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class="vector-toc-list"> <li id="toc-High-risk_people" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#High-risk_people"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.1</span> <span>High-risk people</span> </div> </a> <ul id="toc-High-risk_people-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Otherwise_healthy_people" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Otherwise_healthy_people"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.2</span> <span>Otherwise healthy people</span> </div> </a> <ul id="toc-Otherwise_healthy_people-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.3</span> <span>Prevention</span> </div> </a> <ul id="toc-Prevention-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Side_effects" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Side_effects"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Side effects</span> </div> </a> <ul id="toc-Side_effects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Mechanism_of_action" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Mechanism_of_action"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Mechanism of action</span> </div> </a> <ul id="toc-Mechanism_of_action-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Resistance" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Resistance"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Resistance</span> </div> </a> <button aria-controls="toc-Resistance-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Resistance subsection</span> </button> <ul id="toc-Resistance-sublist" class="vector-toc-list"> <li id="toc-H1N1_flu_or_"swine_flu"" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#H1N1_flu_or_"swine_flu""> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>H1N1 flu or "swine flu"</span> </div> </a> <ul id="toc-H1N1_flu_or_"swine_flu"-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Seasonal_flu" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Seasonal_flu"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>Seasonal flu</span> </div> </a> <ul id="toc-Seasonal_flu-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-H3N2" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#H3N2"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.3</span> <span>H3N2</span> </div> </a> <ul id="toc-H3N2-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Influenza_B" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Influenza_B"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.4</span> <span>Influenza B</span> </div> </a> <ul id="toc-Influenza_B-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-H5N1_avian_influenza_"bird_flu"" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#H5N1_avian_influenza_"bird_flu""> <div class="vector-toc-text"> <span class="vector-toc-numb">4.5</span> <span>H5N1 avian influenza "bird flu"</span> </div> </a> <ul id="toc-H5N1_avian_influenza_"bird_flu"-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-H7N9_avian_influenza" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#H7N9_avian_influenza"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.6</span> <span>H7N9 avian influenza</span> </div> </a> <ul id="toc-H7N9_avian_influenza-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Pharmacokinetics" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Pharmacokinetics"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Pharmacokinetics</span> </div> </a> <ul id="toc-Pharmacokinetics-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Veterinary_use" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Veterinary_use"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Veterinary use</span> </div> </a> <ul id="toc-Veterinary_use-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Research</span> </div> </a> <ul id="toc-Research-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Oseltamivir</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 43 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-43" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">43 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A3%D9%88%D8%B3%D9%8A%D9%84%D8%AA%D8%A7%D9%85%D9%8A%D9%81%D9%8A%D8%B1" title="أوسيلتاميفير – Arabic" lang="ar" hreflang="ar" data-title="أوسيلتاميفير" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D8%A7%D9%88%D8%B3%D9%84%D8%AA%D8%A7%D9%85%DB%8C%D9%88%DB%8C%D8%B1" title="اوسلتامیویر – South Azerbaijani" lang="azb" hreflang="azb" data-title="اوسلتامیویر" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target"><span>تۆرکجه</span></a></li><li class="interlanguage-link interwiki-zh-min-nan mw-list-item"><a href="https://zh-min-nan.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Minnan" lang="nan" hreflang="nan" data-title="Oseltamivir" data-language-autonym="閩南語 / Bân-lâm-gú" data-language-local-name="Minnan" class="interlanguage-link-target"><span>閩南語 / Bân-lâm-gú</span></a></li><li class="interlanguage-link interwiki-bo mw-list-item"><a href="https://bo.wikipedia.org/wiki/%E0%BD%A8%E0%BD%BC%E0%BC%8B%E0%BD%A6%E0%BD%BA%E0%BD%A3%E0%BC%8B%E0%BD%8F%E0%BD%B1%E0%BC%8B%E0%BD%98%E0%BD%B2%E0%BC%8B%E0%BD%9D%E0%BD%B2%E0%BD%A2%E0%BC%8D" title="ཨོ་སེལ་ཏཱ་མི་ཝིར། – Tibetan" lang="bo" hreflang="bo" data-title="ཨོ་སེལ་ཏཱ་མི་ཝིར།" data-language-autonym="བོད་ཡིག" data-language-local-name="Tibetan" class="interlanguage-link-target"><span>བོད་ཡིག</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Czech" lang="cs" hreflang="cs" data-title="Oseltamivir" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Tamiflu" title="Tamiflu – Danish" lang="da" hreflang="da" data-title="Tamiflu" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – German" lang="de" hreflang="de" data-title="Oseltamivir" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%9F%CF%83%CE%B5%CE%BB%CF%84%CE%B1%CE%BC%CE%B9%CE%B2%CE%AF%CF%81%CE%B7" title="Οσελταμιβίρη – Greek" lang="el" hreflang="el" data-title="Οσελταμιβίρη" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Spanish" lang="es" hreflang="es" data-title="Oseltamivir" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Oseltamiviro" title="Oseltamiviro – Esperanto" lang="eo" hreflang="eo" data-title="Oseltamiviro" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target"><span>Esperanto</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A7%D8%B3%D9%84%D8%AA%D8%A7%D9%85%DB%8C%D9%88%DB%8C%D8%B1" title="اسلتامیویر – Persian" lang="fa" hreflang="fa" data-title="اسلتامیویر" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – French" lang="fr" hreflang="fr" data-title="Oseltamivir" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%98%A4%EC%85%80%ED%83%80%EB%AF%B8%EB%B9%84%EB%A5%B4" title="오셀타미비르 – Korean" lang="ko" hreflang="ko" data-title="오셀타미비르" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%95%D5%BD%D5%A5%D5%AC%D5%BF%D5%A1%D5%B4%D5%AB%D5%BE%D5%AB%D6%80" title="Օսելտամիվիր – Armenian" lang="hy" hreflang="hy" data-title="Օսելտամիվիր" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Croatian" lang="hr" hreflang="hr" data-title="Oseltamivir" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Indonesian" lang="id" hreflang="id" data-title="Oseltamivir" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Italian" lang="it" hreflang="it" data-title="Oseltamivir" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%90%D7%95%D7%A1%D7%9C%D7%98%D7%90%D7%9E%D7%99%D7%91%D7%99%D7%A8" title="אוסלטאמיביר – Hebrew" lang="he" hreflang="he" data-title="אוסלטאמיביר" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Oseltamivirum" title="Oseltamivirum – Latin" lang="la" hreflang="la" data-title="Oseltamivirum" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target"><span>Latina</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Oszeltamivir" title="Oszeltamivir – Hungarian" lang="hu" hreflang="hu" data-title="Oszeltamivir" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%9E%D1%81%D0%B5%D0%BB%D1%82%D0%B0%D0%BC%D0%B8%D0%B2%D0%B8%D1%80" title="Оселтамивир – Macedonian" lang="mk" hreflang="mk" data-title="Оселтамивир" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Dutch" lang="nl" hreflang="nl" data-title="Oseltamivir" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%82%AA%E3%82%BB%E3%83%AB%E3%82%BF%E3%83%9F%E3%83%93%E3%83%AB" title="オセルタミビル – Japanese" lang="ja" hreflang="ja" data-title="オセルタミビル" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Oseltamivir" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Oseltamivir" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target"><span>Norsk nynorsk</span></a></li><li class="interlanguage-link interwiki-oc mw-list-item"><a href="https://oc.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Occitan" lang="oc" hreflang="oc" data-title="Oseltamivir" data-language-autonym="Occitan" data-language-local-name="Occitan" class="interlanguage-link-target"><span>Occitan</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%93%E0%AC%B8%E0%AD%87%E0%AC%B2%E0%AC%9F%E0%AC%BE%E0%AC%AE%E0%AC%BF%E0%AC%AD%E0%AC%BF%E0%AC%B0" title="ଓସେଲଟାମିଭିର – Odia" lang="or" hreflang="or" data-title="ଓସେଲଟାମିଭିର" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Oseltamiwir" title="Oseltamiwir – Polish" lang="pl" hreflang="pl" data-title="Oseltamiwir" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Portuguese" lang="pt" hreflang="pt" data-title="Oseltamivir" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Romanian" lang="ro" hreflang="ro" data-title="Oseltamivir" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9E%D1%81%D0%B5%D0%BB%D1%8C%D1%82%D0%B0%D0%BC%D0%B8%D0%B2%D0%B8%D1%80" title="Осельтамивир – Russian" lang="ru" hreflang="ru" data-title="Осельтамивир" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/Tamiflu" title="Tamiflu – Albanian" lang="sq" hreflang="sq" data-title="Tamiflu" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target"><span>Shqip</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Slovenian" lang="sl" hreflang="sl" data-title="Oseltamivir" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Serbian" lang="sr" hreflang="sr" data-title="Oseltamivir" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Oseltamivir" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Oseltamiviiri" title="Oseltamiviiri – Finnish" lang="fi" hreflang="fi" data-title="Oseltamiviiri" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Swedish" lang="sv" hreflang="sv" data-title="Oseltamivir" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B9%82%E0%B8%AD%E0%B9%80%E0%B8%8B%E0%B8%A5%E0%B8%97%E0%B8%B2%E0%B8%A1%E0%B8%B4%E0%B9%80%E0%B8%A7%E0%B8%B5%E0%B8%A2%E0%B8%A3%E0%B9%8C" title="โอเซลทามิเวียร์ – Thai" lang="th" hreflang="th" data-title="โอเซลทามิเวียร์" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Turkish" lang="tr" hreflang="tr" data-title="Oseltamivir" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%9E%D0%B7%D0%B5%D0%BB%D1%8C%D1%82%D0%B0%D0%BC%D1%96%D0%B2%D1%96%D1%80" title="Озельтамівір – Ukrainian" lang="uk" hreflang="uk" data-title="Озельтамівір" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Oseltamivir" title="Oseltamivir – Vietnamese" lang="vi" hreflang="vi" data-title="Oseltamivir" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li 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</div> </div> </nav> </div> </div> </div> <div class="vector-column-end"> <div class="vector-sticky-pinned-container"> <nav class="vector-page-tools-landmark" aria-label="Page tools"> <div id="vector-page-tools-pinned-container" class="vector-pinned-container"> </div> </nav> <nav class="vector-appearance-landmark" aria-label="Appearance"> <div id="vector-appearance-pinned-container" class="vector-pinned-container"> <div id="vector-appearance" class="vector-appearance vector-pinnable-element"> <div class="vector-pinnable-header vector-appearance-pinnable-header vector-pinnable-header-pinned" data-feature-name="appearance-pinned" data-pinnable-element-id="vector-appearance" data-pinned-container-id="vector-appearance-pinned-container" data-unpinned-container-id="vector-appearance-unpinned-container" > <div class="vector-pinnable-header-label">Appearance</div> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-pin-button" 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compound</div> <style data-mw-deduplicate="TemplateStyles:r1269284339">@media screen{html.skin-theme-clientpref-night .mw-parser-output .dark_mode_safe img{background-color:var(--background-color-inverted,#f8f9fa)}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .dark_mode_safe img{background-color:var(--background-color-inverted,#f8f9fa)}}</style> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox" style="border-spacing:2px;"><caption class="infobox-title"><span title="International nonproprietary name (INN): Oseltamivir">Oseltamivir</span></caption><tbody><tr><td colspan="2" class="infobox-image"><span class="mw-default-size skin-invert-image" typeof="mw:File/Frameless"><a href="/wiki/File:Oseltamivir.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/12/Oseltamivir.svg/220px-Oseltamivir.svg.png" decoding="async" width="220" height="132" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/12/Oseltamivir.svg/330px-Oseltamivir.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/12/Oseltamivir.svg/440px-Oseltamivir.svg.png 2x" data-file-width="512" data-file-height="307" /></a></span></td></tr><tr><td colspan="2" class="infobox-image"><span class="mw-default-size bg-transparent" typeof="mw:File/Frameless"><a href="/wiki/File:Oseltamivir-based-on-dihydrogenphosphate-xtal-3D-bs-17.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b8/Oseltamivir-based-on-dihydrogenphosphate-xtal-3D-bs-17.png/220px-Oseltamivir-based-on-dihydrogenphosphate-xtal-3D-bs-17.png" decoding="async" width="220" height="156" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b8/Oseltamivir-based-on-dihydrogenphosphate-xtal-3D-bs-17.png/330px-Oseltamivir-based-on-dihydrogenphosphate-xtal-3D-bs-17.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b8/Oseltamivir-based-on-dihydrogenphosphate-xtal-3D-bs-17.png/440px-Oseltamivir-based-on-dihydrogenphosphate-xtal-3D-bs-17.png 2x" data-file-width="3000" data-file-height="2131" /></a></span></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Clinical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;">Pronunciation</th><td class="infobox-data"><span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="/ɒ/: 'o' in 'body'">ɒ</span><span title="'s' in 'sigh'">s</span><span title="/əl/: 'le' in 'bottle'">əl</span><span title="/ˈ/: primary stress follows">ˈ</span><span title="'t' in 'tie'">t</span><span title="/æ/: 'a' in 'bad'">æ</span><span title="'m' in 'my'">m</span><span title="/ɪ/: 'i' in 'kit'">ɪ</span><span title="'v' in 'vie'">v</span><span title="/ɪər/: 'ear' in 'near'">ɪər</span></span>/</a></span></span> </td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Drug_nomenclature#Trade_names" title="Drug nomenclature">Trade names</a></th><td class="infobox-data">Tamiflu, others</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;">Other names</th><td class="infobox-data">GS-4104</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/American_Society_of_Health-System_Pharmacists" title="American Society of Health-System Pharmacists">AHFS</a>/<a href="/wiki/Drugs.com" title="Drugs.com">Drugs.com</a></th><td class="infobox-data"><span title="www.drugs.com"><a rel="nofollow" class="external text" href="https://www.drugs.com/monograph/oseltamivir-phosphate.html">Monograph</a></span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></th><td class="infobox-data"><span title="medlineplus.gov"><a rel="nofollow" class="external text" href="https://medlineplus.gov/druginfo/meds/a699040.html">a699040</a></span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">License data</a></th><td class="infobox-data"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style><div class="plainlist"> <ul><li><small><abbr class="country-name" title="United States">US</abbr></small> <a href="/wiki/DailyMed" title="DailyMed">DailyMed</a>: <span title="dailymed.