Medications

Vaccines are available to prevent influenza (See Viral Influenza Vaccines section in this report).

For mild influenza, symptom relief is similar to that for colds.

Who Needs Antiviral Drugs

Two classes of antiviral agents have been developed to treat influenza: neuraminidase inhibitors and M2 inhibitors. These drugs can shorten symptoms but there is no indication that they can prevent or reduce complications such as pneumonia. They do not help if they are started after the first 36 hours of illness. Because of emerging drug resistance, some experts suggest these drugs be reserved for severely ill patients or those at high risk.

Most people who get seasonal flu or H1N1 flu will likely recover without needing medical care. Doctors, however, can prescribe antiviral drugs to treat people who become very sick with the flu or are at high risk for flu complications.

If you need treatment for the flu, the CDC recommends that your doctor give you zanamivir (Relenza) or osteltamivir (Tamiflu). These drugs work best if you receive them within 2 days of becoming ill. You may get them later if you are very sick or if you have a high risk for complications.

Those at high risk for complications who are more likely to need treatment include:

• People with weakened immune systems, such as AIDS patients or patients being treated for cancer
• Elderly patients, particularly patients in nursing home
• Very young children (it may be difficult to tell whether pneumonia is related to influenza or caused by respiratory syncytial virus [RSV])
• Hospitalized patients and anyone with serious medical conditions, such as diabetes, heart, circulation, or lung disorders, particularly chronic lung disease
• Drug abusers who use needles
• Pregnant woman, especially those suspected of having H1N1 flu

To prevent infection with H1N1 flu, people living in the same house as someone diagnosed with the virus who also are risk for complications should ask their doctor if they also need a prescription for these medicines.

Anti-Viral Drugs: Neuraminidase Inhibitors

Brands and Benefits. Zanamivir (Relenza) and oseltamivir (Tamiflu) are neuraminidase inhibitors. They are newer agents that have been designed to block a key viral enzyme, neuraminidase, which is involved with viral replication. While effective, their overall benefit is modest.

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Review Date: 01/29/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)