Should the dose of oseltamivir be adjusted for kidney function (creatinine clearance)?
Oseltamivir is excreted through the kidneys so people with reduced kidney function will have higher levels of this drug. However, the drug is very safe; an increase in levels does not increase the risk of adverse events. This does not mean that residents need to have a creatinine clearance estimated before oseltamivir can be started. For treatment, if no serum creatinine has been measured, and there is no reason to suspect kidney failure, 75 mg BID x 5 days is a safe dose. People with a creatinine clearance of 10-30ml/min should reduce the dose of oseltamivir to 75 mg OD x 5 days. For people with creatinine clearance of <10ml/min, treatment decisions should be made on an individual basis. For prophylaxis, people with a creatinine clearance of <30ml/min should reduce the dose of oseltamivir to 75 mg every other day.
