Side Effects of oseltamivir: A Synthesis of Findings from 31 Studies

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Original Abstract of the Article

Major Research Findings

Oseltamivir, a widely used antiviral medication for influenza, has been associated with various side effects. Some studies have shown potential neuropsychiatric side effects, especially in younger patients and males. 31 , 26 , 22 , 17 , 14 , 12 , 9 , 7 . Reports suggest that neuropsychiatric symptoms occur more frequently in children and require careful monitoring. 17 , 9 , 7 . Additionally, oseltamivir can potentially cause liver damage, leading to hepatitis. 4 , . Furthermore, evidence suggests that oseltamivir may contribute to intestinal inflammation. 11 . Therefore, the administration of oseltamivir should be done with caution due to its potential impact on various organs, including the liver and intestines.

Reasons for Side Effects

The exact reasons for oseltamivir's side effects are not fully understood, but several possibilities have been suggested. One factor is its potential to affect the brain. 31 , 29 , 26 , 22 . Studies have shown that oseltamivir can cross the blood-brain barrier and reach the brain. 22 . Additionally, oseltamivir has been linked to potential inhibition of neurotransmitter function. 19 , 14 . Oseltamivir is known to inhibit nicotinic acetylcholine receptors, which could potentially disrupt neurotransmitter function. 19 . Moreover, oseltamivir might interfere with liver enzymes. 25 , 5 . Since oseltamivir is metabolized in the liver, inhibiting liver enzymes could potentially burden the liver. 25 . The side effects of oseltamivir likely result from a combination of these factors.

Common Side Effects

Gastrointestinal

The most common side effects of oseltamivir involve the gastrointestinal system. Symptoms like nausea, vomiting, abdominal pain, and diarrhea have been reported. 27 , 20 , 13 , 4 . These symptoms are generally mild and often subside upon stopping the medication.

Neuropsychiatric

Oseltamivir can potentially cause neuropsychiatric side effects. Hallucinations, delusions, confusion, anxiety, depression, insomnia, and aggression have been reported. 31 , 27 , 26 , 22 , 18 , 17 , 14 , 12 , 9 , 7 . These symptoms are reported to be more common in children. 31 , 26 , 22 , 17 , 14 , 12 , 9 , 7 . Consult a doctor if any neuropsychiatric symptoms arise after taking oseltamivir.

Liver

Oseltamivir can affect the liver. Hepatitis, jaundice, and liver function abnormalities have been reported. 4 , . These symptoms can become serious and potentially life-threatening. If any liver-related symptoms develop while taking oseltamivir, seek immediate medical attention.

Heart

Oseltamivir can have effects on the heart. QT interval prolongation and atrial fibrillation have been reported. 10 . These symptoms can be serious and potentially life-threatening. If you experience any heart-related symptoms while taking oseltamivir, consult a doctor immediately.

Others

Oseltamivir can cause various other side effects beyond the gastrointestinal, neuropsychiatric, liver, and heart systems. Rash, hives, breathing difficulties, dizziness, headaches, and fatigue have been reported. 27 , 20 , 13 , 4 , 1 . These symptoms are usually mild and tend to resolve upon stopping the medication.

Managing Side Effects

Gastrointestinal

If gastrointestinal symptoms develop after taking oseltamivir, they can be alleviated through dietary and medication management. 27 , 20 , 13 . Dietary adjustments include consuming easily digestible foods and staying well-hydrated. Medications like antiemetics, antacids, and antidiarrheal drugs can also be used.

Neuropsychiatric

If neuropsychiatric symptoms occur after taking oseltamivir, it is crucial to consult a doctor for proper evaluation and treatment. 31 , 27 , 26 , 22 , 18 , 17 , 14 , 12 , 9 , 7 . Neuropsychiatric symptoms can become serious and potentially life-threatening. If you experience any neuropsychiatric symptoms while taking oseltamivir, seek immediate medical attention.

Liver

If oseltamivir affects your liver, it is essential to consult a doctor for proper evaluation and treatment. 4 , . Liver-related symptoms can become serious and potentially life-threatening. If you experience any liver symptoms while taking oseltamivir, seek immediate medical attention.

Heart

If oseltamivir affects your heart, it is crucial to consult a doctor for proper evaluation and treatment. 10 . Heart-related symptoms can become serious and potentially life-threatening. If you experience any heart symptoms while taking oseltamivir, seek immediate medical attention.

Comparing Research Studies

Research Similarities

Several research studies have indicated that oseltamivir can potentially cause neuropsychiatric side effects. 31 , 26 , 22 , 17 , 14 , 12 , 9 , 7 . Furthermore, multiple studies have reported that oseltamivir can have a potential impact on the liver. 4 , .