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Oseltamivir">Oseltamivir</a></span></li></ul></div> </td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Pregnancy_category" title="Pregnancy category">Pregnancy<br />category</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li><small><abbr class="country-name" title="Australia">AU</abbr>:</small> B1<sup id="cite_ref-Preg2017_1-0" class="reference"><a href="#cite_note-Preg2017-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Tamiflu_PI_2-0" class="reference"><a href="#cite_note-Tamiflu_PI-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></li> <li class="mw-empty-elt"></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Route_of_administration" title="Route of administration">Routes of<br />administration</a></th><td class="infobox-data"><a href="/wiki/Oral_administration" title="Oral administration">By mouth</a></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Drug_class" title="Drug class">Drug class</a></th><td class="infobox-data"><a href="/wiki/Neuraminidase_inhibitor" title="Neuraminidase inhibitor">Neuraminidase inhibitor</a></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Anatomical_Therapeutic_Chemical_Classification_System" title="Anatomical Therapeutic Chemical Classification System">ATC code</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><a href="/wiki/ATC_code_J05" title="ATC code J05">J05AH02</a> (<span title="www.whocc.no"><a rel="nofollow" class="external text" href="https://www.whocc.no/atc_ddd_index/?code=J05AH02">WHO</a></span>) </li></ul></div></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Legal status</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">Legal status</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li><small><abbr class="country-name" title="Australia">AU</abbr>:</small> <a href="/wiki/Standard_for_the_Uniform_Scheduling_of_Medicines_and_Poisons#Schedule_4" title="Standard for the Uniform Scheduling of Medicines and Poisons">S4</a> (Prescription only)<sup id="cite_ref-Tamiflu_PI_2-1" class="reference"><a href="#cite_note-Tamiflu_PI-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></li> <li><small><abbr class="country-name" title="United Kingdom">UK</abbr>:</small> <a href="/wiki/Prescription_drug" title="Prescription drug">POM</a> (Prescription only)</li> <li><small><abbr class="country-name" title="United States">US</abbr>:</small> <a href="/wiki/Prescription_drug" title="Prescription drug">℞-only</a></li> <li><small><abbr class="country-name" title="European Union">EU</abbr>:</small> Rx-only</li></ul></div> </td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;"><a href="/wiki/Pharmacokinetics" title="Pharmacokinetics">Pharmacokinetic</a> data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Bioavailability" title="Bioavailability">Bioavailability</a></th><td class="infobox-data">>80%<sup id="cite_ref-PK_4-0" class="reference"><a href="#cite_note-PK-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Plasma_protein_binding" title="Plasma protein binding">Protein binding</a></th><td class="infobox-data">42% (parent drug), 3% (active metabolite)<sup id="cite_ref-PK_4-1" class="reference"><a href="#cite_note-PK-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Drug_metabolism" title="Drug metabolism">Metabolism</a></th><td class="infobox-data"><a href="/wiki/Liver" title="Liver">Liver</a>, to oseltamivir carboxylate<sup id="cite_ref-PK_4-4" class="reference"><a href="#cite_note-PK-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Biological_half-life" title="Biological half-life">Elimination <span class="nowrap">half-life</span></a></th><td class="infobox-data">1–3 hours, 6–10 hours (active metabolite)<sup id="cite_ref-PK_4-2" class="reference"><a href="#cite_note-PK-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Excretion" title="Excretion">Excretion</a></th><td class="infobox-data">Urine (>90% as oseltamivir carboxylate), faeces<sup id="cite_ref-PK_4-3" class="reference"><a href="#cite_note-PK-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Identifiers</th></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/IUPAC_nomenclature_of_chemistry" title="IUPAC nomenclature of chemistry">IUPAC name</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all; text-align:left; padding-left:1.5em; text-indent:-1.5em;"><li style="line-height: inherit; margin: 0"><div style="font-size: 97%;">ethyl (3<i>R</i>,4<i>R</i>,5<i>S</i>)-5-amino-4-acetamido-3-(pentan-3-yloxy)-cyclohex-1-ene-1-carboxylate</div></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/CAS_Registry_Number" title="CAS Registry Number">CAS Number</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="commonchemistry.cas.org"><a rel="nofollow" class="external text" href="https://commonchemistry.cas.org/detail?cas_rn=196618-13-0">196618-13-0</a></span><sup> <span typeof="mw:File"><span><img alt="☒" src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a2/X_mark.svg/7px-X_mark.svg.png" decoding="async" width="7" height="8" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a2/X_mark.svg/11px-X_mark.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a2/X_mark.svg/14px-X_mark.svg.png 2x" data-file-width="525" data-file-height="600" /></span></span><span style="display:none">N</span></sup> 204255-11-8</li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/PubChem#CID" title="PubChem">PubChem</a> <span style="font-weight:normal"><abbr title="Compound ID">CID</abbr></span></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="pubchem.ncbi.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://pubchem.ncbi.nlm.nih.gov/compound/65028">65028</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/DrugBank" title="DrugBank">DrugBank</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.drugbank.ca"><a rel="nofollow" class="external text" href="https://www.drugbank.ca/drugs/DB00198">DB00198</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChemSpider" title="ChemSpider">ChemSpider</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.chemspider.com"><a rel="nofollow" class="external text" href="https://www.chemspider.com/Chemical-Structure.58540.html">58540</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Unique_Ingredient_Identifier" title="Unique Ingredient Identifier">UNII</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="precision.fda.gov"><a rel="nofollow" class="external text" href="https://precision.fda.gov/uniisearch/srs/unii/20O93L6F9H">20O93L6F9H</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/KEGG" title="KEGG">KEGG</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.kegg.jp"><a rel="nofollow" class="external text" href="https://www.kegg.jp/entry/D08306">D08306</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li><li>as salt: <span title="www.kegg.jp"><a rel="nofollow" class="external text" href="https://www.kegg.jp/entry/D00900">D00900</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChEBI" title="ChEBI">ChEBI</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.ebi.ac.uk"><a rel="nofollow" class="external text" href="https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:7798">CHEBI:7798</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChEMBL" title="ChEMBL">ChEMBL</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.ebi.ac.uk"><a rel="nofollow" class="external text" href="https://www.ebi.ac.uk/chembl/explore/compound/ChEMBL1229">ChEMBL1229</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/CompTox_Chemicals_Dashboard" title="CompTox Chemicals Dashboard">CompTox Dashboard</a> <span style="font-weight:normal">(<abbr title="U.S. Environmental Protection Agency">EPA</abbr>)</span></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="comptox.epa.gov"><a rel="nofollow" class="external text" href="https://comptox.epa.gov/dashboard/chemical/details/DTXSID9044291">DTXSID9044291</a> <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q211509#P3117" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></span></li></ul></div></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Chemical and physical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Chemical_formula" title="Chemical formula">Formula</a></th><td class="infobox-data"><span title="Carbon">C</span><sub>16</sub><span title="Hydrogen">H</span><sub>28</sub><span title="Nitrogen">N</span><sub>2</sub><span title="Oxygen">O</span><sub>4</sub></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Molar_mass" title="Molar mass">Molar mass</a></th><td class="infobox-data"><span class="nowrap"><span data-sort-value="7002312410000000000♠"></span>312.410</span> g·mol<sup>−1</sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;">3D model (<a href="/wiki/JSmol" class="mw-redirect" title="JSmol">JSmol</a>)</th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="chemapps.stolaf.edu (3D interactive model)"><a rel="nofollow" class="external text" href="https://chemapps.stolaf.edu/jmol/jmol.php?model=CCC%28CC%29OC1C%3DC%28CC%28C1NC%28%3DO%29C%29N%29C%28%3DO%29OCC">Interactive image</a></span></li></ul></div></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/Simplified_molecular-input_line-entry_system" class="mw-redirect" title="Simplified molecular-input line-entry system">SMILES</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all;"><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">CCC(CC)OC1C=C(CC(C1NC(=O)C)N)C(=O)OCC</div></li></ul> </div></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/International_Chemical_Identifier" title="International Chemical Identifier">InChI</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all;"><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">InChI=1S/C16H28N2O4/c1-5-12(6-2)22-14-9-11(16(20)21-7-3)8-13(17)15(14)18-10(4)19/h9,12-15H,5-8,17H2,1-4H3,(H,18,19)/t13-,14+,15+/m0/s1<sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></div></li><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">Key:VSZGPKBBMSAYNT-RRFJBIMHSA-N<sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></div></li></ul> </div></td></tr><tr><td colspan="2" class="infobox-below"><style data-mw-deduplicate="TemplateStyles:r886047488">.mw-parser-output .nobold{font-weight:normal}</style><span class="nobold"> <sup><span typeof="mw:File"><span><img alt="☒" src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a2/X_mark.svg/7px-X_mark.svg.png" decoding="async" width="7" height="8" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a2/X_mark.svg/11px-X_mark.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a2/X_mark.svg/14px-X_mark.svg.png 2x" data-file-width="525" data-file-height="600" /></span></span><span style="display:none">N</span><span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup> <a href="/wiki/Wikipedia:WikiProject_Chemicals/Chembox_validation" title="Wikipedia:WikiProject Chemicals/Chembox validation">(what is this?)</a></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r886047488"><span class="nobold">  <span class="reflink plainlinks nourlexpansion"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Special:ComparePages&rev1=459589411&page2=Oseltamivir">(verify)</a></span></span></td></tr></tbody></table> <p><b>Oseltamivir</b>, sold under the brand name <b>Tamiflu</b> among others, is an <a href="/wiki/Antiviral_medication" class="mw-redirect" title="Antiviral medication">antiviral medication</a> used to treat and prevent <a href="/wiki/Influenza_A_virus" title="Influenza A virus">influenza A</a> and <a href="/wiki/Influenza_B_virus" title="Influenza B virus">influenza B</a>, viruses that cause <a href="/wiki/Influenza" title="Influenza">the flu</a>.<sup id="cite_ref-AHFS2017_5-0" class="reference"><a href="#cite_note-AHFS2017-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Many medical organizations recommend it in people who have complications or are at high risk of complications within 48 hours of first symptoms of infection.<sup id="cite_ref-CDC2014up_6-0" class="reference"><a href="#cite_note-CDC2014up-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> They recommend it to prevent infection in those at high risk, but not the general population.<sup id="cite_ref-CDC2014up_6-1" class="reference"><a href="#cite_note-CDC2014up-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a> (CDC) recommends that clinicians use their discretion to treat those at lower risk who present within 48 hours of first symptoms of infection.<sup id="cite_ref-CDC2014up_6-2" class="reference"><a href="#cite_note-CDC2014up-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ECDC2014_7-0" class="reference"><a href="#cite_note-ECDC2014-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NICE2009_8-0" class="reference"><a href="#cite_note-NICE2009-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> It is taken by mouth, either as a pill or liquid.<sup id="cite_ref-AHFS2017_5-1" class="reference"><a href="#cite_note-AHFS2017-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>Recommendations regarding oseltamivir are controversial as are criticisms of the recommendations.<sup id="cite_ref-CDC2014up_6-3" class="reference"><a href="#cite_note-CDC2014up-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-IDSA2014_9-0" class="reference"><a href="#cite_note-IDSA2014-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Brownlee2013_10-0" class="reference"><a href="#cite_note-Brownlee2013-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Butler2014_11-0" class="reference"><a href="#cite_note-Butler2014-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> A 2014 <a href="/wiki/Cochrane_Review" class="mw-redirect" title="Cochrane Review">Cochrane Review</a> concluded that oseltamivir does not reduce hospitalizations, and that there is no evidence of reduction in complications of influenza.<sup id="cite_ref-Butler2014_11-1" class="reference"><a href="#cite_note-Butler2014-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Two <a href="/wiki/Meta-analysis" title="Meta-analysis">meta-analyses</a> have concluded that benefits in those who are otherwise healthy do not outweigh its risks.<sup id="cite_ref-Mich2013_12-0" class="reference"><a href="#cite_note-Mich2013-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Ebe2013_13-0" class="reference"><a href="#cite_note-Ebe2013-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> They also found little evidence regarding whether treatment changes the risk of hospitalization or death in high risk populations.<sup id="cite_ref-Mich2013_12-1" class="reference"><a href="#cite_note-Mich2013-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Ebe2013_13-1" class="reference"><a href="#cite_note-Ebe2013-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> However, another meta-analysis found that oseltamivir was effective for prevention of influenza at the individual and household levels.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>Common side effects include <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>, <a href="/wiki/Diarrhea" title="Diarrhea">diarrhea</a>, headache, and trouble sleeping.<sup id="cite_ref-AHFS2017_5-2" class="reference"><a href="#cite_note-AHFS2017-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Other side effects may include <a href="/wiki/Psychiatric_symptoms" class="mw-redirect" title="Psychiatric symptoms">psychiatric symptoms</a> and <a href="/wiki/Seizures" class="mw-redirect" title="Seizures">seizures</a>.<sup id="cite_ref-AHFS2017_5-3" class="reference"><a href="#cite_note-AHFS2017-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Cochrane2012_15-0" class="reference"><a href="#cite_note-Cochrane2012-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Jeff2014_16-0" class="reference"><a href="#cite_note-Jeff2014-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> In the United States it is recommended for influenza infection during pregnancy.<sup id="cite_ref-Preg2017_1-1" class="reference"><a href="#cite_note-Preg2017-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> It has been taken by a small number of pregnant women without signs of problems.<sup id="cite_ref-Preg2017_1-2" class="reference"><a href="#cite_note-Preg2017-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Dose adjustment may be needed in those with kidney problems.<sup id="cite_ref-AHFS2017_5-4" class="reference"><a href="#cite_note-AHFS2017-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>Oseltamivir was approved for medical use in the US in 1999.<sup id="cite_ref-AHFS2017_5-5" class="reference"><a href="#cite_note-AHFS2017-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> It was the first <a href="/wiki/Neuraminidase_inhibitor" title="Neuraminidase inhibitor">neuraminidase inhibitor</a> available by mouth.