Antiviral Drugs for Seasonal Influenza: Additional Links and Resources

Antiviral Treatment Recommendations are available.

Neuraminidase Inhibitors

The majority of currently circulating influenza viruses are susceptible to the neuraminidase inhibitor antiviral medications—oseltamivir, zanamivir and peramivir; however, sporadic cases of oseltamivir and peramivir-resistant influenza viruses have been detected worldwide in recent years. Antiviral treatment with a neuraminidase inhibitor is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at greater risk for influenza-related complications.

• Oseltamivir (available as a generic or under the trade name Tamiflu®) is FDA-approved for treatment of influenza in persons aged two weeks and older, and for chemoprophylaxis to prevent influenza in people one year of age and older. Although not part of the FDA-approved indications, use of oral oseltamivir for treatment of influenza in infants younger than 14 days old, and for chemoprophylaxis in infants 3 months to 1 year of age, is recommended by the CDC and the American Academy of Pediatrics. If a child is younger than 3 months old, use of oseltamivir for chemoprophylaxis is not recommended unless the situation is judged critical due to limited data in this age group. Generic oseltamivir was approved by the FDA in August and became available in December of 2016.
• Zanamivir (trade name Relenza®) is FDA-approved to treat flu in people 7 years and older and to prevent influenza in people 5 years and older. It is not recommended for use in people with underlying respiratory disease, including people with asthma.
• Peramivir (trade  name Rapivab®) is FDA-approved to treat flu in adults 18 years and older.

Adamantanes

In recent years, widespread adamantane resistance among influenza A (H3N2) virus strains has made this class of medications less useful clinically. In addition, circulating 2009 H1N1 virus strains are resistant to adamantanes. Therefore, amantadine and rimantadine are not recommended for antiviral treatment or chemoprophylaxis of currently circulating influenza A virus strains. (These medications are active against influenza A viruses but not influenza B viruses.)

• Amantadine (generic) is approved to treat and prevent only influenza A viruses in people older than 1 year.
• Rimantadine (generic or under the trade name Flumadine®) is approved to prevent only influenza A virus infection among people older than 1 year. It is approved to treat only influenza A virus infections in people 17 and older.

The CDC’s weekly FluView report provides the latest information on antiviral drug resistant isolates collected via routine surveillance in the United States.

Find package inserts and label updates for approved drug products at Drugs@FDA.