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Swine Flu Treatments - Kids and Swine Flu

Swine Flu Basics

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Updated September 23, 2009

The current swine flu cases are caused by a virus.

Specifically, they are being caused by a swine influenza A (H1N1) virus, a new strain of flu virus.

It is because this is a new strain of flu virus that it is spreading so easily and why so many kids are getting sick with the swine flu this year.

Fortunately, there are treatments for the swine flu.

Keep in mind that the CDC states that the 'priority use for these drugs this season is to treat people who are very sick (hospitalized) or people who are sick with flu symptoms and who are at increased risk of serious flu complications, such as pregnant women, young children, people 65 and older and people with chronic health conditions.'

That means that most people who get swine flu, including healthy children over age five years of age, won't need Tamiflu or Relenza.

Swine Flu Treatments

As with the regular seasonal flu, antiviral flu medications, including Tamiflu (oseltamivir) and Relenza (zanamivir), are available to prevent and treat the swine flu.

What makes this confusing is that there were many reports this past flu season that the seasonal flu virus was resistant to Tamiflu. In fact, it was recommended that doctors go back to using older medicines like Symmetrel (amantadine) or Flumadine (rimantadine) with Tamiflu or Relenza instead, if someone had a seasonal influenza A (H1N1) virus infection.

In contrast, the swine influenza A (H1N1) virus is still sensitive to Tamiflu and Relenza.

As with seasonal flu, Tamiflu and Relenza should be started within 48 hours of your child developing swine flu symptoms. According to the CDC, these flu medications can even be started after 48 hours though, especially if a patient is hospitalized or is at high risk to develop complications from the flu.

Swine Flu Treatments for Kids

Although Tamiflu is available as a syrup, it has never been approved for use in children under 12 months of age. Fortunately, the Food and Drug Administration has approved the use of Tamiflu for infants under an Emergency Use Authorization.

Dosing of Tamiflu for treatment of swine flu in infants includes:

  • 12 mg twice daily for 5 days in infants under 3 months old
  • 20 mg twice daily for 5 days in infants 3 to 5 months old
  • 25 mg twice daily for 5 days in infants 6 to 11 months old

Dosing of Tamiflu for prevention (prophylaxis) of swine flu in infants includes:

  • 20 mg once daily for 10 days in infants 3 to 5 months old
  • 25 mg once daily for 10 days in infants 6 to 11 months old

It is not recommended that infants under 3 months old routinely take Tamiflu for prevention of swine flu.

Children over 12 months old would take routine dosages of Tamiflu, just like they would for seasonal flu, to prevent and treat swine flu.

Relenza is still only recommended for children who are at least 7 years old (treatment) and who are at least 5 years old (prevention).

Tamiflu Shortages

The increasing flu activity has already led to limited supplies of Tamiflu suspension. Fortunately, the CDC reports that 'supplies of adult formulation (75 mg) oseltamivir (Tamiflu) and zanamivir (Relenza) are meeting current demand.'

So what do you do if your younger child who can't swallow pills needs Tamiflu?

Options include:

  • having your pharmacist follow the FDA-approved instructions for the emergency compounding of an oral suspension from Tamiflu 75mg capsules
  • having your pediatrician prescribe Tamiflu capsules, which are available in 30mg, 45mg, and 75mg capsules, and then open and mix the appropriate capsule size with a sweetened liquid, such as regular or sugar-free chocolate syrup


Sources:

CDC. Antiviral Drugs and Swine Influenza. Accessed April 2009.
http://www.cdc.gov/swineflu/antiviral_swine.htm

CDC. Interim Guidance on Antiviral Recommendations for Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection and Close Contacts. Accessed April 2009.
http://www.cdc.gov/swineflu/recommendations.htm

CDC. 2009-2010 Influenza Season: Information for Pharmacists. Accessed September 2009.
http://www.cdc.gov/H1N1flu/pharmacist/pharmacist_info.htm

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