When to Take Tamiflu, According to a Doctor

We've gathered the facts on this pricey and controversial drug.

Every year when flu season rolls around, you're probably tempted to spend a good hour or two consulting with Dr. Google about what drugs could help at the first signs of the flu (fever, chest pain, body chills). Or not. Let's face it, the flu renders almost everybody useless, and you probably feel miserable enough to take just about anything. But you might not know exactly when to take Tamiflu, or similar drugs, should you get the flu.

Odds are your doc will prescribe one of four antiviral meds: inhaled zanamivir (brand name Relenza), intravenous peramivir (Rapivab), baloxavir marboxil (Xofluza), or oral oseltamivir, otherwise known as Tamiflu.

Tamiflu has been the subject of controversy in recent years—which has left many wondering, Does Tamiflu work? And are Tamiflu side effects worth it? Here are the facts on the pricey drug so you can weigh the pros and cons before you're too achy to think straight.

Does Tamiflu work?

A 2014 Cochrane review found that the drug did not reduce hospitalization rates for the flu and only shortened the duration of people's symptoms by 17 hours. But 17 hours isn't nothing when you feel totally terrible.

It is worth noting that the study authors expressed some doubt about their findings: "We identified problems in the design of many of the studies that we included, which affects our confidence in their results."

As for flu prevention, the FDA says Tamiflu can also keep people from getting sick in the first place.

Can I skip the flu shot and take Tamiflu instead?

Nope—the drug is not a substitute for early flu vaccination, according to the drug's manufacturer. Getting a flu shot is the best way to prevent the flu. Your protection lasts through the entire season. Plus, Tamiflu is expensive. Consumer Reports quoted the cost of a five-day course as at least $100.

When should I take Tamiflu?

Tamiflu is approved to treat influenza in people whose symptoms have not lasted longer than two days (which might come as a surprise to anyone who has gotten a script after being sick for a week.)

"The literature on antivirals for influenza shows that they work best when taken 48 to 72 hours after the onset of flu symptoms," explains Susan Rehm, MD, vice chair of the department of infectious disease at the Cleveland Clinic. If you take antivirals after that window, "the potential benefits are less," she notes.

That said, doctors might prescribe Tamiflu to people who are immunocompromised or at risk of flu-related complications, even if the 72-hour period has passed, Dr. Rehm says. "Even healthy people may develop complications of influenza, like bacterial pneumonia," she says. (If you have a fever or shortness of breath that lingers, alert your doctor, Dr. Rehm urges.)

Should I be worried about resistance to Tamiflu?

According to the Centers for Disease Control and Prevention, "antiviral resistance to oseltamivir… among circulating influenza viruses is currently low."

Basically, whether you take Tamiflu or not is up to you and your doctor. No one should take any drug unnecessarily, Dr. Rehm points out. And the side effects of Tamiflu—which include nausea and vomiting—are worth considering. But, she says, among her patients who have decided to take Tamiflu, "many comment that they seemed to have recovered more quickly."

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