Children and Flu Antiviral Drugs

Antiviral Drugs

While getting an influenza (flu) vaccine each year is recommended by CDC as the first and most important step in protecting against flu, there also are drugs that can treat flu illness.  These “flu antiviral drugs” are an important treatment option for children with suspected or confirmed flu.

Antiviral drugs for children come in the form of pills, liquid, inhaled powder, or intravenous solution. They fight flu by keeping flu viruses from reproducing in the body. Antiviral drugs must be prescribed by a doctor — they are not available over-the-counter. For treatment, flu antiviral drugs should ideally be started within 2 days after becoming sick, but children who are at high risk for flu complications or who are hospitalized can still benefit when antiviral treatment is started after 2 days from becoming sick. If a child is sick with flu, antiviral drugs offer a safe and effective treatment option.

Flu antiviral drugs only work against influenza viruses — they will not help against other viruses that may cause illness symptoms similar to flu.

Benefits from Antiviral Treatment of Influenza

Flu antiviral drugs can make flu symptoms milder and can shorten duration of illness. Antiviral drugs work best if started soon after getting sick (within two days of symptoms starting). Early treatment of flu with antiviral drugs also has been shown to reduce the incidence of ear infections and the need for antibiotic treatment in children between 1 and 12 years old. Treatment with antiviral drugs also may reduce more serious flu-related complications like pneumonia and hospitalizations. Studies in both adults and children show that treatment of hospitalized patients can be beneficial in preventing respiratory failure and death.

CDC and the American Academy of Pediatrics (AAP) recommend antiviral drugs to treat confirmed or suspected flu in children with severe, complicated, or progressive illness, or who are hospitalized with confirmed or suspected flu, as early as possible. Prompt initiation of antiviral treatment also is recommended for children who are at high risk of serious flu complications and who have confirmed or suspected flu of any severity. Children at high risk of flu-related complications include children younger than 5 years old (especially those younger than 2 years) and children of any age with certain chronic health conditions like asthma, diabetes, or heart or lung disease. For more information on the AAP recommendations, visit the AAP’s Red Book Online Influenza Resource Page Externalexternal icon.

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Antiviral Drugs Approved for Use in Children

Mixing Oseltamivir Capsules

If your child’s provider prescribes oseltamivir capsules for your child and your child cannot swallow capsules, the prescribed capsules may be opened, mixed with a thick sweetened liquid, and given that way.

There are four flu antiviral drugs approved by the U.S. Food and Drug Administration (FDA) for use in the United States which are recommended by CDC for use in children during the 2019-2020 flu season:

  • Oseltamivir (available as a generic version or under the trade name Tamiflu®) is approved for treatment of flu in children 2 weeks old or older. Oral oseltamivir comes in the form of pills and liquid. Although not part of the FDA-approved indications, use of oral oseltamivir for treatment of flu in infants younger than 14 days old.
  • Zanamivir (trade name Relenza®) is approved for treatment of flu in children 7 years and older. It is not recommended for use in children with underlying respiratory disease, including those with asthma and other chronic lung diseases.  Inhaled zanamivir is given via a special inhaler (Diskhaler®).
  • Peramivir (trade name Rapivab®) is given intravenously and recommended for use in children 2 years and older.
  • Baloxavir (trade name Xofluza®) is a pill that is given as single dose by mouth and is approved for early outpatient treatment of children with flu who are aged 12 years and older.

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Side Effects of Antiviral Drugs

Side effects vary for each medication. The most common side effects for oseltamivir are nausea and vomiting. Zanamivir can cause difficulty breathing in people with underlying lung disease and peramivir can cause diarrhea. Other less common side effects also have been reported. Your health care provider can give you more information about these drugs or you can check the Food and Drug Administration (FDA)external icon website for specific information about antiviral drugs, including the manufacturer’s package insert.

If Your Child Gets the Flu

Your child’s health care provider can help decide whether your child should take antiviral drugs if they become sick with flu this season. Flu signs and symptoms include fever, headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose and muscle aches. It’s important to note that some children with flu will not have a fever.

For more information about influenza antiviral drugs, visit Treatment – Antiviral Drugs.

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