Research Differences

The incidence and severity of oseltamivir's side effects vary across research studies. This variation could be attributed to differences in study populations, dosages, administration methods, and individual factors. Additionally, oseltamivir side effects can differ based on individual sensitivities.

Considerations for Real-Life Applications

Oseltamivir is an effective medication for treating influenza, but it's important to be aware of the potential side effects. Neuropsychiatric side effects have been reported to be more common in children. 31 , 26 , 22 , 17 , 14 , 12 , 9 , 7 . When considering oseltamivir, consult a doctor, understand the risks and benefits, and make informed decisions regarding treatment.

Limitations of Current Research

Research on oseltamivir's side effects is still limited. There are many unanswered questions regarding long-term effects, individual sensitivity, and the specific mechanisms behind the side effects. Further investigation is needed.

Future Research Directions

Further research on oseltamivir's side effects is essential. Specifically, more studies are needed to understand the long-term effects, individual variations, and the mechanisms underlying these side effects.

Conclusion

Oseltamivir is an effective medication for treating influenza but carries potential side effects. When considering oseltamivir, consult a doctor, understand the risks and benefits, and make informed decisions regarding treatment.

Literature analysis of 31 papers
Positive Content
17
Neutral Content
0
Negative Content
14
Article Type
2
0
0
6
27
1.

Acute Cheilitis Associated with Oseltamivir after Influenzae A Infection.

Author: YokoyamaKoji, MamadaMitsukazu

Cheilitis
Stomatitis

A case report describes novel side effects associated with oseltamivir, an influenza treatment drug. The patient developed cheilitis and stomatitis after taking oseltamivir, but symptoms resolved after discontinuation.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

2.

Increased α-2,6 sialic acid on microglia in amyloid pathology is resistant to oseltamivir.

Author: FastenauCaitlyn, WicklineJessica L, SmithSabrina, OdfalkKristian F, SolanoLeigh, BieniekKevin F, HoppSarah C

Neuropsychiatric side effects

This study investigated the effects of the antiviral drug oseltamivir on brain sialylation in a mouse model of Alzheimer's disease. While oseltamivir did not affect behavior or amyloid plaques, it revealed a unique distribution of sialic acid residues on plaque-associated microglia, suggesting that microglia may be resistant to changes in sialylation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Oseltamivir and acute hepatitis, reality association or coincidence?

Author: MastroianniAntonio, VangeliValeria, GrecoSonia, UrsoFilippo, GrecoFrancesca, ChidichimoLuciana, MauroMaria Vittoria

Influenza treatment
Hepatitis

Oseltamivir is an antiviral medication that inhibits influenza neuraminidase enzymes, active against both influenza A and B viruses. This is the first reported case in Italy linking the development of acute hepatitis and oseltamivir therapy, in a patient suffering from influenza H1N1 infection. This case report suggests that experts should consider adding potential serious liver reactions to the oseltamivir product label.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

5.

Adverse Effects of Oseltamivir Phosphate Therapy on the Liver of LDLR-/- Mice Without Any Benefit on Atherosclerosis and Thrombosis.

Author: BocquetOlivier, WahartAmandine, SarazinThomas, VincentElise, SchneiderChristophe, FougeratAnne, GayralStéphanie, HenryAubéri, BlaiseSébastien, Romier-CrouzetBéatrice, BoulagnonCamille, JaissonStéphane, GilleryPhilippe, BennasrouneAmar, SarteletHervé, LaffargueMuriel, MartinyLaurent, DucaLaurent, MauricePascal

Atherosclerosis treatment
Liver toxicity

Oseltamivir phosphate is a drug used to treat influenza. This study found that the drug may have limited benefits for atherosclerosis (hardening of the arteries) and may even cause liver problems.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Drug-induced Neuropsychiatric Adverse Events Using Post-Marketing Surveillance.

Author: WakabayashiTomohito, NakatsujiTakahiro, KambaraHiroko, NiinomiIku, OyamaSaki, InadaAyaka, UenoSayaka, UchidaMayako, IwanagaKazunori, IidaTatsuya, HosohataKeiko

Abnormal behavior

This study aimed to identify drugs associated with abnormal behavior in pediatric patients using a spontaneous reporting system database. The study found that several drugs, including neuraminidase inhibitors, were associated with abnormal behavior.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Delayed Onset of Manic Symptoms in a Patient with Influenza A (H1N1) after administration of Oseltamivir (Tamiflu): A Case Report.