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> It is on the <a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">World Health Organization's List of Essential Medicines</a> but was downgraded to "complementary" status in 2017.<sup id="cite_ref-WHO_TRS_1006_18-0" class="reference"><a href="#cite_note-WHO_TRS_1006-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-WHO21st_20-0" class="reference"><a href="#cite_note-WHO21st-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> A <a href="/wiki/Generic_medication" class="mw-redirect" title="Generic medication">generic version</a> was approved in the US in 2016.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> In 2022, it was the 205th most commonly prescribed medication in the United States, with more than 1<span class="nowrap"> </span>million prescriptions.<sup id="cite_ref-Top_300_of_2022_23-0" class="reference"><a href="#cite_note-Top_300_of_2022-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Medical_use">Medical use</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=1" title="Edit section: Medical use"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:A_Tamiflu_(oseltamivir)_capsule.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/97/A_Tamiflu_%28oseltamivir%29_capsule.jpg/220px-A_Tamiflu_%28oseltamivir%29_capsule.jpg" decoding="async" width="220" height="127" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/97/A_Tamiflu_%28oseltamivir%29_capsule.jpg/330px-A_Tamiflu_%28oseltamivir%29_capsule.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/97/A_Tamiflu_%28oseltamivir%29_capsule.jpg/440px-A_Tamiflu_%28oseltamivir%29_capsule.jpg 2x" data-file-width="2981" data-file-height="1721" /></a><figcaption>An oseltamivir capsule</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Tamiflu_dry_syrup.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/54/Tamiflu_dry_syrup.png/220px-Tamiflu_dry_syrup.png" decoding="async" width="220" height="198" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/54/Tamiflu_dry_syrup.png/330px-Tamiflu_dry_syrup.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/54/Tamiflu_dry_syrup.png/440px-Tamiflu_dry_syrup.png 2x" data-file-width="2918" data-file-height="2625" /></a><figcaption>Oseltamivir dry syrup type</figcaption></figure> <p>Oseltamivir is used for the prevention and treatment of <a href="/wiki/Influenza" title="Influenza">influenza</a> caused by influenza A and B viruses.<sup id="cite_ref-AHFS2017_5-6" class="reference"><a href="#cite_note-AHFS2017-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Tamiflu_Label_25-0" class="reference"><a href="#cite_note-Tamiflu_Label-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> It is on the <a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">World Health Organization's List of Essential Medicines</a>.<sup id="cite_ref-WHO21st_20-1" class="reference"><a href="#cite_note-WHO21st-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> The WHO supports its use for severe illness due to confirmed or suspected influenza virus infection in critically ill people who have been hospitalized.<sup id="cite_ref-WHO21st_20-2" class="reference"><a href="#cite_note-WHO21st-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> Oseltamivir's risk-benefit ratio is controversial.<sup id="cite_ref-Brownlee2013_10-1" class="reference"><a href="#cite_note-Brownlee2013-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Butler2014_11-2" class="reference"><a href="#cite_note-Butler2014-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> In 2017, it was moved from the core to the complementary list based on its lower cost-effectiveness.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> The Expert Committee did not recommend the deletion of oseltamivir from the EML and EMLc, recognizing that it is the only medicine included on the Model Lists for critically ill patients with influenza and for influenza pandemic preparedness.<sup id="cite_ref-WHO_TRS_1006_18-1" class="reference"><a href="#cite_note-WHO_TRS_1006-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> However, the Committee noted that, since the inclusion of oseltamivir on the Model List in 2009, new evidence in seasonal and pandemic influenza has lowered earlier estimates of the magnitude of effect of oseltamivir on relevant clinical outcomes.<sup id="cite_ref-WHO_TRS_1006_18-2" class="reference"><a href="#cite_note-WHO_TRS_1006-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> The Committee recommended that the listing of oseltamivir be amended, moving the medicine from the core to the Complementary List, and that its use be restricted to severe illness due to confirmed or suspected influenza virus infection in critically ill hospitalized patients.<sup id="cite_ref-WHO_TRS_1006_18-3" class="reference"><a href="#cite_note-WHO_TRS_1006-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> The Expert Committee noted that WHO guidelines for pharmacological management of pandemic and seasonal influenza would be updated in 2017: unless new information is provided to support the use of oseltamivir in seasonal and pandemic outbreaks, the next Expert Committee might consider oseltamivir for deletion.<sup id="cite_ref-WHO_TRS_1006_18-4" class="reference"><a href="#cite_note-WHO_TRS_1006-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="High-risk_people">High-risk people</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=2" title="Edit section: High-risk people"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The US <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a> (CDC), <a href="/wiki/European_Centre_for_Disease_Prevention_and_Control" title="European Centre for Disease Prevention and Control">European Centre for Disease Prevention and Control</a> (ECDC), <a href="/wiki/Public_Health_England" title="Public Health England">Public Health England</a> and the <a href="/wiki/American_Academy_of_Pediatrics" title="American Academy of Pediatrics">American Academy of Pediatrics</a> (AAP) recommend the use of oseltamivir for people who have complications or are at high risk for complications.<sup id="cite_ref-CDC2014up_6-4" class="reference"><a href="#cite_note-CDC2014up-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ECDC2014_7-1" class="reference"><a href="#cite_note-ECDC2014-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-CDC2014_27-0" class="reference"><a href="#cite_note-CDC2014-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-AAP_28-0" class="reference"><a href="#cite_note-AAP-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-PHE_29-0" class="reference"><a href="#cite_note-PHE-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> This includes those who are hospitalized, young children, those over the age of 65, people with other significant health problems, those who are pregnant, and <a href="/wiki/Indigenous_peoples_of_the_Americas" title="Indigenous peoples of the Americas">Indigenous peoples of the Americas</a> among others.<sup id="cite_ref-CDC2014_27-1" class="reference"><a href="#cite_note-CDC2014-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Infectious_Disease_Society_of_America" class="mw-redirect" title="Infectious Disease Society of America">Infectious Disease Society of America</a> takes the same position as the CDC.<sup id="cite_ref-IDSA2014_9-1" class="reference"><a href="#cite_note-IDSA2014-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>A systematic review of <a href="/wiki/Systematic_review" title="Systematic review">systematic reviews</a> in <i><a href="/wiki/PLoS_One" class="mw-redirect" title="PLoS One">PLoS One</a></i> did not find evidence for benefits in people who are at risk, noting that "the trials were not designed or powered to give results regarding serious complications, hospitalization and mortality",<sup id="cite_ref-Mich2013_12-2" class="reference"><a href="#cite_note-Mich2013-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> as did a 2014 Cochrane Review.<sup id="cite_ref-Cochrane2014_30-0" class="reference"><a href="#cite_note-Cochrane2014-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> The Cochrane Review further recommended: "On the basis of the findings of this review, clinicians and healthcare policy-makers should urgently revise current recommendations for use of the neuraminidase inhibitors (NIs) for individuals with influenza."<sup id="cite_ref-Cochrane2014_30-1" class="reference"><a href="#cite_note-Cochrane2014-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> That is not utilizing NIs for prevention or treatment "Based on these findings there appears to be no evidence for patients, clinicians or policy-makers to use these drugs to prevent serious outcomes, both in annual influenza and pandemic influenza outbreaks."<sup id="cite_ref-Cochrane2014_30-2" class="reference"><a href="#cite_note-Cochrane2014-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> </p><p>The CDC, ECDC, Public Health England, Infectious Disease Society of America, the AAP, and <a href="/wiki/Hoffmann-La_Roche" class="mw-redirect" title="Hoffmann-La Roche">Roche</a> (the originator) reject the conclusions of the Cochrane Review, arguing in part that the analysis inappropriately forms conclusions about outcomes in people who are seriously ill based on results obtained primarily in healthy populations, and that the analysis inappropriately included results from people not infected with influenza.<sup id="cite_ref-CDC2014up_6-5" class="reference"><a href="#cite_note-CDC2014up-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ECDC2014_7-2" class="reference"><a href="#cite_note-ECDC2014-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-IDSA2014_9-2" class="reference"><a href="#cite_note-IDSA2014-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-AAP_28-1" class="reference"><a href="#cite_note-AAP-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-PHE_29-1" class="reference"><a href="#cite_note-PHE-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> The EMA did not change its labeling of the drug in response to the Cochrane study.<sup id="cite_ref-ReutersEMA_31-0" class="reference"><a href="#cite_note-ReutersEMA-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </p><p>A 2014 review recommended that all people admitted to intensive care units during influenza outbreaks with a diagnosis of <a href="/wiki/Community-acquired_pneumonia" title="Community-acquired pneumonia">community-acquired pneumonia</a> receive oseltamivir until the absence of influenza infection is established by <a href="/wiki/Polymerase_chain_reaction" title="Polymerase chain reaction">polymerase chain reaction</a> (PCR) testing.<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p><p>A 2015 systematic review and meta-analysis found oseltamivir effective at treating the symptoms of influenza, reducing the length of hospitalization, and reducing the risk of <a href="/wiki/Otitis_media" title="Otitis media">otitis media</a>. The same review found that oseltamivir did not significantly increase the risk of adverse events.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> A 2016 systematic review found that oseltamivir slightly reduced the time it takes for the symptoms of influenza to be alleviated, and that it also increased the risk of "nausea, vomiting, [and] psychiatric events in adults and vomiting in children."<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> The decrease in duration of sickness was about 18 hours.<sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Otherwise_healthy_people">Otherwise healthy people</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=3" title="Edit section: Otherwise healthy people"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In those who are otherwise healthy the CDC states that antivirals may be considered within the first 48 hours.<sup id="cite_ref-CDC2014_27-2" class="reference"><a href="#cite_note-CDC2014-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> A German clinical practice guideline recommends against its use.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> </p><p>Two 2013 <a href="/wiki/Meta-analysis" title="Meta-analysis">meta-analyses</a> have concluded that benefits in those who are otherwise healthy do not outweigh its risks.<sup id="cite_ref-Mich2013_12-3" class="reference"><a href="#cite_note-Mich2013-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Ebe2013_13-2" class="reference"><a href="#cite_note-Ebe2013-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> When the analysis was restricted to people with confirmed infection, the same 2014 Cochrane Review (see above) found unclear evidence of change in the risk of complications such as <a href="/wiki/Pneumonia" title="Pneumonia">pneumonia</a>,<sup id="cite_ref-Cochrane2014_30-3" class="reference"><a href="#cite_note-Cochrane2014-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> while three other reviews found a decreased risk.<sup id="cite_ref-Ebe2013_13-3" class="reference"><a href="#cite_note-Ebe2013-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> Together, published studies suggest that oseltamivir reduces the duration of symptoms by 0.5–1.0 day.<sup id="cite_ref-Burch2009_39-0" class="reference"><a href="#cite_note-Burch2009-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> Any benefit of treatment must be balanced against side effects, which include psychiatric symptoms and increased rates of vomiting.<sup id="cite_ref-Jeff2014_16-1" class="reference"><a href="#cite_note-Jeff2014-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p><p>The 2014 <a href="/wiki/Cochrane_Collaboration" class="mw-redirect" title="Cochrane Collaboration">Cochrane Collaboration</a> review concluded that oseltamivir did not affect the need for hospitalizations, and that there is no proof of reduction of complications of influenza (such as pneumonia) because of a lack of diagnostic definitions, or reduction of the spread of the virus. There was also evidence that suggested that oseltamivir prevented some people from producing sufficient numbers of their own antibodies to fight infection. The authors recommended that guidance should be revised to take account of the evidence of small benefit and increased risk of harms.<sup id="cite_ref-Cochrane2014_30-4" class="reference"><a href="#cite_note-Cochrane2014-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> </p><p>The US <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a> (CDC), the <a href="/wiki/European_Centre_for_Disease_Prevention_and_Control" title="European Centre for Disease Prevention and Control">European Centre for Disease Prevention and Control</a> (ECDC), the <a href="/wiki/Public_Health_England" title="Public Health England">Public Health England</a> (PHE), the <a href="/wiki/Infectious_Disease_Society_of_America" class="mw-redirect" title="Infectious Disease Society of America">Infectious Disease Society of America</a> (IDSA), the <a href="/wiki/American_Academy_of_Pediatrics" title="American Academy of Pediatrics">American Academy of Pediatrics</a> (AAP), and Roche (the originator) rejected the recommendations of the 2014 Cochrane Review to urgently change treatment guidelines and drug labels.<sup id="cite_ref-CDC2014up_6-6" class="reference"><a href="#cite_note-CDC2014up-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ECDC2014_7-3" class="reference"><a href="#cite_note-ECDC2014-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-IDSA2014_9-3" class="reference"><a href="#cite_note-IDSA2014-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-AAP_28-2" class="reference"><a href="#cite_note-AAP-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-PHE_29-2" class="reference"><a href="#cite_note-PHE-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ReutersEMA_31-1" class="reference"><a href="#cite_note-ReutersEMA-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Prevention">Prevention</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=4" title="Edit section: Prevention"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>As of 2017<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Oseltamivir&action=edit">[update]</a></sup>, the CDC does not recommend to use oseltamivir generally for prevention due to concerns that widespread use will encourage resistance development.