Is Tamiflu safe with LBD?

This year we know the flu vaccine isn’t as effective as it could be. And we hear that we should get a prescription for Tamiflu (oseltamivir) immediately if we’ve been exposed to the flu or if we come down with it.

It does seem to be helpful—but only if you take it early on. In a study, the drug helped shorten the time adults were sick by 30% compared to people who didn’t take it within 48 hours of their first symptoms.

But how safe is it for our loved ones with LBD? My first guess was “I’ll bet it is pretty safe.” I was basing this on the fact that most antibiotics are safe for most LBDers. Of course, Tamiflu is an antiviral, not an antibiotic. Does that make a difference? Here’s what our research showed. We researched several sites but found the two shown here to be the most helpful. First, Tamiflu’s “Treatment for Adults”  tells us that Tamiflu is used in two ways:

• Treatment, once symptoms appear: The standard adult dose of Tamiflu is 75mg, twice daily for 5 days. To be effective, treatment must start within 48 hours of the first flu symptom. A smaller dose can be used to treat a child as young as two weeks. You might ask about the effectiveness of a smaller dose for an elderly person or someone with dementia.
• Prevention, as when you’ve been exposed, but before any symptoms appear, or for up to six weeks during a community outbreak: One dose, once daily for 10 days, or longer as prescribed. (A smaller dose can be used for a child an young as one year. Again, you might ask about a smaller dose for an elderly person or someone with dementia.

Their website also warns us that Tamiflu:

• Is not a substitute for an annual flu vaccination  We should all get flu vaccines if we haven't already. 
• Does not prevent bacterial infections that may happen with the flu. Call the doctor if you have symptoms such as sudden fever, aches, chills or tiredness. 

On other websites, including Drugs.com, we learned that Tamiflu does have some anticholinergic action--and thus, the possibility of drug sensitivity with LBD. The two issues here are strength and duration.

• Strength: The fact that it is approved for use in young children tells us that the action is normally mild. Tamiflu can cause all of those GI symptoms we relate with anticholinergics: from dry mouth to nausea (common) to urine retention (rare). On rare occasions, it has caused those neurological symptoms such as hallucinations that we relate with LBD drug sensitivity, but mainly in children. It may also cause the same symptoms in the elderly (and we can impose here, anyone with dementia) although this is apparently even more rare.
• Duration: Tamiflu has a half-life of 6-10 hours, meaning, that most of it will leave the system in less than a day. Thus, you can try the drug knowing than any unwanted symptoms will not last long. If some do show up, then given the amount of severity, you and the prescribing doctor can decide if they are worth the protection the drug provides.

And so, my first guess was about right. There is some anticholinergic action, but it is usually mild and the duration of the drug is fairly short. Therefore, given this year's especially virulent flu, if it were my loved one, I'd definitely give Tamiflu a try, If you do, monitor carefully for unwanted symptoms and consult the doctor immediately if any show up.

If you need help paying for your drugs, this website might help.

The information in this blog is for your educational purposes only. Do not use it instead of consulting a doctor.

For information about Lewy body disorders read our books:

A Caregivers’ Guide to Lewy Body Dementia

Managing Cognitive Issues in Parkinson’s & Other LewyBody Disorders