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Flu: reimbursement of Tamiflu° extended to children, despite serious, even fatal risks

Tamiflu° is now reimbursed in France for flu prevention in infants over the age of 1 year, even though its benefit-risk balance is increasingly uncertain.

Tamiflu° (oseltamivir) is an antiviral drug marketed for the prevention and treatment of flu. Given its modest effectiveness, it may not be appropriate to extend the reimbursement (at 35%) of Tamiflu° to flu prevention in children at risk over the age of 1 year. The lack of evidence of a reduction in flu complications and the appearance of drug-resistant strains of the flu virus make its benefit-risk balance increasingly uncertain. Like the anti-flu drug amantadine, oseltamivir is also a psychotropic agent, with sometimes serious, even fatal, neurological and psychiatric effects. Reports of serious, sometimes fatal, neuropsychiatric disorders associated with oseltamivir are increasingly frequent (especially in Japan): suicidal behaviour, hallucinations, convulsions, delirium, people jumping out of windows to their deaths, etc., as well as serious adverse cutaneous effects. This worrying evidence concerning oseltamivir makes it advisable to restrict its use as a flu preventive drug, especially in children. Vaccination against flu still remains the first-choice preventive measure both in adults and in children at risk.

©Prescrire June 2007

Source: "Oseltamivir et enfants : remboursement élargi malgré les risques" Rev Prescrire 2007 ; 27 (284) : 423.

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