<sup id="cite_ref-CDC2014_27-3" class="reference"><a href="#cite_note-CDC2014-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> They recommend that it be considered in those at high risk, who have been exposed to influenza within 48 hours and have not received or only recently been vaccinated.<sup id="cite_ref-CDC2014_27-4" class="reference"><a href="#cite_note-CDC2014-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> They recommended it during outbreaks in <a href="/wiki/Long_term_care_facilities" class="mw-redirect" title="Long term care facilities">long term care facilities</a> and in those who are significantly immunosuppressed.<sup id="cite_ref-CDC2014_27-5" class="reference"><a href="#cite_note-CDC2014-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> </p><p>As of 2011<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Oseltamivir&action=edit">[update]</a></sup>, reviews concluded that when oseltamivir is used preventatively it decreases the risk of exposed people developing symptomatic disease.<sup id="cite_ref-Cochrane2014_30-5" class="reference"><a href="#cite_note-Cochrane2014-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> A systematic review of systematic reviews found low to moderate evidence that it decreases the risk of getting symptomatic influenza by 1 to 12% (a relative decrease of 64 to 92%).<sup id="cite_ref-Mich2013_12-4" class="reference"><a href="#cite_note-Mich2013-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> It recommended against its use in healthy, low-risk persons due to cost, the risk of resistance development, and side effects and concluded it might be useful for prevention in unvaccinated <a href="/wiki/High-risk_people" title="High-risk people">high risk persons.</a><sup id="cite_ref-Mich2013_12-5" class="reference"><a href="#cite_note-Mich2013-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Side_effects">Side effects</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=5" title="Edit section: Side effects"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Tamiflu.JPG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/98/Tamiflu.JPG/220px-Tamiflu.JPG" decoding="async" width="220" height="142" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/98/Tamiflu.JPG/330px-Tamiflu.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/98/Tamiflu.JPG/440px-Tamiflu.JPG 2x" data-file-width="800" data-file-height="518" /></a><figcaption>A package of capsules</figcaption></figure> <p>According to the FDA, the two most common <a href="/wiki/Adverse_drug_reaction" title="Adverse drug reaction">adverse drug reactions</a> associated with oseltamivir therapy are nausea (10% vs 6% placebo) and vomiting (9% vs 3% placebo).<sup id="cite_ref-fda_42-0" class="reference"><a href="#cite_note-fda-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> In adults, oseltamivir increased the risk of nausea for which the <a href="/wiki/Number_needed_to_harm" title="Number needed to harm">number needed to harm</a> was 28 and for vomiting was 22. So, for every 22 adult people on oseltamivir one experienced vomiting. In the treatment of children, oseltamivir also induced vomiting. The number needed to harm was 19. So, for every 19 children on oseltamivir one experienced vomiting. When used as a prophylactic there were more headaches, kidney, and psychiatric events.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (February 2025)">citation needed</span></a></i>]</sup> Oseltamivir's effect on the heart is unclear: it may reduce cardiac symptoms, but may also induce serious arrhythmias.<sup id="cite_ref-Cochrane2014_30-6" class="reference"><a href="#cite_note-Cochrane2014-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> </p><p>Postmarketing reports include <a href="/wiki/Hepatitis" title="Hepatitis">liver inflammation</a> and elevated liver enzymes, rash, allergic reactions including <a href="/wiki/Anaphylaxis" title="Anaphylaxis">anaphylaxis</a>, <a href="/wiki/Toxic_epidermal_necrolysis" title="Toxic epidermal necrolysis">toxic epidermal necrolysis</a>, <a href="/wiki/Cardiac_arrhythmia" class="mw-redirect" title="Cardiac arrhythmia">abnormal heart rhythms</a>, seizure, confusion, aggravation of diabetes, and <a href="/wiki/Hemorrhage" class="mw-redirect" title="Hemorrhage">haemorrhagic</a> <a href="/wiki/Colitis" title="Colitis">colitis</a> and <a href="/wiki/Stevens%E2%80%93Johnson_syndrome" title="Stevens–Johnson syndrome">Stevens–Johnson syndrome</a>.<sup id="cite_ref-rocheinfo_43-0" class="reference"><a href="#cite_note-rocheinfo-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-rossi_2006_44-0" class="reference"><a href="#cite_note-rossi_2006-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> Neuropsychiatric symptoms and body pain, followed by skin problems, were identified as the side effects most significantly reducing patient satisfaction on a drug review platform.<sup id="cite_ref-Antipov_2019_45-0" class="reference"><a href="#cite_note-Antipov_2019-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> </p><p>The US and EU package inserts for oseltamivir contain a warning of psychiatric effects observed in post-marketing surveillance.<sup id="cite_ref-Cohen_2014_46-0" class="reference"><a href="#cite_note-Cohen_2014-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-FDApedsafe_47-0" class="reference"><a href="#cite_note-FDApedsafe-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> The frequency of these appears to be low and a causative role for oseltamivir has not been established.<sup id="cite_ref-FDApedsafe_47-1" class="reference"><a href="#cite_note-FDApedsafe-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Medscape_48-0" class="reference"><a href="#cite_note-Medscape-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> The 2014 Cochrane Review found a dose-response effect on psychiatric events. In trials of prevention in adults one person was harmed for every 94 treated.<sup id="cite_ref-Cochrane2014_30-7" class="reference"><a href="#cite_note-Cochrane2014-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> Neither of the two most cited published treatment trials of oseltamivir reported any drug-attributable serious adverse events.<sup id="cite_ref-Cohen_2014_46-1" class="reference"><a href="#cite_note-Cohen_2014-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> </p><p>It is <a href="/wiki/Pregnancy_category" title="Pregnancy category">pregnancy category</a> B in Australia, meaning that it has been taken by a small number of women without signs of problems and in animal studies it looks safe.<sup id="cite_ref-Australian_Government_49-0" class="reference"><a href="#cite_note-Australian_Government-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> Dose adjustment may be needed in those with kidney problems.<sup id="cite_ref-AHFS2017_5-7" class="reference"><a href="#cite_note-AHFS2017-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Mechanism_of_action">Mechanism of action</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=6" title="Edit section: Mechanism of action"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Oseltamivir is a <a href="/wiki/Neuraminidase_inhibitor" title="Neuraminidase inhibitor">neuraminidase inhibitor</a>, a <a href="/wiki/Competitive_inhibitor" class="mw-redirect" title="Competitive inhibitor">competitive inhibitor</a> of influenza's <a href="/wiki/Neuraminidase" title="Neuraminidase">neuraminidase</a> enzyme. The neuraminidase enzyme binds to the <a href="/wiki/Sialic_acid" title="Sialic acid">sialic acid</a> which is found on <a href="/wiki/Glycoproteins" class="mw-redirect" title="Glycoproteins">glycoproteins</a> on the surface of human cells. Then it cleaves the sialic acid, which helps new virions to exit the cell. As Oseltamivir is an analogue of the sialic acid, the enzyme can bind to Oseltamivir instead, in which case the enzyme will not bind to sialic acid, so it will not cleave it and new virons will not exit the cell.<sup id="cite_ref-Tamiflu_Label_25-1" class="reference"><a href="#cite_note-Tamiflu_Label-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Resistance">Resistance</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=7" title="Edit section: Resistance"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output 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.mw-parser-output .sidebar:not(.notheme) .sidebar-list-title,html.skin-theme-clientpref-os .mw-parser-output .sidebar:not(.notheme) .sidebar-title-with-pretitle{background:transparent!important}html.skin-theme-clientpref-os .mw-parser-output .sidebar:not(.notheme) .sidebar-title-with-pretitle a{color:var(--color-progressive)!important}}@media print{body.ns-0 .mw-parser-output .sidebar{display:none!important}}</style><table class="sidebar sidebar-collapse nomobile nowraplinks"><tbody><tr><th class="sidebar-title" style="background:"><a href="/wiki/Influenza" title="Influenza">Influenza (flu)</a></th></tr><tr><td class="sidebar-image"><span typeof="mw:File"><a href="/wiki/File:H1N1_navbox.jpg" class="mw-file-description" title="H1N1 virus"><img alt="H1N1 virus" src="//upload.wikimedia.org/wikipedia/commons/thumb/e/ea/H1N1_navbox.jpg/160px-H1N1_navbox.jpg" decoding="async" width="160" height="105" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/ea/H1N1_navbox.jpg/240px-H1N1_navbox.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/ea/H1N1_navbox.jpg/320px-H1N1_navbox.jpg 2x" data-file-width="1750" data-file-height="1147" /></a></span></td></tr><tr><td class="sidebar-content hlist"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="text-align:center; background:;color: var(--color-base)"><a href="/wiki/Influenza#Classification" title="Influenza">Types</a></div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Avian_influenza" title="Avian influenza">Avian</a> <ul><li><a href="/wiki/Influenza_A_virus_subtype_H5N1" title="Influenza A virus subtype H5N1">A/H5N1 subtype</a></li></ul></li> <li><a href="/wiki/Canine_influenza" title="Canine influenza">Canine</a></li> <li><a href="/wiki/Equine_influenza" title="Equine influenza">Equine</a></li> <li><a href="/wiki/Swine_influenza" title="Swine influenza">Swine</a> <ul><li><a href="/wiki/Influenza_A_virus_subtype_H1N1" title="Influenza A virus subtype H1N1">A/H1N1 subtype</a></li></ul></li></ul></div></div></td> </tr><tr><td class="sidebar-content hlist"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="text-align:center; background:;color: var(--color-base)"><a href="/wiki/Influenza_vaccine" title="Influenza vaccine">Vaccines</a></div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/2009_swine_flu_pandemic_vaccine" title="2009 swine flu pandemic vaccine">2009 pandemic</a> <ul><li><a href="/wiki/Pandemrix" title="Pandemrix">Pandemrix</a></li></ul></li> <li><a href="/wiki/Live_attenuated_influenza_vaccine" title="Live attenuated influenza vaccine">Live attenuated</a></li> <li><a href="/wiki/Seasonal_influenza_vaccine_brands" class="mw-redirect" title="Seasonal influenza vaccine brands">Seasonal flu vaccine brands</a></li></ul></div></div></td> </tr><tr><td class="sidebar-content hlist"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="text-align:center; background:;color: var(--color-base)"><a href="/wiki/Influenza_treatment" class="mw-redirect" title="Influenza treatment">Treatment</a></div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Amantadine" title="Amantadine">Amantadine</a></li> <li><a href="/wiki/Baloxavir_marboxil" title="Baloxavir marboxil">Baloxavir marboxil</a></li> <li><a href="/wiki/Laninamivir" title="Laninamivir">Laninamivir</a></li> <li><a class="mw-selflink selflink">Oseltamivir</a></li> <li><a href="/wiki/Peramivir" title="Peramivir">Peramivir</a></li> <li><a href="/wiki/Rimantadine" title="Rimantadine">Rimantadine</a></li> <li><a href="/wiki/Umifenovir" title="Umifenovir">Umifenovir</a></li> <li><a href="/wiki/Zanamivir" title="Zanamivir">Zanamivir</a></li></ul></div></div></td> </tr><tr><td class="sidebar-content hlist"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="text-align:center; background:;color: var(--color-base)"><a href="/wiki/Influenza_pandemic" title="Influenza pandemic">Pandemics</a></div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/1889%E2%80%931890_pandemic" title="1889–1890 pandemic">1889-1890 Russian flu</a></li> <li><a href="/wiki/Spanish_flu" title="Spanish flu">1918 Spanish flu</a></li> <li><a href="/wiki/1957%E2%80%931958_influenza_pandemic" title="1957–1958 influenza pandemic">1957-1958 Asian flu</a></li> <li><a href="/wiki/Hong_Kong_flu" title="Hong Kong flu">1968 Hong Kong flu</a></li> <li><a href="/wiki/1977_Russian_flu" title="1977 Russian flu">1977 Russian flu</a></li> <li><a href="/wiki/2009_swine_flu_pandemic" title="2009 swine flu pandemic">2009 swine flu</a></li></ul></div></div></td> </tr><tr><td class="sidebar-content hlist"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="text-align:center; background:;color: var(--color-base)"><a href="/wiki/Outbreak" class="mw-redirect" title="Outbreak">Outbreaks</a></div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/1976_swine_flu_outbreak" title="1976 swine flu outbreak">1976 swine flu</a></li> <li><a href="/wiki/2006_H5N1_outbreak_in_India" title="2006 H5N1 outbreak in India">2006 H5N1 India</a></li> <li><a href="/wiki/2007_Australian_equine_influenza_outbreak" title="2007 Australian equine influenza outbreak">2007 Australian equine</a></li> <li><a href="/wiki/2007_Bernard_Matthews_H5N1_outbreak" title="2007 Bernard Matthews H5N1 outbreak">2007 Bernard Matthews H5N1</a></li> <li><a href="/wiki/2008_H5N1_outbreak_in_West_Bengal" title="2008 H5N1 outbreak in West Bengal">2008 West Bengal</a></li> <li><a href="/wiki/2015_United_States_H5N2_outbreak" title="2015 United States H5N2 outbreak">2015 United States H5N2 outbreak</a></li> <li><a href="/wiki/2020%E2%80%932022_H5N8_outbreak" class="mw-redirect" title="2020–2022 H5N8 outbreak">2020–2022 H5N8 outbreak</a></li></ul></div></div></td> </tr><tr><td class="sidebar-content hlist"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="text-align:center; background:;color: var(--color-base)">See also</div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Flu_season" title="Flu season">Flu season</a></li> <li><a href="/wiki/Evolution_of_influenza" class="mw-redirect" title="Evolution of influenza">Influenza evolution</a></li> <li><a href="/wiki/Influenza_research" class="mw-redirect" title="Influenza research">Influenza research</a></li> <li><a href="/wiki/Influenza-like_illness" title="Influenza-like illness">Influenza-like illness</a></li> <li><a href="/wiki/Historical_annual_reformulations_of_the_influenza_vaccine" title="Historical annual reformulations of the influenza vaccine">Vaccine reformulations</a></li></ul></div></div></td> </tr><tr><td class="sidebar-navbar"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Influenza_sidebar" title="Template:Influenza sidebar"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Influenza_sidebar" title="Template talk:Influenza sidebar"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Influenza_sidebar" title="Special:EditPage/Template:Influenza sidebar"><abbr title="Edit this template">e</abbr></a></li></ul></div></td></tr></tbody></table> <p>The vast majority of mutations conferring resistance are single <a href="/wiki/Amino_acid" title="Amino acid">amino acid</a> residue substitutions (His274Tyr in N1) in the <a href="/wiki/Neuraminidase" title="Neuraminidase">neuraminidase</a> enzyme.<sup id="cite_ref-ResistanceRev2011_50-0" class="reference"><a href="#cite_note-ResistanceRev2011-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> A 2011 meta-analysis of 15 studies found a pooled incidence rate for oseltamivir resistance of 2.6%. Subgroup analyses detected higher rates among influenza A patients, especially the H1N1 subtype. It was found that a substantial number of patients might become oseltamivir-resistant as a result of oseltamivir use, and that oseltamivir resistance might be significantly associated with pneumonia.