Author: JhonMin, KimJu-Wan, KangHee-Ju, KimSeon-Young, LeeJu-Yeon, KimSung-Wan, ShinIl-Seon, KimJae-Min

Psychiatric side effects

Oseltamivir is a drug used to treat influenza. This case report describes a young girl who developed manic symptoms after taking oseltamivir and receiving the HPV vaccine. The study suggests that clinicians should closely monitor patients taking oseltamivir, especially those who are young, have a family history of psychiatric disorder, or have drug sensitivity.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

8.

First case of acute cholestatic hepatitis attributed to oseltamivir in a young girl with ah1n1 influenza.

Author: MastroianniA, GrecoS, VangeliV, RitaccaR, MauroM V, GuadagninoG

Influenza treatment
Acute hepatitis

This is the first case report linking the development of acute hepatitis to the consumption of oseltamivir in a patient suffering from influenza H1N1 infection.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Neuropsychiatric Effects of Antiviral Drugs.

Author: ZareifopoulosNicholas, LagadinouMaria, KarelaAnastasia, KyriakopoulouOurania, VelissarisDimitrios

Neuropsychiatric complications

Antiviral drugs can cause significant neuropsychiatric complications ranging from mild symptoms like irritability and difficulty sleeping to severe complications like depression, psychosis, and painful peripheral neuropathy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Prolongation of QT interval due to hydroxychloroquine overdose used in COVID-19 treatment.

Author: AkselGökhan, IslamMehmet Muzaffer, AslanTuncay, ErogluSerkan Emre

QT prolongation

This case report presents a young patient who experienced QT interval prolongation due to hydroxychloroquine overdose, highlighting the importance of patient education and monitoring for potential cardiac side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

11.

Acute ischemic colitis with hematochezia related to baloxavir marboxil treatment for influenza A.

Author: KanaiNorihito, HashimotoTakafumi, FukudaMasataka, ShijyoTakayuki

Anti-influenza medication
Ischemic colitis

This case report describes a 62-year-old Japanese woman who developed acute ischemic colitis after taking baloxavir for influenza A. This case suggests a potential risk of ischemic colitis with baloxavir and highlights the need for further investigation into drug-induced colitis associated with anti-influenza medications.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Neuropsychiatric events in an adult patient with influenza a (H3N2) treated with oseltamivir (Tamiflu): a case report.

Author: ChenRuochan, FangZhixiong, HuangYan

Influenza treatment
Neuropsychiatric events

Oseltamivir is an effective treatment for influenza, but it may cause neuropsychiatric events in young patients and males, and a case has been reported in an older patient.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Advances in Studies of P-Glycoprotein and Its Expression Regulators.

Author: YanoKentaro, TomonoTakumi, OgiharaTakuo

Drug brain distribution

This review discussed recent advances in studies on P-glycoprotein (P-gp). The review highlighted the heterogeneous distribution of P-gp along the small intestine, the post-translational regulation of P-gp localization and function by ERM proteins, and the influence of P-gp on drug distribution in the brain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Pharmacological Aspects of Neuro-Immune Interactions.

Author: TarasovVadim V, KudryashovNikita V, ChubarevVladimir N, KalininaTatiana S, BarretoGeorge E, AshrafGhulam Md, AlievGjumrakch

Antiviral
Immunomodulatory
Neuroprotection
Abnormal behavior
Delirium
Depression
Impaired perception
Suicides

This review analyzed the central effects of drugs with antiviral or immunotropic activity, and their relationship to changes in immune system reactivity and proinflammatory response. The authors suggest that integrative mechanisms underlying neuro-immune interactions may explain the pleiotropic pharmacological effects of these drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

Analysis of a child who developed abnormal neuropsychiatric symptoms after administration of oseltamivir: a case report.

Author: MorimotoKaori, NagaokaKei, NagaiAkira, KashiiHirofumi, HosokawaMasakiyo, TakahashiYukitoshi, OgiharaTakuo, KubotaMasaya

Neuropsychiatric side effects

A 15-year-old Japanese female with influenza developed abnormal psychiatric symptoms after taking oseltamivir. These symptoms resolved after cessation of the drug and administration of benzodiazepine. Further investigation revealed that the serum level of the active metabolite Ro 64-0802 was higher than expected. This, in conjunction with the patient's genetic profile, suggests that abnormal exposure to Ro 64-0802 may have contributed to her psychiatric symptoms.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Acute exacerbation of psychiatric symptoms during influenza treatment with oseltamivir in chronic schizophrenia.

Author: LanChen-Chia, LiuChia-Chien, ChenYing-Sheue

Influenza prophylaxis
Influenza treatment
Affective symptoms
Psychiatric side effects
Psychotic symptoms

This report describes two chronic schizophrenia patients in Taiwan manifesting psychiatric instability who were being treated with oseltamivir for suspected influenza infection.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

The mechanisms of sudden-onset type adverse reactions to oseltamivir.

