the authors of the warning letter said.

“It’s an egregious error that there is a conflict in the prescription labeling instructions and the dosage device that comes in the exact same box. It’s incredibly confusing to parents,” letter co-author Michael Wolf, an associate professor of medicine and learning sciences at Northwestern University Feinberg School of Medicine, said in a news release from the university. “Tamiflu is one of the main courses of treatment right now for H1N1, and it is being widely used among children, even infants.”

Doctors and Pharmacies Should be on Alert

To help prevent problems with improper doses of Tamiflu, the authors of the letter said pharmacies and physicians should be instructed to ensure that the prescription label instructions for use are in the same dosing units as those on the measurement device inside the box.

Parents should also be sure they know the proper dose of Tamiflu to give their children before they leave the doctor’s office or pharmacy, the scientists said.

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