<sup id="cite_ref-ResistanceRev2011_50-1" class="reference"><a href="#cite_note-ResistanceRev2011-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> In severely immunocompromised patients there were reports of prolonged shedding of oseltamivir- (or <a href="/wiki/Zanamivir" title="Zanamivir">zanamivir</a>)-resistant virus, even after oseltamivir treatment was stopped.<sup id="cite_ref-CDC2014up_6-7" class="reference"><a href="#cite_note-CDC2014up-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="H1N1_flu_or_"swine_flu""><span id="H1N1_flu_or_.22swine_flu.22"></span>H1N1 flu or "swine flu"</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=8" title="Edit section: H1N1 flu or "swine flu""><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>As of December 15, 2010<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Oseltamivir&action=edit">[update]</a></sup>, the <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> (WHO) reported 314 samples of the prevalent <a href="/wiki/2009_flu_pandemic" class="mw-redirect" title="2009 flu pandemic">2009 pandemic H1N1 flu</a> tested worldwide showed resistance to oseltamivir.<sup id="cite_ref-Update_on_oseltamivir_resistance_to_influenza_H1N1_(2009)_viruses_51-0" class="reference"><a href="#cite_note-Update_on_oseltamivir_resistance_to_influenza_H1N1_(2009)_viruses-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> </p><p>The CDC found sporadic oseltamivir-resistant 2009 H1N1 virus infections had been identified, including with rare episodes of limited transmission, but the public health impact had been limited. Those sporadic cases of resistance were found in immunosuppressed patients during oseltamivir treatment and persons who developed illness while receiving oseltamivir chemoprophylaxis.<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> </p><p>During 2011, a new influenza A(H1N1)2009 variant with mildly reduced oseltamivir (and zanamivir) sensitivity was detected in more than 10% of community specimens in Singapore and more than 30% of samples from northern Australia.<sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> </p><p>While there is concern that antiviral resistance may develop in people with haematologic malignancies due to their inability to reduce viral loads and several surveillance studies found oseltamivir-resistant pH1N1 after administration of oseltamivir in those people, as of November 2013<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Oseltamivir&action=edit">[update]</a></sup>, widespread transmission of oseltamivir-resistant pH1N1 has not occurred.<sup id="cite_ref-54" class="reference"><a href="#cite_note-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </p><p>During the 2007–08 flu season, the US CDC found 10.9% of H1N1 samples (n=1,020) to be resistant.<sup id="cite_ref-55" class="reference"><a href="#cite_note-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> In the 2008–09 season, the proportion of resistant H1N1 increased to 99.4%, while no other seasonal strains (H3N2, B) showed resistance.<sup id="cite_ref-56" class="reference"><a href="#cite_note-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Seasonal_flu">Seasonal flu</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=9" title="Edit section: Seasonal flu"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>From 2009 to 2014, oseltamivir resistance was very low in seasonal flu. In the 2010–11 flu season, 99.1% of H1N1, 99.8% of H3N, and 100% of Influenza B remained oseltamivir susceptible in the US.<sup id="cite_ref-57" class="reference"><a href="#cite_note-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup> In January 2012, the US and European CDCs reported all seasonal flu samples tested since October 2011 to be oseltamivir susceptible.<sup id="cite_ref-58" class="reference"><a href="#cite_note-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup> In the 2013–14 season only 1% of 2009 H1N1 viruses showed oseltamivir resistance. No other influenza viruses were resistant to oseltamivir.<sup id="cite_ref-60" class="reference"><a href="#cite_note-60"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="H3N2">H3N2</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=10" title="Edit section: H3N2"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Three studies have found resistance in 0%, 3.3%, and 18% of subjects.<sup id="cite_ref-ResistanceRev2011_50-2" class="reference"><a href="#cite_note-ResistanceRev2011-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> In the study with the 18% resistance rate, the subjects were children, many of whom had not been previously exposed to influenza virus and therefore had a weakened immune response; the results suggest that higher and earlier dosing may be necessary in such populations.<sup id="cite_ref-ward_et_al._2005_61-0" class="reference"><a href="#cite_note-ward_et_al._2005-61"><span class="cite-bracket">[</span>61<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Influenza_B">Influenza B</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=11" title="Edit section: Influenza B"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 2007, Japanese investigators detected neuraminidase-resistant influenza B virus strains in individuals not treated with these drugs. The prevalence was 1.7%.<sup id="cite_ref-62" class="reference"><a href="#cite_note-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> According to the CDC, As of 2019<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Oseltamivir&action=edit">[update]</a></sup>, transmission of oseltamivir-resistant influenza B virus strains—from persons treated with the drug—is rare.<sup id="cite_ref-63" class="reference"><a href="#cite_note-63"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="H5N1_avian_influenza_"bird_flu""><span id="H5N1_avian_influenza_.22bird_flu.22"></span>H5N1 avian influenza "bird flu"</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=12" title="Edit section: H5N1 avian influenza "bird flu""><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>As of 2013<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Oseltamivir&action=edit">[update]</a></sup>, H274Y and N294S mutations that confer resistance to oseltamivir have been identified in a few H5N1 isolates from infected patients treated with oseltamivir, and have emerged spontaneously in Egypt.<sup id="cite_ref-pmid23279894_64-0" class="reference"><a href="#cite_note-pmid23279894-64"><span class="cite-bracket">[</span>64<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="H7N9_avian_influenza">H7N9 avian influenza</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=13" title="Edit section: H7N9 avian influenza"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>As of 2013<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Oseltamivir&action=edit">[update]</a></sup>, two of 14 adults infected with A(H7N9) and treated with oseltamivir developed oseltamivir-resistant virus with the Arg292Lys mutation.<sup id="cite_ref-65" class="reference"><a href="#cite_note-65"><span class="cite-bracket">[</span>65<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Pharmacokinetics">Pharmacokinetics</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=14" title="Edit section: Pharmacokinetics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Its oral bioavailability is over 80% and is extensively metabolised to its active form upon first-pass through the liver, via esterases.<sup id="cite_ref-PK_4-5" class="reference"><a href="#cite_note-PK-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> It does not interact with cytochrome P450 enzymes in the liver.<sup id="cite_ref-fda_42-1" class="reference"><a href="#cite_note-fda-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> It has a <a href="/wiki/Volume_of_distribution" title="Volume of distribution">volume of distribution</a> of 23–26 litres.<sup id="cite_ref-PK_4-6" class="reference"><a href="#cite_note-PK-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Its <a href="/wiki/Elimination_half-life" class="mw-redirect" title="Elimination half-life">half-life</a> is about 1–3 hours and its active carboxylate metabolite has a half-life of 6–10 hours.<sup id="cite_ref-PK_4-7" class="reference"><a href="#cite_note-PK-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> More than 90% of the oral dose is eliminated in the urine as the active metabolite.<sup id="cite_ref-PK_4-8" class="reference"><a href="#cite_note-PK-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=15" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Illicium_verum00.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f2/Illicium_verum00.jpg/220px-Illicium_verum00.jpg" decoding="async" width="220" height="396" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f2/Illicium_verum00.jpg/330px-Illicium_verum00.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f2/Illicium_verum00.jpg/440px-Illicium_verum00.jpg 2x" data-file-width="691" data-file-height="1245" /></a><figcaption>Plate from <a href="/wiki/Fran%C3%A7ois-Pierre_Chaumeton" title="François-Pierre Chaumeton">François-Pierre Chaumeton</a>'s 1833 "Flore Medicale"</figcaption></figure> <p>Oseltamivir was discovered by scientists at <a href="/wiki/Gilead_Sciences" title="Gilead Sciences">Gilead Sciences</a> using <a href="/wiki/Shikimic_acid" title="Shikimic acid">shikimic acid</a> as a starting point for <a href="/wiki/Oseltamivir_total_synthesis" title="Oseltamivir total synthesis">synthesis</a>; shikimic acid was originally available only as an extract of <a href="/wiki/Chinese_star_anise" class="mw-redirect" title="Chinese star anise">Chinese star anise</a>; but by 2006, 30% of the supply was manufactured <a href="/wiki/Recombinant_DNA" title="Recombinant DNA">recombinantly</a> in <i>E. coli.</i><sup id="cite_ref-TamifluSupply_66-0" class="reference"><a href="#cite_note-TamifluSupply-66"><span class="cite-bracket">[</span>66<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Rawat_67-0" class="reference"><a href="#cite_note-Rawat-67"><span class="cite-bracket">[</span>67<span class="cite-bracket">]</span></a></sup> Gilead exclusively licensed their relevant patents to <a href="/wiki/Hoffmann-La_Roche" class="mw-redirect" title="Hoffmann-La Roche">Roche</a> in 1996.<sup id="cite_ref-WIPO_68-0" class="reference"><a href="#cite_note-WIPO-68"><span class="cite-bracket">[</span>68<span class="cite-bracket">]</span></a></sup> The drug has not been patent-protected in Thailand, the Philippines, Indonesia, and several other countries.<sup id="cite_ref-WIPO_68-1" class="reference"><a href="#cite_note-WIPO-68"><span class="cite-bracket">[</span>68<span class="cite-bracket">]</span></a></sup> </p><p>In 1999, the FDA approved oseltamivir phosphate for the treatment of influenza in adults<sup id="cite_ref-69" class="reference"><a href="#cite_note-69"><span class="cite-bracket">[</span>69<span class="cite-bracket">]</span></a></sup> based on two double-blind, randomized, placebo-controlled clinical trials.<sup id="cite_ref-70" class="reference"><a href="#cite_note-70"><span class="cite-bracket">[</span>70<span class="cite-bracket">]</span></a></sup> In June 2002, the <a href="/wiki/European_Medicines_Agency" title="European Medicines Agency">European Medicines Agency</a> (EMA) approved oseltamivir phosphate for prophylaxis and treatment of influenza. In 2003, a pooled analysis of ten randomised clinical trials concluded that oseltamivir reduced the risk of lower respiratory tract infections resulting in antibiotic use and hospital admissions in adults.<sup id="cite_ref-kaiser_meta_analysis_71-0" class="reference"><a href="#cite_note-kaiser_meta_analysis-71"><span class="cite-bracket">[</span>71<span class="cite-bracket">]</span></a></sup> </p><p>Oseltamivir (as Tamiflu) was widely used during the H5N1 avian influenza <a href="/wiki/Epidemic" title="Epidemic">epidemic</a> in Southeast Asia in 2005.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag needs references to reliable medical sources. (January 2020)">medical citation needed</span></a></i>]</sup> In response to the epidemic, various governments – including those of the United Kingdom, Canada, Israel, United States, and Australia – stockpiled quantities of oseltamivir in preparation for a possible <a href="/wiki/Pandemic" title="Pandemic">pandemic</a><sup id="cite_ref-72" class="reference"><a href="#cite_note-72"><span class="cite-bracket">[</span>72<span class="cite-bracket">]</span></a></sup> and there were worldwide shortages of the drug, driven by the high demand for stockpiling.<sup id="cite_ref-TamifluSupply_66-1" class="reference"><a href="#cite_note-TamifluSupply-66"><span class="cite-bracket">[</span>66<span class="cite-bracket">]</span></a></sup> In November 2005, US President <a href="/wiki/George_W._Bush" title="George W. Bush">George W. Bush</a> requested that Congress fund US$1 billion for the production and stockpile of oseltamivir, after Congress had already approved $1.8 billion for military use of the drug. Defense Secretary Donald Rumsfeld, who was a past chairman of Gilead Sciences, recused himself from all government decisions regarding the drug.<sup id="cite_ref-73" class="reference"><a href="#cite_note-73"><span class="cite-bracket">[</span>73<span class="cite-bracket">]</span></a></sup> </p><p>In 2006, a Cochrane Review (since withdrawn) raised controversy by concluding that oseltamivir should not be used during routine seasonal influenza because of its low effectiveness.<sup id="cite_ref-74" class="reference"><a href="#cite_note-74"><span class="cite-bracket">[</span>74<span class="cite-bracket">]</span></a></sup> </p><p>In December 2008, the Indian drug company <a href="/wiki/Cipla" title="Cipla">Cipla</a> won a case in India's court system allowing it to manufacture a cheaper generic version of Tamiflu, called Antiflu. In May 2009, Cipla won approval from the World Health Organization (WHO) certifying that its drug Antiflu was as effective as Tamiflu, and Antiflu is included in the WHO list of prequalified medicinal products.<sup id="cite_ref-75" class="reference"><a href="#cite_note-75"><span class="cite-bracket">[</span>75<span class="cite-bracket">]</span></a></sup> </p> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Tamiflu-display-trailer-miami.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fb/Tamiflu-display-trailer-miami.jpg/300px-Tamiflu-display-trailer-miami.jpg" decoding="async" width="300" height="212" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fb/Tamiflu-display-trailer-miami.jpg/450px-Tamiflu-display-trailer-miami.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fb/Tamiflu-display-trailer-miami.jpg/600px-Tamiflu-display-trailer-miami.jpg 2x" data-file-width="840" data-file-height="594" /></a><figcaption>Marketing display used at festivals features a person living in a hermetically sealed environment</figcaption></figure> <p>In 2009, a new A/H1N1 influenza virus was discovered to be spreading in North America. In June 2009, the WHO declared the A/H1N1 influenza a pandemic.<sup id="cite_ref-jefferson_bmj_2014_76-0" class="reference"><a href="#cite_note-jefferson_bmj_2014-76"><span class="cite-bracket">[</span>76<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/National_Institute_for_Health_and_Care_Excellence" title="National Institute for Health and Care Excellence">National Institute for Health and Care Excellence</a> (NICE), the CDC, the WHO, and the ECDC maintained their recommendation to use oseltamivir.<sup id="cite_ref-NICE2009_8-1" class="reference"><a href="#cite_note-NICE2009-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-WHO_guidelines_77-0" class="reference"><a href="#cite_note-WHO_guidelines-77"><span class="cite-bracket">[</span>77<span class="cite-bracket">]</span></a></sup> </p><p>From 2010 to 2012, Cochrane requested Roche's full clinical study reports of their trials, which they did not provide.<sup id="cite_ref-BMJ_Tamiflu_78-0" class="reference"><a href="#cite_note-BMJ_Tamiflu-78"><span class="cite-bracket">[</span>78<span class="cite-bracket">]</span></a></sup> In 2011, a <a href="/wiki/Freedom_of_information_request" class="mw-redirect" title="Freedom of information request">freedom of information request</a> to the European Medicines Agency (EMA) provided Cochrane with reports from 16 Roche oseltamivir trials. In 2012, the Cochrane team published an interim review based on those reports. In 2013, Roche released 74 full clinical study reports of oseltamivir trials after GSK released the data on <a href="/wiki/Zanamivir" title="Zanamivir">zanamivir</a> studies.