Flu: Should I Take Antiviral Medicine?

Flu: Should I Take Antiviral Medicine?
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts
Compare your options
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?

1. Get the facts

Your options

Take antiviral medicine to treat or prevent the flu.
Do not take antiviral medicine.

Key points to remember

Most healthy adults who get the flu don't need antiviral medicine.
Taking an antiviral may be a good idea for people who are at high risk for serious problems (complications) from the flu. This includes children, people 65 and older, and those with long-term (chronic) diseases or a weak immune system.
Antiviral medicines can shorten the course of the flu but only by about 1 day. And you need to take the medicine within 2 days of getting sick for it to work.
Antivirals may help control flu outbreaks in settings where people are at high risk of complications, such as nursing homes. If you live or work in such a setting during an outbreak, you may want to take an antiviral medicine, even if you got a flu vaccine.
Antivirals do not take the place of a flu vaccine. The best way to avoid getting the flu is to get a flu vaccine each year, as soon as it's available.

FAQs

What are antiviral medicines for the flu?

Antivirals are medicines that make it harder for viruses to grow in your body. You can take an influenza (flu) antiviral either to prevent the flu or to treat the flu after you have it. Their main use is to help protect people who are at high risk for serious problems from the flu, such as pneumonia.

Antiviral medicines recommended for the flu are the neuraminidase inhibitors, which include oseltamivir (Tamiflu) and zanamivir (Relenza).

There are two main types of influenza virus—type A and type B. Type A causes most flu outbreaks. The neuraminidase inhibitors help fight both A and B viruses.

These antiviral medicines will not help fight other types of viral infections, such as colds.

Note: How well antiviral medicines work can vary from year to year as flu viruses change. For the past few years, the U.S. Centers for Disease Control and Prevention (CDC) has advised doctors not to use the antivirals amantadine and rimantadine to treat or prevent the flu.¹ These medicines have not worked against most types of the flu virus. If you decide to take an antiviral, your doctor can prescribe the best one for you. For the most recent news on antiviral drugs, see the CDC's Web page on seasonal flu at www.cdc.gov/flu.

Who can take antivirals?

Antivirals are most often used to help control flu outbreaks in settings such as nursing homes and hospitals, where people who are at high risk for serious problems live close together.

Antivirals may be given to:

People who are at high risk for serious problems from the flu, such as children, people 65 and older, and those with long-term (chronic) diseases or a weak immune system.
People who did not get a flu vaccine and who are in close contact with anyone at high risk for problems from the flu.
People at high risk for problems from the flu who are not able to get a flu vaccine.

Doctors may also prescribe antivirals for anyone who is diagnosed with the flu within the first 2 days of illness. This may help shorten the course of the flu and help prevent its spread.

Who should not take antiviral medicine?

Some antivirals are not intended for children or for people who have serious breathing problems, such as asthma or COPD. But your doctor can prescribe the correct type.

Antivirals can cost a lot—from about $70 to $100. They may not be worth the cost for people who are not at high risk from the flu.

Why might your doctor recommend antiviral medicines for you?

If you get the flu, your doctor may advise you to take antivirals to treat the flu if:

You are at high risk for problems from the flu because of your age or health.
You live or work with someone who is at high risk for problems from the flu.
You have been sick for less than 2 days. If you have been sick for more than 2 days, the medicine won't help.

Your doctor may advise you to take antivirals to prevent the flu if:

You are at high risk for problems from the flu because of your age or health and you did not get a flu vaccine.
You live or work in a setting where there has been a flu outbreak, such as a nursing home.

