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FDA notified of oseltamivir oral suspension shortage
There is currently a temporary shortage of oseltamivir oral suspension, according to an FDA press release.
Tamiflu (oseltamivir, Genentech) 30 mg, 45 mg, and 75 mg capsules remain available. Genentech expects additional Tamiflu Oral Suspension to be available by mid-January.
The FDA has provided for health care professionals the approved instructions on how to prepare an oral suspension from the 75-mg capsules. The instructions are available on the package insert and the FDA drug shortages website.
Perspective
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As all clinicians are aware, drug product shortages occur all too commonly. With overall influenza activity high in the US, according to the CDC (www.cdc.gov/flu/weekly/fluviewinteractive.htm), it is certainly not a good time for a shortage of this antiviral agent. This is especially important when one considers that children younger than 5 years of age, and especially children younger than 2 years, are at higher risk for complications from influenza – ages that may be among the greatest users of Tamiflu suspension.
Although this shortage is occurring, a recipe for compounding a suspension (of the same concentration as the commercial product – 6 mg/mL) is readily available, and it should be relatively straightforward to prepare by a pharmacy. The recipe is available online (www.tamiflu.com/hcp/resources/hcp_resources_pharmacists.jsp).
When Tamiflu suspension is prescribed during this shortage, it will likely be helpful for prescribers to spend a few minutes explaining to parents and caregivers that extra time may be required at some pharmacies to prepare this compounded liquid. As well, it may be wise to call the patient’s pharmacy of choice to inquire if the pharmacy can indeed compound this suspension (eg, the pharmacy may not have the mixing vehicle in stock). And, with respect to timing, it is also important to consider that clinical benefit from Tamiflu use is greatest when treatment is initiated early, preferably within 48 hours of illness onset.
Additional information about Tamiflu dosing and alternative pharmacotherapies for influenza can be found online from the CDC (www.cdc.gov/flu/professionals/index.htm).