<sup id="cite_ref-79" class="reference"><a href="#cite_note-79"><span class="cite-bracket">[</span>79<span class="cite-bracket">]</span></a></sup> In 2014, Cochrane published an updated review based solely on full clinical study reports and regulatory documents.<sup id="cite_ref-Cochrane2014_30-8" class="reference"><a href="#cite_note-Cochrane2014-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-BMJ_Tamiflu_78-1" class="reference"><a href="#cite_note-BMJ_Tamiflu-78"><span class="cite-bracket">[</span>78<span class="cite-bracket">]</span></a></sup> In 2016, Roche's oseltamivir patents began to expire.<sup id="cite_ref-WIPO_68-2" class="reference"><a href="#cite_note-WIPO-68"><span class="cite-bracket">[</span>68<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Veterinary_use">Veterinary use</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=16" title="Edit section: Veterinary use"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There have been<sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers"><span title="The time period mentioned near this tag is ambiguous. (January 2020)">when?</span></a></i>]</sup> reports of oseltamivir reducing disease severity and hospitalization time in <a href="/wiki/Canine_parvovirus" title="Canine parvovirus">canine parvovirus</a> infection.<sup id="cite_ref-80" class="reference"><a href="#cite_note-80"><span class="cite-bracket">[</span>80<span class="cite-bracket">]</span></a></sup> The drug may limit the ability of the virus to invade the <a href="/wiki/Crypt_(anatomy)" title="Crypt (anatomy)">crypt</a> cells of the <a href="/wiki/Small_intestine" title="Small intestine">small intestine</a> and decrease gastrointestinal <a href="/wiki/Bacteria" title="Bacteria">bacterial</a> colonization and toxin production.<sup id="cite_ref-81" class="reference"><a href="#cite_note-81"><span class="cite-bracket">[</span>81<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=17" title="Edit section: Research"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Oseltamivir has been deemed ineffective at treating <a href="/wiki/COVID-19" title="COVID-19">COVID-19</a>, consistent with the <a href="/wiki/SARS-CoV-2" title="SARS-CoV-2">SARS-CoV-2 virus</a> lacking influenza's neuraminidase enzyme.<sup id="cite_ref-82" class="reference"><a href="#cite_note-82"><span class="cite-bracket">[</span>82<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=18" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-Preg2017-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-Preg2017_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Preg2017_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Preg2017_1-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.drugs.com/pregnancy/oseltamivir.html">"Oseltamivir (Tamiflu) Use During Pregnancy"</a>. <i>Drugs.com</i>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20170909094948/https://www.drugs.com/pregnancy/oseltamivir.html">Archived</a> from the original on 9 September 2017<span class="reference-accessdate">. Retrieved <span class="nowrap">16 January</span> 2017</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Drugs.com&rft.atitle=Oseltamivir+%28Tamiflu%29+Use+During+Pregnancy&rft_id=https%3A%2F%2Fwww.drugs.com%2Fpregnancy%2Foseltamivir.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3AOseltamivir" class="Z3988"></span></span> </li> <li id="cite_note-Tamiflu_PI-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-Tamiflu_PI_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Tamiflu_PI_2-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRoche_Products_Pty_Limited" class="citation web cs1">Roche Products Pty Limited. <a rel="nofollow" class="external text" href="https://www.guildlink.com.au/gc/ws/ro/pi.cfm?product=roptamif10512">"Tamiflu (oseltamivir phosphate)"</a>. <i>Australian Product Information</i>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20230424145821/https://www.guildlink.com.au/gc/ws/ro/pi.cfm?product=roptamif10512">Archived</a> from the original on 24 April 2023<span class="reference-accessdate">. Retrieved <span class="nowrap">9 January</span> 2023</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Australian+Product+Information&rft.atitle=Tamiflu+%28oseltamivir+phosphate%29&rft.au=Roche+Products+Pty+Limited&rft_id=https%3A%2F%2Fwww.guildlink.com.au%2Fgc%2Fws%2Fro%2Fpi.cfm%3Fproduct%3Droptamif10512&rfr_id=info%3Asid%2Fen.wikipedia.org%3AOseltamivir" class="Z3988"></span></span> </li> <li id="cite_note-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-3">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.tga.gov.au/resources/prescription-medicines-registrations/alembic-oseltamivir-alemvir-alemzy-oselembic-oseltamivir-agh-oseltamivir-aghl-oseltamivir-appl-tamirac-alembic-pharmaceuticals-australia-pty-ltd">"ALEMBIC OSELTAMIVIR, ALEMVIR , ALEMZY , OSELEMBIC, OSELTAMIVIR AGH, OSELTAMIVIR AGHL, OSELTAMIVIR APPL , TAMIRAC (Alembic Pharmaceuticals Australia Pty Ltd)"</a>. <i>Therapeutic Goods Administration (TGA)</i>. 5 December 2022. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20230318044942/https://www.tga.gov.au/resources/prescription-medicines-registrations/alembic-oseltamivir-alemvir-alemzy-oselembic-oseltamivir-agh-oseltamivir-aghl-oseltamivir-appl-tamirac-alembic-pharmaceuticals-australia-pty-ltd">Archived</a> from the original on 18 March 2023<span class="reference-accessdate">. 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Administration">Food and Drug Administration</a> (FDA)</i>. 31 August 2011.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=U.S.+Food+and+Drug+Administration+%28FDA%29&rft.atitle=FDA+Drug+Safety+Communication%3A+Important+safety+changes+to+the+influenza+drug+Tamiflu+%28oseltamivir+phosphate%29+for+oral+suspension&rft.date=2011-08-31&rft_id=http%3A%2F%2Fwww.fda.gov%2Fdrugs%2Fdrug-safety-and-availability%2Ffda-drug-safety-communication-important-safety-changes-influenza-drug-tamiflu-oseltamivir-phosphate&rfr_id=info%3Asid%2Fen.wikipedia.org%3AOseltamivir" class="Z3988"></span></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Oseltamivir&action=edit&section=20" title="Edit section: External links"><span>edit</span></a><span 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aria-labelledby="RNA_virus_antivirals_(primarily_J05,_also_S01AD_and_D06BB)555" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:RNA_antivirals" title="Template:RNA antivirals"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:RNA_antivirals" title="Template talk:RNA antivirals"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:RNA_antivirals" title="Special:EditPage/Template:RNA antivirals"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="RNA_virus_antivirals_(primarily_J05,_also_S01AD_and_D06BB)555" style="font-size:114%;margin:0 4em"><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a> <a href="/wiki/Antiviral_drug" title="Antiviral drug">antivirals</a> (primarily <a href="/wiki/ATC_code_J05" title="ATC code J05">J05</a>, also <a href="/wiki/ATC_code_S01#S01AD" title="ATC code S01">S01AD</a> and <a href="/wiki/ATC_code_D06#D06BB" title="ATC code D06">D06BB</a>)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hepatitis_C" title="Hepatitis C">Hepatitis C</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/NS3_(HCV)" class="mw-redirect" title="NS3 (HCV)">NS3</a>/<a href="/wiki/NS4A" class="mw-redirect" title="NS4A">4A</a> protease inhibitors (–previr)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Asunaprevir" title="Asunaprevir">Asunaprevir</a></li> <li><a href="/wiki/Boceprevir" title="Boceprevir">Boceprevir</a><sup><b>‡</b></sup></li> <li><a href="/wiki/Ciluprevir" title="Ciluprevir">Ciluprevir</a><sup><b>§</b></sup></li> <li><a href="/wiki/Danoprevir" title="Danoprevir">Danoprevir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Faldaprevir" title="Faldaprevir">Faldaprevir</a><sup><b>‡</b></sup></li> <li><a href="/wiki/Glecaprevir" title="Glecaprevir">Glecaprevir</a></li> <li><a href="/wiki/Grazoprevir" title="Grazoprevir">Grazoprevir</a></li> <li><a href="/wiki/Narlaprevir" title="Narlaprevir">Narlaprevir</a></li> <li><a href="/wiki/Paritaprevir" title="Paritaprevir">Paritaprevir</a></li> <li><a href="/wiki/Simeprevir" title="Simeprevir">Simeprevir</a></li> <li><a href="/wiki/Sovaprevir" title="Sovaprevir">Sovaprevir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Telaprevir" title="Telaprevir">Telaprevir</a><sup><b>‡</b></sup></li> <li><a href="/wiki/Vaniprevir" title="Vaniprevir">Vaniprevir</a></li> <li><a href="/w/index.php?title=Vedroprevir&action=edit&redlink=1" class="new" title="Vedroprevir (page does not exist)">Vedroprevir</a><sup><b>§</b></sup></li> <li><a href="/wiki/Voxilaprevir" title="Voxilaprevir">Voxilaprevir</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/NS5A" class="mw-redirect" title="NS5A">NS5A</a> inhibitors (–asvir)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Coblopasvir" title="Coblopasvir">Coblopasvir</a></li> <li><a href="/wiki/Daclatasvir" title="Daclatasvir">Daclatasvir</a><sup><b>#</b></sup></li> <li><a href="/wiki/Elbasvir" title="Elbasvir">Elbasvir</a></li> <li><a href="/wiki/Ledipasvir" title="Ledipasvir">Ledipasvir</a></li> <li><a href="/wiki/Odalasvir" title="Odalasvir">Odalasvir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Ombitasvir" title="Ombitasvir">Ombitasvir</a></li> <li><a href="/wiki/Pibrentasvir" title="Pibrentasvir">Pibrentasvir</a></li> <li><a href="/wiki/Ravidasvir" title="Ravidasvir">Ravidasvir</a><sup><b>†</b></sup></li> <li><a href="/w/index.php?title=Ruzasvir&action=edit&redlink=1" class="new" title="Ruzasvir (page does not exist)">Ruzasvir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Samatasvir" title="Samatasvir">Samatasvir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Velpatasvir" title="Velpatasvir">Velpatasvir</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/NS5B" class="mw-redirect" title="NS5B">NS5B</a> <a href="/wiki/RNA_polymerase" title="RNA polymerase">RNA polymerase</a> inhibitors (–buvir)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Beclabuvir" title="Beclabuvir">Beclabuvir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Bemnifosbuvir" title="Bemnifosbuvir">Bemnifosbuvir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Dasabuvir" title="Dasabuvir">Dasabuvir</a><sup><b>#</b></sup></li> <li><a href="/wiki/Deleobuvir" title="Deleobuvir">Deleobuvir</a><sup><b>§</b></sup></li> <li><a href="/wiki/Filibuvir" title="Filibuvir">Filibuvir</a><sup><b>§</b></sup></li> <li><a href="/wiki/GS-6620" title="GS-6620">GS-6620</a><sup><b>§</b></sup></li> <li><a href="/wiki/IDX-184" title="IDX-184">IDX-184</a><sup><b>§</b></sup></li> <li><a href="/wiki/Setrobuvir" title="Setrobuvir">Setrobuvir</a><sup><b>§</b></sup></li> <li><a href="/wiki/Sofosbuvir" title="Sofosbuvir">Sofosbuvir</a><sup><b>#</b></sup></li> <li><a href="/w/index.php?title=Tegobuvir&action=edit&redlink=1" class="new" title="Tegobuvir (page does not exist)">Tegobuvir</a><sup><b>§</b></sup></li> <li><a href="/wiki/TMC-647055" title="TMC-647055">TMC-647055</a><sup><b>§</b></sup></li> <li><a href="/wiki/Radalbuvir" title="Radalbuvir">Radalbuvir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Uprifosbuvir" title="Uprifosbuvir">Uprifosbuvir</a><sup><b>†</b></sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Combination drugs</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Elbasvir/grazoprevir" title="Elbasvir/grazoprevir">Elbasvir/grazoprevir</a></li> <li><a href="/wiki/Glecaprevir/pibrentasvir" title="Glecaprevir/pibrentasvir">Glecaprevir/pibrentasvir</a></li> <li><a href="/wiki/Ledipasvir/sofosbuvir" title="Ledipasvir/sofosbuvir">Ledipasvir/sofosbuvir</a><sup><b>#</b></sup></li> <li><a href="/wiki/Ombitasvir/paritaprevir/ritonavir" title="Ombitasvir/paritaprevir/ritonavir">Ombitasvir/paritaprevir/ritonavir</a><sup><b>#</b></sup></li> <li><a href="/wiki/Sofosbuvir/daclatasvir" title="Sofosbuvir/daclatasvir">Sofosbuvir/daclatasvir</a></li> <li><a href="/wiki/Sofosbuvir/velpatasvir" title="Sofosbuvir/velpatasvir">Sofosbuvir/velpatasvir</a><sup><b>#</b></sup></li> <li><a href="/wiki/Sofosbuvir/velpatasvir/voxilaprevir" title="Sofosbuvir/velpatasvir/voxilaprevir">Sofosbuvir/velpatasvir/voxilaprevir</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hepatitis_D" title="Hepatitis D">Hepatitis D</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bulevirtide" title="Bulevirtide">Bulevirtide</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Picornavirus" title="Picornavirus">Picornavirus</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Viral_entry" title="Viral entry">viral entry</a>:</i> <a href="/wiki/Pleconaril" title="Pleconaril">Pleconaril</a><sup><b>†</b></sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Anti-<a href="/wiki/Influenza" title="Influenza">influenza</a> agents</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Baloxavir_marboxil" title="Baloxavir marboxil">Baloxavir marboxil</a></li> <li><a href="/wiki/Pimodivir" title="Pimodivir">Pimodivir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Umifenovir" title="Umifenovir">Umifenovir</a></li></ul> <ul><li><i><a href="/wiki/Adamantane" title="Adamantane">adamantane derivatives</a>/<a href="/wiki/M2_protein" class="mw-redirect" title="M2 protein">M2 inhibitors</a></i> (<a href="/wiki/Adapromine" title="Adapromine">Adapromine</a></li> <li><a href="/wiki/Amantadine" title="Amantadine">Amantadine</a></li> <li><a href="/wiki/Rimantadine" title="Rimantadine">Rimantadine</a>)</li></ul> <ul><li><i><a href="/wiki/Neuraminidase_inhibitor" title="Neuraminidase inhibitor">neuraminidase inhibitors</a>/<a href="/wiki/Antiviral_drug#Release_phase" title="Antiviral drug">release phase</a></i> (<a class="mw-selflink selflink">Oseltamivir</a><sup><b>#</b></sup></li> <li><a href="/wiki/Zanamivir" title="Zanamivir">Zanamivir</a></li> <li><a href="/wiki/Peramivir" title="Peramivir">Peramivir</a>, <a href="/wiki/Laninamivir" title="Laninamivir">Laninamivir</a><sup><b>†</b></sup>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Multiple/general</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Interferon" title="Interferon">Interferon</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Interferon_alfa_2b" class="mw-redirect" title="Interferon alfa 2b">Interferon alfa 2b</a></li> <li><a href="/wiki/Peginterferon_alfa-2a" title="Peginterferon alfa-2a">Peginterferon alfa-2a</a><sup><b>#</b></sup></li> <li><a href="/wiki/Peginterferon_alfa-2b" title="Peginterferon alfa-2b">Peginterferon alfa-2b</a><sup><b>#</b></sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/3C-like_protease" title="3C-like protease">3CL protease</a> inhibitors (–trelvir)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Atilotrelvir" title="Atilotrelvir">Atilotrelvir</a></li> <li><a href="/wiki/Ensitrelvir" title="Ensitrelvir">Ensitrelvir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Ibuzatrelvir" title="Ibuzatrelvir">Ibuzatrelvir</a></li> <li><a href="/wiki/Lufotrelvir" title="Lufotrelvir">Lufotrelvir</a></li> <li><a href="/wiki/Nirmatrelvir" title="Nirmatrelvir">Nirmatrelvir</a><sup><b>†</b></sup> (<a href="/wiki/Nirmatrelvir/ritonavir" title="Nirmatrelvir/ritonavir">+ritonavir</a>)<sup><b>†</b></sup></li> <li><a href="/wiki/Rupintrivir" title="Rupintrivir">Rupintrivir</a></li> <li><a href="/wiki/Simnotrelvir" class="mw-redirect" title="Simnotrelvir">Simnotrelvir</a> (<a href="/wiki/Simnotrelvir/ritonavir" title="Simnotrelvir/ritonavir">+ritonavir</a><sup><b>†</b></sup>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">RNA pol inhibitors</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/CMX521" title="CMX521">CMX521</a><sup><b>§</b></sup></li> <li><a href="/wiki/Deuremidevir" title="Deuremidevir">Deuremidevir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Favipiravir" title="Favipiravir">Favipiravir</a></li> <li><a href="/wiki/Galidesivir" title="Galidesivir">Galidesivir</a><sup><b>†</b></sup></li> <li><a href="/wiki/GS-441524" title="GS-441524">GS-441524</a><sup><b>§</b></sup></li> <li><a href="/wiki/Remdesivir" title="Remdesivir">Remdesivir</a></li> <li><a href="/wiki/MK-608" title="MK-608">MK-608</a><sup><b>§</b></sup></li> <li><a href="/wiki/Mericitabine" title="Mericitabine">Mericitabine</a><sup><b>†</b></sup></li> <li><a