2. Compare your options

	Take antivirals for the flu	Don't take antivirals for the flu
	What is usually involved? You see your doctor and get the prescription filled. You take the medicine for 5 to 7 days.	What is usually involved? You take care of yourself until you are better.
	What are the benefits? Antiviral medicines can shorten the course of the flu by about 1 day if you take them within 2 days of getting sick. They may make you less likely to spread the flu. They may help control flu outbreaks in settings such as nursing homes, where people are at high risk for problems from the flu. They may help prevent flu in people who did not get a flu vaccine.	What are the benefits? You won't be exposed to risks or side effects from the medicines. You don't increase the risk of drug-resistant viruses that are harder to treat.
	What are the risks and side effects? Antiviral medicines for the flu may cause minor problems, such as diarrhea, sinus infection (sinusitis), or nausea and vomiting (more common with Tamiflu [oseltamivir]). Relenza (zanamivir) may cause breathing problems in people who have serious lung problems. Tamiflu may increase the risk for self-injury and confusion in people who have the flu, especially children. They should be watched closely, and any odd behavior should be reported to a doctor. Taking antivirals when you don't really need them may lead to drug-resistant viruses that are harder to treat.	What are the risks and side effects? The flu may last about 1 day longer than it would without medicines. People who are at risk for problems from the flu are more likely to have them if they don't take medicines. You may be more likely to spread the flu to others.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about taking antiviral medicine for the flu

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"My dad has Alzheimer's, so he is in a nursing home. The residents get a flu shot every year, but last winter they had a flu outbreak in the home. They gave antivirals to everyone in his unit, and luckily he didn't get sick. He's so weak that I don't think he would have survived if he had gotten the flu."

— Danni, age 48

"I got the flu last winter, and it was pretty miserable. Somebody told me there was antiviral medicine I could take that could help, so I asked my doctor about it. He said it's mostly used for people who would be in danger if they got sick. He said he could prescribe it if I wanted, but it would only shorten the flu by about a day. I'm young and strong, so why spend the money? But this year I'm going to get a flu shot for sure."

— Cody, age 29

"Yesterday my wife came down with what I know are flu symptoms. I have to fly to China on Friday for a big meeting. I called my doctor, and she prescribed antivirals for me. I hope they work, because I can't afford to get sick now."

— Paul, age 34

"I help take care of my brother, Frank, who is bedridden. I had a bad reaction to the flu shot when I last got it, so my doctor suggested that I take an antiviral medicine instead. This helps keep me from getting the flu and passing it to Frank."

— Maybelle, age 67

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antivirals

Reasons not to take antivirals

I want to get over the flu as quickly as possible.

I don't want to take medicine if it will only shorten the flu by 1 day.

More important

Equally important

More important

I'm very worried about problems from the flu, such as pneumonia.

I'm not worried about pneumonia or other problems from the flu.

More important

Equally important

More important

I want to do everything I can to stop being sick.

I don't want to go to the doctor or take medicine unless I really need to.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking antivirals

NOT taking antivirals

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1. If you are age 65 or older, should you take antiviral medicine if you get the flu?

Yes
No
I'm not sure

That's right. Older adults are at higher risk for problems from the flu, such as pneumonia. Antivirals may help prevent these problems.

2. Can antiviral medicines help you get over the flu faster, no matter when you start taking them?

Yes
No
I'm not sure

You're right. Antivirals help only if you start taking them within the first 2 days of getting sick.

3. Could you still need to take antiviral medicines for the flu, even if you had a flu vaccine?

Yes
No
I'm not sure

You're right. You can get the flu even if you had a flu vaccine. So if you are at high risk or you live or work with people who are at high risk, you may still need antiviral medicine.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2. Check what you need to do before you make this decision.

I'm ready to take action.
I want to discuss the options with others.
I want to learn more about my options.

Use the following space to list questions, concerns, and next steps.

Credits and References

Credits

By	Healthwise Staff
Primary Medical Reviewer	E. Gregory Thompson MD - Internal Medicine
Primary Medical Reviewer	Adam Husney MD - Family Medicine
Primary Medical Reviewer	Christine Hahn MD - Epidemiology

References

Citations

Centers for Disease Control and Prevention (2014). Influenza Antiviral Medications: Summary for Clinicians. http://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm. Accessed April 11, 2014.