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TABLE 4

Comparison of oseltamivir and zanamivir 8, 9

Oseltamivir

Zanamivir

Indication

Approved for treating people 1 year of age or older

Approved for treating people 7 years of age and older

Dosage form

Note: In July, the FDA issued an Emergency Use Authorization for use in patients younger than 1 year of age

Capsule or liquid

Note: Only for use in people without underlying respiratory or heart disease, including people with asthma

Inhaler

Side effects Nausea or vomiting

Length of treatment

Five days, but may be longer in hospitalized patients

Dizziness, sinusitis, runny or stuffy nose, cough, diarrhea, nausea or headache

Five days, but may be longer in hospitalized patients

available suspension. 11

Pharmacy technicians can assist pharmacists in alerting them to these patient safety risks. Pharmacies also can alert prescribers in the area of this issue and encourage them to prescribe this medication in a mg dose.

commoN pa TIeNT Ques TIoNs aNd aNs Wers regardINg H1N1

Pharmacies often are the first place people visit with questions about their health, so it is logical to assume pharmacy technicians and pharmacists will be approached with many questions regarding the H1N1 flu. The following are a number of frequently asked questions that pharmacy technicians and pharmacists can help answer for patients.

 

National Community Pharmacists Association, among others. This tool may be found on any of the above listed pharmacy associations’ Web sites.

 

WHa T aNTIVIral medIca TIoNs are aVaIlable To Trea T H1N1?

Two currently available antiviral medications, oseltamivir (Tamiflu®) and zanamivir (Relenza®), are recommended for treatment and prevention of H1N1 influenza. Table 4 provides a comparison of oseltamivir and zanamivir. These medications should be started within two days of the patient experiencing symptoms and can lessen symptom severity and shorten the duration of the flu by one to two days.

Due to potential limited availability of these medications, prescribers are instructed to prescribe these medications for patients in the following groups. 10

 

• Patients who are very sick (hospitalized)

• Patients who are sick and at increased risk for serious flu complications including:

- pregnant women - young children

- people over 65 years of age

- people with chronic illness or immunosuppressive disorders

- people younger than 19 years of age who are receiving long-term aspirin therapy

 

patient safety considerations with oseltamivir

On Oct. 15, the Institute for Safe Medication Practices issued a medication safety alert to all healthcare professionals regarding the risk of dosing errors related to the concentration of pharmacy-compounded Tamiflu® oral suspension being dispensed in response to shortages of the manufacturer’s oral suspension.

The commercially manufactured Tamiflu® suspension for children has been in short supply, and as a result, many pharmacists are compounding a suspension made from Tamiflu® capsules, which are more widely available. However, an issue has arisen due to the compounded suspension resulting in a 15 mg/mL oseltamivir base concentration, not the 12 mg/mL base concentration of the commercially

Will the benefits of the 2009 H1N1 influenza vaccines outweigh the risks?

The best proven way to prevent influenza infection and its complications is by vaccination.

 

Are the 2009 H1N1 influenza vaccines safe?

The H1N1 vaccines have undergone the same testing as the seasonal flu vaccines have and are produced by the same technology as seasonal flu vaccines. Health officials expect the H1N1 vaccine to have a similar safety profile as the seasonal flu vaccine, which has a long established safety track record. The CDC and FDA are closely monitoring for any unexpected adverse events.

 

What side effects may occur with the H1N1 vaccines?

If side effects occur, they likely will be similar to those experienced following the seasonal influenza vaccine. Side effects typically associated with the seasonal flu shot include soreness, redness or swelling at the injection site, low-grade fever and aches. Side effects from the seasonal nasal spray vaccine may include runny nose, headache, sore throat and cough. 7

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References:

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