href="/wiki/Molnupiravir" title="Molnupiravir">Molnupiravir</a></li> <li><a href="/wiki/NITD008" title="NITD008">NITD008</a><sup><b>§</b></sup></li> <li><a href="/wiki/Ribavirin" title="Ribavirin">Ribavirin</a><sup><b>#</b></sup></li> <li><a href="/wiki/Taribavirin" title="Taribavirin">Taribavirin</a><sup><b>†</b></sup></li> <li><a href="/wiki/Triazavirin" class="mw-redirect" title="Triazavirin">Triazavirin</a></li> <li><a href="/wiki/Valopicitabine" title="Valopicitabine">Valopicitabine</a><sup><b>†</b></sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Multiple/Unknown/Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/EICAR_(antiviral)" title="EICAR (antiviral)">EICAR</a><sup><b>§</b></sup></li> <li><a href="/wiki/Merimepodib" title="Merimepodib">Merimepodib</a><sup><b>§</b></sup></li> <li><a href="/wiki/Moroxydine" title="Moroxydine">Moroxydine</a></li> <li><a href="/wiki/Presatovir" title="Presatovir">Presatovir</a><sup><b>†</b></sup></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><td class="navbox-abovebelow" colspan="2" style="padding: 0px;"><div><div class="hlist"> <ul><li><sup>#</sup><a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">WHO-EM</a></li> <li><sup>‡</sup><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">Withdrawn</a> from market</li> <li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical trials</a>: <ul><li><sup>†</sup><a href="/wiki/Phases_of_clinical_research#Phase_III" title="Phases of clinical research">Phase III</a></li> <li><sup>§</sup>Never to phase III</li></ul></li></ul> </div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Influenza468" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Influenza" title="Template:Influenza"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Influenza" title="Template talk:Influenza"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Influenza" title="Special:EditPage/Template:Influenza"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Influenza468" style="font-size:114%;margin:0 4em"><a href="/wiki/Influenza" title="Influenza">Influenza</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">General topics</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Influenza_research" class="mw-redirect" title="Influenza research">Research</a></li> <li><a href="/wiki/Influenza_vaccine" title="Influenza vaccine">Vaccine</a></li> <li><a href="/wiki/Influenza_treatment" class="mw-redirect" title="Influenza treatment">Treatment</a></li> <li><a href="/wiki/Influenza_Genome_Sequencing_Project" title="Influenza Genome Sequencing Project">Genome sequencing</a></li> <li><a href="/wiki/Reassortment" title="Reassortment">Reassortment</a></li> <li><a href="/wiki/Superinfection" title="Superinfection">Superinfection</a></li> <li><a href="/wiki/Flu_season" title="Flu season">Flu season</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Viruses</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Orthomyxoviridae" title="Orthomyxoviridae">Orthomyxoviridae</a></li> <li><a href="/wiki/Influenza_A_virus" title="Influenza A virus">Influenza A</a></li> <li><a href="/wiki/Influenzavirus_B" class="mw-redirect" title="Influenzavirus B">Influenza B</a></li> <li><a href="/wiki/Influenzavirus_C" class="mw-redirect" title="Influenzavirus C">Influenza C</a></li> <li><a href="/wiki/Influenzavirus_D" class="mw-redirect" title="Influenzavirus D">Influenza D</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Influenza A virus<br />subtypes</div></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Influenza_A_virus_subtype_H1N1" title="Influenza A virus subtype H1N1">H1N1</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H1N2" title="Influenza A virus subtype H1N2">H1N2</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H2N2" title="Influenza A virus subtype H2N2">H2N2</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H2N3" title="Influenza A virus subtype H2N3">H2N3</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H3N1" title="Influenza A virus subtype H3N1">H3N1</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H3N2" title="Influenza A virus subtype H3N2">H3N2</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H3N8" title="Influenza A virus subtype H3N8">H3N8</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H5N1" title="Influenza A virus subtype H5N1">H5N1</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H5N2" title="Influenza A virus subtype H5N2">H5N2</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H5N3" title="Influenza A virus subtype H5N3">H5N3</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H5N6" title="Influenza A virus subtype H5N6">H5N6</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H5N8" title="Influenza A virus subtype H5N8">H5N8</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H5N9" title="Influenza A virus subtype H5N9">H5N9</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H6N1" title="Influenza A virus subtype H6N1">H6N1</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H7N1" title="Influenza A virus subtype H7N1">H7N1</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H7N2" title="Influenza A virus subtype H7N2">H7N2</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H7N3" title="Influenza A virus subtype H7N3">H7N3</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H7N4" title="Influenza A virus subtype H7N4">H7N4</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H7N7" title="Influenza A virus subtype H7N7">H7N7</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H7N9" title="Influenza A virus subtype H7N9">H7N9</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H9N2" title="Influenza A virus subtype H9N2">H9N2</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H10N3" title="Influenza A virus subtype H10N3">H10N3</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H10N7" title="Influenza A virus subtype H10N7">H10N7</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H10N8" title="Influenza A virus subtype H10N8">H10N8</a></li> <li><a href="/w/index.php?title=Influenza_A_virus_subtype_H11N2&action=edit&redlink=1" class="new" title="Influenza A virus subtype H11N2 (page does not exist)">H11N2</a></li> <li><a href="/w/index.php?title=Influenza_A_virus_subtype_H11N9&action=edit&redlink=1" class="new" title="Influenza A virus subtype H11N9 (page does not exist)">H11N9</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Influenza_A_virus_subtype_H1N1" title="Influenza A virus subtype H1N1">H1N1</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;"><a href="/wiki/Influenza_pandemic" title="Influenza pandemic">Pandemics</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Spanish_flu" title="Spanish flu">1918 (Spanish flu)</a></li> <li><a href="/wiki/1977_Russian_flu" title="1977 Russian flu">1977 (Russian flu)</a></li> <li><a href="/wiki/2009_swine_flu_pandemic" title="2009 swine flu pandemic">2009 (Swine flu)</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;">Science</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pandemic_H1N1/09_virus" title="Pandemic H1N1/09 virus">2009 A/H1N1</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Influenza_A_virus_subtype_H5N1" title="Influenza A virus subtype H5N1">H5N1</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;">Outbreaks</th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bird_flu_in_Croatia" class="mw-redirect" title="Bird flu in Croatia">Croatia (2005)</a></li> <li><a href="/wiki/2006_H5N1_outbreak_in_India" title="2006 H5N1 outbreak in India">India (2006)</a></li> <li><a href="/wiki/2007_Bernard_Matthews_H5N1_outbreak" title="2007 Bernard Matthews H5N1 outbreak">UK (2007)</a></li> <li><a href="/wiki/2008_H5N1_outbreak_in_West_Bengal" title="2008 H5N1 outbreak in West Bengal">West Bengal (2008)</a></li> <li><a href="/wiki/2020%E2%80%932024_H5N1_outbreak" class="mw-redirect" title="2020–2024 H5N1 outbreak">2020s outbreak</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;">Science</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/H5N1_genetic_structure" title="H5N1 genetic structure">Genetic structure</a></li> <li><a href="/wiki/Transmission_and_infection_of_H5N1" title="Transmission and infection of H5N1">Transmission and infection</a></li> <li><a href="/wiki/Global_spread_of_H5N1" title="Global spread of H5N1">Global spread</a></li> <li><a href="/wiki/H5N1_vaccine" title="H5N1 vaccine">Vaccine</a> <ul><li><a href="/wiki/H5N1_clinical_trials" class="mw-redirect" title="H5N1 clinical trials">clinical trials</a></li></ul></li> <li><a href="/wiki/Human_mortality_from_H5N1" title="Human mortality from H5N1">Human mortality</a></li> <li><a href="/wiki/Social_effects_of_H5N1" title="Social effects of H5N1">Social impact</a></li> <li><a href="/wiki/Influenza_pandemic#Government_preparations_for_a_potential_H5N1_pandemic_(2003–2009)" title="Influenza pandemic">Pandemic preparation</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Influenza_A_virus_subtype_H5N8" title="Influenza A virus subtype H5N8">H5N8</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;">Outbreaks</th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/2020%E2%80%932023_H5N8_outbreak" title="2020–2023 H5N8 outbreak">2020–2023</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Influenza_treatment" class="mw-redirect" title="Influenza treatment">Treatments</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;"><a href="/wiki/Antiviral_drug" title="Antiviral drug">Antiviral drugs</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Adamantane" title="Adamantane">Adamantane derivatives</a> <ul><li><a href="/wiki/Amantadine" title="Amantadine">Amantadine</a></li> <li><a href="/wiki/Rimantadine" title="Rimantadine">Rimantadine</a></li></ul></li> <li><a href="/wiki/Neuraminidase_inhibitor" title="Neuraminidase inhibitor">Neuraminidase inhibitor</a> <ul><li><a class="mw-selflink selflink">Oseltamivir</a></li> <li><a href="/wiki/Laninamivir" title="Laninamivir">Laninamivir</a></li> <li><a href="/wiki/Peramivir" title="Peramivir">Peramivir</a></li> <li><a href="/wiki/Zanamivir" title="Zanamivir">Zanamivir</a></li></ul></li> <li><a href="/wiki/Peramivir" title="Peramivir">Peramivir <span style="font-size:85%;">(experimental)</span></a></li> <li><a href="/wiki/Umifenovir" title="Umifenovir">Umifenovir</a></li> <li><a href="/wiki/Baloxavir_marboxil" title="Baloxavir marboxil">Baloxavir marboxil</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;"><a href="/wiki/Influenza_vaccine" title="Influenza vaccine">Vaccines</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Live_attenuated_influenza_vaccine" title="Live attenuated influenza vaccine">Live attenuated influenza vaccine</a></li> <li><a href="/wiki/Seasonal_influenza_vaccine_brands" class="mw-redirect" title="Seasonal influenza vaccine brands">Brands</a></li> <li><a href="/wiki/Pandemrix" title="Pandemrix">Pandemrix</a></li> <li><a href="/wiki/Audenz" class="mw-redirect" title="Audenz">Audenz</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Pandemics and<br />epidemics</div></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;"><a href="/wiki/Influenza_pandemic" title="Influenza pandemic">Pandemics</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/1510_influenza_pandemic" title="1510 influenza pandemic">Influenza pandemic (1510)</a></li> <li><a href="/wiki/1557_influenza_pandemic" title="1557 influenza pandemic">Influenza pandemic (1557)</a></li> <li><a href="/wiki/1889%E2%80%931890_pandemic" title="1889–1890 pandemic">Russian flu (1889–1890)</a></li> <li><a href="/wiki/1918_flu_pandemic" class="mw-redirect" title="1918 flu pandemic">Spanish flu (1918)</a></li> <li><a href="/wiki/1957%E2%80%931958_influenza_pandemic" title="1957–1958 influenza pandemic">Asian flu (1957-1958)</a></li> <li><a href="/wiki/Hong_Kong_flu" title="Hong Kong flu">Hong Kong flu (1968)</a></li> <li><a href="/wiki/1977_Russian_flu" title="1977 Russian flu">1977 Russian flu</a></li> <li><a href="/wiki/2009_swine_flu_pandemic" title="2009 swine flu pandemic">Swine flu (2009)</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;"><a href="/wiki/List_of_epidemics_and_pandemics" title="List of epidemics and pandemics">Epidemics</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fujian_flu" title="Fujian flu">Fujian flu (H3N2)</a> <ul><li><a href="/wiki/1989%E2%80%931990_flu_epidemic_in_the_United_Kingdom" title="1989–1990 flu epidemic in the United Kingdom">1989–1990 UK outbreak</a></li></ul></li> <li><a href="/wiki/2017_Central_Luzon_H5N6_outbreak" title="2017 Central Luzon H5N6 outbreak">Central Luzon H5N6 (2017)</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Non-human</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;">Mammals</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Canine_influenza" title="Canine influenza">Canine</a></li> <li><a href="/wiki/Cat_flu" title="Cat flu">Feline</a></li> <li><a href="/wiki/Equine_influenza" title="Equine influenza">Equine</a> <ul><li><a href="/wiki/2007_Australian_equine_influenza_outbreak" title="2007 Australian equine influenza outbreak">2007 Australian outbreak</a></li></ul></li> <li><a href="/wiki/Swine_influenza" title="Swine influenza">Swine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;">Non-mammals</th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Avian_influenza" title="Avian influenza">Avian</a></li> <li><a href="/wiki/Fujian_flu" title="Fujian flu">Fujian (H5N1)</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acute_bronchitis" title="Acute bronchitis">Acute bronchitis</a></li> <li><a href="/wiki/Bronchiolitis" title="Bronchiolitis">Bronchiolitis</a></li> <li><a href="/wiki/Croup" title="Croup">Croup</a></li> <li><a href="/wiki/Otitis_media" title="Otitis media">Otitis media</a></li> <li><a href="/wiki/Pharyngitis" title="Pharyngitis">Pharyngitis</a></li> <li><a href="/wiki/Pneumonia" title="Pneumonia">Pneumonia</a></li> <li><a href="/wiki/Sinusitis" title="Sinusitis">Sinusitis</a></li> <li><a href="/wiki/Streptococcal_pharyngitis" title="Streptococcal pharyngitis">Strep throat</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related topics</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Influenza-like_illness" title="Influenza-like illness">Influenza-like illness</a></li> <li><a href="/wiki/2017%E2%80%932018_United_States_flu_season" title="2017–2018 United States flu season">2017–2018 United States flu season</a></li> <li><a href="/wiki/US_influenza_statistics_by_flu_season" class="mw-redirect" title="US influenza statistics by flu season">US influenza statistics by flu season</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style></div><div role="navigation" class="navbox" aria-labelledby="2009_swine_flu_pandemic472" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:2009_flu_pandemic" title="Template:2009 flu pandemic"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:2009_flu_pandemic" title="Template talk:2009 flu pandemic"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:2009_flu_pandemic" title="Special:EditPage/Template:2009 flu pandemic"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="2009_swine_flu_pandemic472" style="font-size:114%;margin:0 4em"><a href="/wiki/2009_swine_flu_pandemic" title="2009 swine flu pandemic">2009 swine flu pandemic</a></div></th></tr><tr><td class="navbox-abovebelow" colspan="2"><div><a href="/wiki/2009_swine_flu_pandemic_timeline" title="2009 swine flu pandemic timeline">Outbreak timeline</a> · <a href="/wiki/2009_swine_flu_pandemic_tables" title="2009 swine flu pandemic tables">Pandemic tables</a></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/2009_swine_flu_pandemic_by_country" title="2009 swine flu pandemic by country">Location</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/2009_flu_pandemic_in_Africa" class="mw-redirect" title="2009 flu pandemic in Africa">Africa</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/2009_swine_flu_pandemic_in_Africa#Algeria" title="2009 swine flu pandemic in Africa">Algeria</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Africa#Benin" title="2009 swine flu pandemic in Africa">Benin</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Africa#Egypt" title="2009 swine flu pandemic in Africa">Egypt</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Africa#Ethiopia" title="2009 