that Tamiflu should not be prescribed to teenagers for fear that it
can lead to bizarre and self-destructive behaviour, after
investigatingthe deaths of18 Japanese children. "
Not only is H1N1 virus immune to Tamilflu, Tamilflu can also kill.
Note: Current Swine Flu is not H1N1 flu.
Tamiflu: What you MUST know as swine flu threatens to strike
By Angela Epstein
Last updated at 9:55 PM on 02nd May 2009
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The Government has announced that stocks of drugs - known as
antivirals - to fight the imminent threat of a swine flu pandemic are
being built up to cover more than 50million people - or 80 per cent of
the country's population.
The UK is already widely recognised as one of the best prepared
countries in the world, according to the Government. Previous flu
pandemics have infected between 25 to 35 per cent of the population.
The key drug in fighting the disease is Tamiflu and it has, according
to Health Secretary Alan Johnson, already proved effective on patients
in Mexico.
Tourists wear masks in Mexico City
Fear: Tourists in Garibaldi Square in Mexico City wear face masks to
try to protect themselves from the swine flu virus
Demand for Tamiflu - manufactured by Swiss drugs company Roche - is
soaring. Pharmacists have warned that their supplies, which are
separate from the Government stockpile, may not last, with demand in
some areas up 1,000 per cent.
Meanwhile, many people are sufficiently worried by the outbreak of
swine flu to seek their own supplies online, and not always from
reputable sites.
So what do you need to know about Tamiflu? Here, with the help of
leading experts, we set the record straight.
Can I still die if I've taken Tamiflu?
Yes, according to Dr John Watkins, clinical senior lecturer in the
departofment of primary care and public health at Cardiff University,
and a consultant epidemiologist. It is critical for a sufferer to take
Tamiflu as soon as possible after developing symptoms.
The earlier you take it - within two days is best - the smaller the
virus load in your body and the less chance of potentially fatal
complications such as pneumonia.
Does it have side-effects?
Yes, although not everyone will experience them. 'The most common ones
are nausea, vomiting and stomach ache,' says GP Wendy Denning of
London's the Health Doctors clinic. 'Tamiflu should be taken after
food. However, if a person is sick within an hour of taking it, it is
likely to be ineffective.'
Roche revised the Tamiflu patient information last year, warning that
it can cause hallucinations, delirium or abnormal behaviour, which
sometimes 'results in fatal outcomes'.
This was after the Japanese government warned doctors in March 2007
that Tamiflu should not be prescribed to teenagers for fear that it
can lead to bizarre and self-destructive behaviour, after
investigatingthe deaths of18 Japanese children.
How readily available is Tamiflu?
The Department of Health has courses for 50 per cent of the population
which is being conserved for treatment. It is now increasing the
stockpile so pharmacists will not be able to buy any more stock.
Normal supplies of Tamiflu in pharmacists are usually relatively small
as prescription is restricted by the National Institute for Health and
Clinical Excellence guidelines.
The Government stocks are now being distributed to primary care
trusts.
Swine flu virus
Lethal: The swine flu virus
How do I get Tamiflu now?
You will be prescribed it by your GP only if there is a serious
concern that you may be suffering from swine flu. However, as any form
of flu is highly contagious, the advice is to contact your doctor or
NHS direct (0845 4647) for advice. Do not travel to your surgery or
hospital.
'Unless you get a home visit, your doctor will take down the details
of your symptoms over the phone as well as assess factors such as
whether you have recently been to a relevant country.
'If your GP is sufficiently concerned about your risk they will
contact the Health Protection Agency who will make contact with you
ensuring Tamiflu is delivered to you,' says Dr Watkins.
You can get Tamiflu with a private prescription, but its availability
would depend on how much a pharmacist had in stock, whereas a
prescription from your GP in response to the current swine flu scare
would come from the Government's stockpile which now is being made
available regionally.
The cost is higher than on the NHS as you have to pay for the full
amount of the medicine and also any dispensing fee the pharmacist
chooses to charge.
Private health firms which have already amassed their own stockpiles
have seen a surge in sales of anti-viral drugs following concerns that
the Health Service would be unable to meet demand if a swine flu
pandemic broke out. One company reportedly sold Tamiflu to 25,000
customers in one day.
Costs vary. A pack of ten capsules from Healthcare Connections costs
£49 at www.easyfluprotection.co.uk.
If I buy online, how do I know if I'm dealing with a reputable
company?
You can check whether they are registered with the Royal
Pharmaceutical Society. In December 2007, the society launched an
internet pharmacy logo to identify legitimate online pharmacies so
that the public can be sure they are buying safe and genuine medicines
online. For further information go to www.rpsgb.org.uk.
When you buy on the internet from a reputable company or pharmacy, you
should get a free online consultation which is reviewed by a
registered doctor.
Once you fill in the prescription form provided and your medical
details are checked and approved by their doctor, you can place an
order.
Are there risks of buying it online?
'If you do not have a valid prescription for Tamiflu there is no way
of knowing whether you are getting the real thing when you buy
online,' says London-based GP Rob Hicks.