Author: HamaR, BennettC L

Abnormal behavior
Sudden death

This review examines the growing evidence for a link between oseltamivir and abnormal behaviors and sudden death in humans, particularly in children and adolescents. Oseltamivir is known to have various effects on the central nervous system (CNS), including inhibition of nicotinic acetylcholine receptors and monoamine oxidase-A (MAO-A), which may contribute to these adverse events.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

A part-randomized study of intravenous oseltamivir in adolescents and adults.

Author: VárkonyiI, ChappeyC, GiraudonM, BurleighL

Safe intravenous administration
Systemic exposure

Intravenous oseltamivir is a potential treatment option for seriously ill influenza patients unable to take oral medication. This study evaluated its safety and pharmacokinetics in hospitalized adults and adolescents with laboratory-confirmed influenza. While intravenous oseltamivir was not associated with significant safety concerns at the tested dosages, further research is needed to optimize dosing and explore its efficacy in this patient population.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Combination therapy with amantadine, oseltamivir and ribavirin for influenza A infection: safety and pharmacokinetics.

Author: SeoSachiko, EnglundJanet A, NguyenJack T, PukrittayakameeSasithon, LindegardhNiklas, TarningJoel, TambyahPaul A, RenaudChristian, WentGregory T, de JongMenno D, BoeckhMichael J

Antiviral efficacy

A triple-combination antiviral drug (TCAD) regimen consisting of amantadine (AMT), oseltamivir (OSL) and ribavirin (RBV) demonstrated good efficacy in an animal model for the treatment of drug-resistant influenza A.

Clinical Trial, Phase IThe first stage of clinical trials in humans. Evaluates the safety, tolerability, and pharmacokinetics of a new drug/treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Developmental changes of brain distribution and localization of oseltamivir and its active metabolite Ro 64-0802 in rats.

Author: MorimotoKaori, NagamiTakaaki, MatsumotoNoriko, WadaSho, KanoTakashi, KakinumaChihaya, OgiharaTakuo

Mental instability
Suicidal tendencies

Oseltamivir is a drug used to treat influenza. This study found that oseltamivir concentrations in the brain of young rats were much higher than in older rats, potentially explaining the rare side effect of mental instability and suicidal tendencies in young patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

23.

Oseltamivir and inhaled zanamivir as influenza prophylaxis in Thai health workers: a randomized, double-blind, placebo-controlled safety trial over 16 weeks.

Author: AnekthananonT, PukrittayakameeS, PukritayakameeS, RatanasuwanW, JittamalaP, WerarakP, CharunwatthanaP, SuwanagoolS, LawpoolsriS, StepniewskaK, SapchookulP, PuthavathanaP, FukudaC, LindegardhN, TarningJ, WhiteN J, DayN, TaylorW R J

Influenza prophylaxis
Intercurrent infections

Oseltamivir and zanamivir were well tolerated in healthy hospital professionals for primary influenza prophylaxis over 16 weeks.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

27.

Antivirals for influenza: strategies for use in pediatrics.

Author: SmithSteven M, GumsJohn G

Influenza treatment
Reduced bacterial infections
Drug resistance
Neuropsychiatric events

Influenza infection is a major cause of morbidity and mortality, especially in children. While vaccination is recommended, its efficacy is reduced in children. Antiviral therapies, particularly neuraminidase inhibitors, are effective treatment options. However, emerging resistance and potential neuropsychiatric side effects are concerns.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

30.

Oseltamivir (tamiflu) is a substrate of peptide transporter 1.

Author: OgiharaTakuo, KanoTakashi, WagatsumaTamae, WadaSho, YabuuchiHikaru, EnomotoShigeki, MorimotoKaori, ShirasakaYoshiyuki, KobayashiShoko, TamaiIkumi

Influenza treatment
Neuropsychiatric side effects

Oseltamivir, an influenza treatment, is absorbed in the intestines through the peptide transporter 1 (PEPT1).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

31.

Biodistribution and metabolism of the anti-influenza drug [11C]oseltamivir and its active metabolite [11C]Ro 64-0802 in mice.

Author: HatoriAkiko, AraiTakuya, YanamotoKazuhiko, YamasakiTomoteru, KawamuraKazunori, YuiJoji, KonnoFujiko, NakaoRyuji, SuzukiKazutoshi, ZhangMing-Rong

Neuropsychiatric side effects

Oseltamivir phosphate (Tamiflu) is an anti-influenza drug that has been associated with abnormal behavior and death, especially in Japan. This study explores the use of [(11)C]oseltamivir and [(11)C]Ro 64-0802 as positron emission tomography (PET) ligands in mice to measure the amounts of these drugs in the brain, potentially providing insights into their neuropsychiatric side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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