swine flu pandemic in Africa">Ethiopia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Africa#Ghana" title="2009 swine flu pandemic in Africa">Ghana</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Africa#Kenya" title="2009 swine flu pandemic in Africa">Kenya</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Africa#Libya" title="2009 swine flu pandemic in Africa">Libya</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Africa#Morocco" title="2009 swine flu pandemic in Africa">Morocco</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Africa#Namibia" title="2009 swine flu pandemic in Africa">Namibia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Africa#Nigeria" title="2009 swine flu pandemic in Africa">Nigeria</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Africa#South_Africa" title="2009 swine flu pandemic in Africa">South Africa</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Africa#Tunisia" title="2009 swine flu pandemic in Africa">Tunisia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Africa#Zambia" title="2009 swine flu pandemic in Africa">Zambia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/2009_swine_flu_pandemic_in_Asia" title="2009 swine flu pandemic in Asia">Asia</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Azerbaijan" title="2009 swine flu pandemic in Asia">Azerbaijan</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Bahrain" title="2009 swine flu pandemic in Asia">Bahrain</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Bangladesh" title="2009 swine flu pandemic in Asia">Bangladesh</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Cambodia" title="2009 swine flu pandemic in Asia">Cambodia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#China_(People's_Republic_of_China)" title="2009 swine flu pandemic in Asia">China</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Cyprus" title="2009 swine flu pandemic in Asia">Cyprus</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Georgia" title="2009 swine flu pandemic in Asia">Georgia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Hong_Kong" title="2009 swine flu pandemic in Hong Kong">Hong Kong</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_India" title="2009 swine flu pandemic in India">India</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Indonesia" title="2009 swine flu pandemic in Asia">Indonesia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Iran" title="2009 swine flu pandemic in Asia">Iran</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Israel" title="2009 swine flu pandemic in Asia">Israel</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Japan" title="2009 swine flu pandemic in Japan">Japan</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Kazakhstan" title="2009 swine flu pandemic in Asia">Kazakhstan</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Kuwait" title="2009 swine flu pandemic in Asia">Kuwait</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Laos" title="2009 swine flu pandemic in Asia">Laos</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Lebanon" title="2009 swine flu pandemic in Asia">Lebanon</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Macau" title="2009 swine flu pandemic in Asia">Macau</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Malaysia" title="2009 swine flu pandemic in Malaysia">Malaysia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Mongolia" title="2009 swine flu pandemic in Asia">Mongolia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Maldives" title="2009 swine flu pandemic in Asia">Maldives</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Myanmar" title="2009 swine flu pandemic in Asia">Myanmar</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#North_Korea" title="2009 swine flu pandemic in Asia">North Korea</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Pakistan" title="2009 swine flu pandemic in Asia">Pakistan</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_the_Philippines" title="2009 swine flu pandemic in the Philippines">Philippines</a> <ul><li><a href="/wiki/2009_swine_flu_pandemic_in_the_Philippines_by_region" title="2009 swine flu pandemic in the Philippines by region">by region</a></li></ul></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Saudi_Arabia" title="2009 swine flu pandemic in Asia">Saudi Arabia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Singapore" title="2009 swine flu pandemic in Asia">Singapore</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Sri_Lanka" title="2009 swine flu pandemic in Asia">Sri Lanka</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#South_Korea" title="2009 swine flu pandemic in Asia">South Korea</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Taiwan" title="2009 swine flu pandemic in Asia">Taiwan</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Thailand" title="2009 swine flu pandemic in Asia">Thailand</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#United_Arab_Emirates" title="2009 swine flu pandemic in Asia">United Arab Emirates</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Uzbekistan" title="2009 swine flu pandemic in Asia">Uzbekistan</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Asia#Vietnam" title="2009 swine flu pandemic in Asia">Vietnam</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/2009_swine_flu_pandemic_in_Europe" title="2009 swine flu pandemic in Europe">Europe</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Albania" title="2009 swine flu pandemic in Europe">Albania</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Austria" title="2009 swine flu pandemic in Europe">Austria</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Belgium" title="2009 swine flu pandemic in Europe">Belgium</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Bosnia_and_Herzegovina" title="2009 swine flu pandemic in Europe">Bosnia and Herzegovina</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Bulgaria" title="2009 swine flu pandemic in Europe">Bulgaria</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Croatia" title="2009 swine flu pandemic in Europe">Croatia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Denmark" title="2009 swine flu pandemic in Europe">Denmark</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Estonia" title="2009 swine flu pandemic in Europe">Estonia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Finland" title="2009 swine flu pandemic in Europe">Finland</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_France" title="2009 swine flu pandemic in France">France</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Germany" title="2009 swine flu pandemic in Germany">Germany</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Greece" title="2009 swine flu pandemic in Europe">Greece</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Hungary" title="2009 swine flu pandemic in Europe">Hungary</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Iceland" title="2009 swine flu pandemic in Europe">Iceland</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Ireland" title="2009 swine flu pandemic in Europe">Ireland</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Italy" title="2009 swine flu pandemic in Europe">Italy</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Kosovo" title="2009 swine flu pandemic in Europe">Kosovo</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Lithuania" title="2009 swine flu pandemic in Europe">Lithuania</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Luxembourg" title="2009 swine flu pandemic in Europe">Luxembourg</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Macedonia" title="2009 swine flu pandemic in Europe">Macedonia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Montenegro" title="2009 swine flu pandemic in Europe">Montenegro</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Netherlands" title="2009 swine flu pandemic in Europe">Netherlands</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Norway" title="2009 swine flu pandemic in Norway">Norway</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Poland" title="2009 swine flu pandemic in Europe">Poland</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Portugal" title="2009 swine flu pandemic in Portugal">Portugal</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Romania" title="2009 swine flu pandemic in Europe">Romania</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Russia" title="2009 swine flu pandemic in Europe">Russia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Serbia" title="2009 swine flu pandemic in Europe">Serbia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Slovenia" title="2009 swine flu pandemic in Europe">Slovenia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Spain" title="2009 swine flu pandemic in Spain">Spain</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Sweden" title="2009 swine flu pandemic in Europe">Sweden</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Europe#Switzerland" title="2009 swine flu pandemic in Europe">Switzerland</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Turkey" title="2009 swine flu pandemic in Turkey">Turkey</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Ukraine" title="2009 swine flu pandemic in Ukraine">Ukraine</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_the_United_Kingdom" title="2009 swine flu pandemic in the United Kingdom">United Kingdom</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/2009_swine_flu_pandemic_in_North_America" title="2009 swine flu pandemic in North America">North America</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/2009_swine_flu_pandemic_in_North_America#Aruba" title="2009 swine flu pandemic in North America">Aruba</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_North_America#Belize" title="2009 swine flu pandemic in North America">Belize</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Canada" title="2009 swine flu pandemic in Canada">Canada</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Costa_Rica" title="2009 swine flu pandemic in Costa Rica">Costa Rica</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_North_America#Cuba" title="2009 swine flu pandemic in North America">Cuba</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_North_America#Dominican_Republic" title="2009 swine flu pandemic in North America">Dominican Republic</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_North_America#Guatemala" title="2009 swine flu pandemic in North America">Guatemala</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_North_America#Honduras" title="2009 swine flu pandemic in North America">Honduras</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_North_America#Jamaica" title="2009 swine flu pandemic in North America">Jamaica</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Mexico" title="2009 swine flu pandemic in Mexico">Mexico</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_North_America#Panama" title="2009 swine flu pandemic in North America">Panama</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_North_America#Trinidad_and_Tobago" title="2009 swine flu pandemic in North America">Trinidad and Tobago</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_the_United_States" title="2009 swine flu pandemic in the United States">United States</a> <ul><li><a href="/wiki/2009_swine_flu_pandemic_in_the_United_States_by_state" title="2009 swine flu pandemic in the United States by state">by state</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/2009_swine_flu_pandemic_in_South_America" title="2009 swine flu pandemic in South America">South America</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/2009_swine_flu_pandemic_in_Argentina" title="2009 swine flu pandemic in Argentina">Argentina</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_South_America#Bolivia" title="2009 swine flu pandemic in South America">Bolivia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Brazil" title="2009 swine flu pandemic in Brazil">Brazil</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_South_America#Chile" title="2009 swine flu pandemic in South America">Chile</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_South_America#Colombia" title="2009 swine flu pandemic in South America">Colombia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_South_America#Ecuador" title="2009 swine flu pandemic in South America">Ecuador</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_South_America#Paraguay" title="2009 swine flu pandemic in South America">Paraguay</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_South_America#peru" title="2009 swine flu pandemic in South America">Peru</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Uruguay" title="2009 swine flu pandemic in Uruguay">Uruguay</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_South_America#Venezuela" title="2009 swine flu pandemic in South America">Venezuela</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/2009_swine_flu_pandemic_in_Oceania" title="2009 swine flu pandemic in Oceania">Oceania</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/2009_swine_flu_pandemic_in_Australia" title="2009 swine flu pandemic in Australia">Australia</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Oceania#fiji" title="2009 swine flu pandemic in Oceania">Fiji</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Oceania#Nauru" title="2009 swine flu pandemic in Oceania">Nauru</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_New_Zealand" title="2009 swine flu pandemic in New Zealand">New Zealand</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Oceania#Palau" title="2009 swine flu pandemic in Oceania">Palau</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Oceania#Papua_New_Guinea" title="2009 swine flu pandemic in Oceania">Papua New Guinea</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Oceania#Solomon_Islands" title="2009 swine flu pandemic in Oceania">Solomon Islands</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Oceania#Tonga" title="2009 swine flu pandemic in Oceania">Tonga</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Oceania#Tokelau" title="2009 swine flu pandemic in Oceania">Tokelau</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_in_Oceania#Vanuatu" title="2009 swine flu pandemic in Oceania">Vanuatu</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Category:2009_swine_flu_pandemic" title="Category:2009 swine flu pandemic">Related</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Influenza_pandemic" title="Influenza pandemic">Influenza pandemic</a></li> <li><a href="/wiki/Spanish_flu" title="Spanish flu">Spanish flu</a></li> <li><a href="/wiki/Swine_influenza" title="Swine influenza">Swine influenza</a></li> <li><a href="/wiki/Influenza" title="Influenza">Influenza</a></li> <li><a href="/wiki/Influenzavirus_A" class="mw-redirect" title="Influenzavirus A">Influenza A</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H1N1" title="Influenza A virus subtype H1N1">H1N1</a></li> <li><a href="/wiki/Pandemic_H1N1/09_virus" title="Pandemic H1N1/09 virus">2009 A/H1N1</a></li> <li><a href="/wiki/2009_swine_flu_pandemic_vaccine" title="2009 swine flu pandemic vaccine">2009 A/H1N1 vaccine</a></li> <li><a href="/wiki/2009_swine_flu_outbreak_actions_concerning_pigs" class="mw-redirect" title="2009 swine flu outbreak actions concerning pigs">Actions with pigs</a></li> <li><a class="mw-selflink-fragment" href="#H1N1_flu_or_"Swine_flu"">Tamiflu resistance</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Spanish_flu" title="Spanish flu">Spanish flu</a>, <a href="/wiki/Influenza_A_virus_subtype_H5N1" title="Influenza A virus subtype H5N1">H5N1</a>, <a href="/wiki/Avian_influenza" title="Avian influenza">Bird flu</a>, and <a href="/wiki/Influenza-like_illness" title="Influenza-like illness">Influenza-like illness</a></div></div></td></tr></tbody></table></div> <style data-mw-deduplicate="TemplateStyles:r1130092004">.mw-parser-output .portal-bar{font-size:88%;font-weight:bold;display:flex;justify-content:center;align-items:baseline}.mw-parser-output .portal-bar-bordered{padding:0 2em;background-color:#fdfdfd;border:1px solid #a2a9b1;clear:both;margin:1em auto 0}.mw-parser-output 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