Apart from the fact that the product could be counterfeit or even
toxic, you will not know whether you are protected from swine flu
since there is no way of knowing whether the drugs are working or
not.'
Many websites - particularly foreign websites - operate illegally by
offering the supply of prescriptiononly medicines such as Tamiflu
without having a valid prescription.
Woman taking tablet
Dose: Twice a day
When was Tamiflu invented?
Tamiflu was discovered in 1999, by Gilead Sciences, a Californian
biotech company set up by doctor Michael Riordan in 1987. The company
focus is on antiviral drugs to treat HIV, hepatitis B or influenza. It
is manufactured by Roche.
Does the current flu vaccine protect against swine flu?
It remains unclear how effective the flu vaccines would be as the new
strain is genetically distinct from other flu strains.
'There could be a cross immunity with the current flu vaccine, but we
do not know that yet,' says John Oxford, professor of virology at
Barts and London Medicine schools.
Scientists in the UK and the US are racing to produce a new bespoke
vaccine, but it may take months to perfect and to manufacture enough
supplies to meet what could be huge demand.
A vaccine was used to protect humans from a version of swine flu in
the US in 1976. However, it caused serious side effects, including an
estimated 500 cases of Guillain-Barré syndrome, a nervous disorder
leading to weakness and paralysis. There were more deaths from the
vaccine than the outbreak.
Will I be able to get Tamiflu on the NHS if I don't have flu
symptoms?
The Government is giving antivirals to the close contacts of the
confirmed cases. The definition of close contacts is based on Health
Protection Agency (HPA) guidance, which states that individuals
exposed to a probable or confirmed case within a distance of one metre
or less and for longer than one hour should be offered antivirals as a
precautionary measure.
The HPA is an independent UK organisation set up by the Government in
2003 to protect the public from threats to their health from
infectious diseases and environmental hazards.
It does this by providing advice and information to the public, to
health professionals such as doctors and nurses, and to national and
local government.
Who will be a priority for Tamiflu?
The Government is working with the NHS to ensure that antivirals are
now being distributed to primary care trusts (PCTs) so that PCTs can
in turn distribute them.
There will be no specific pecking order at GP surgeries. 'As a GP you
assess everyone on an individual basis. You don't think about how many
doses of Tamiflu are available and who deserves it most,' says Dr
Hicks. 'However, there will be guidelines to manage the situation from
the HPA.'
Certain people are more vulnerable to complications arising from flu
including the elderly, diabetics, those with existing heart disease
and children under two.
How is it taken?
In tablet form, the normal dose to treat an influenza infection in
adults is one 75mg capsule taken twice a day for five days, says Dr
Denning. As a pre-emptive strike, it is taken once a day for ten days.
Is it the only treatment?
No, another medication known as Relenza is also available. It is
inhaled rather than taken in tablet form. 'Relenza becomes effective
in minutes whereas Tamiflu takes about an hour to get into the
system,' adds Professor Oxford.
Relenza is used for pregnant women and people with certain kidney
conditions who are unable to take Tamiflu.
What is the youngest age a child can take Tamiflu?
Current advice suggests they can take it from one year old.
Does it interfere with other betablockers or the pill?
Not according to Dr John Watkins. 'Tamiflu is a relatively clean drug
so it doesn't really interfere with other medication. It has to be
used with caution if anyone has any form of renal problems or
impairment.'
Can my pet catch swine flu?
'Viruses tend to be species specific,' says Dr Watkins. 'But the virus
could affect mammalian pets such as dogs and cats. There isn't an
animal equivalent since most animal drugs tend to be modifications of
human drugs.'
How does the drug work?
Tamiflu, known by its generic name as oseltamivir, is not a cure for
swine flu, but can help sufferers recover by relieving some of the
symptoms - as well as reducing the duration of the illness and the
potential risks for serious complications, such as pneumonia.
According to John Oxford, Professor of Virology at Barts and the
London School of Medicine, the drug works by inhibiting chemicals
known as neuraminidase enzymes in the virus. 'This then stops the
virus from reproducing and spreading in the body, so shortening and
reducing the severity of the symptoms when taken within two days of
falling ill.'
What the patients are asking
We asked London GP Dr Ellie Cannon the most common questions she has
been asked about swine flu in her surgery this week:
Q: I have a runny nose and sore throat. Do I have swine flu?
A: Not if you don't have a rapidly rising temperature and you haven't
been in a high risk area: Mexico, Texas, San Diego or New York.
Q: Can I take anything to prevent getting swine flu?
A: If you are in contact with someone with a confirmed case of swine
flu you can take Tamiflu preventatively. Otherwise there is nothing we
can offer.
Q: What should I do if I think I have symptoms this weekend?
A: Do not go to see the doctor. Stay at home and call your GP, or NHS
direct. You will be visited at home if it sounds as if you may be a
high risk.
Q: Do you think I need to get my own supply?
A: No. Should you need it, Tamiflu will be made available to you and
your family.
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