Liquid Tamiflu shortage puts pressure on pharmacists, parents

Not a day goes by without some fear that the H1N1 vaccine will remain out of reach for too many, too long. Now, it's the children's dose of liquid Tamiflu that has parents scouring pharmacies, sometimes late into the night. Tamiflu is a popular antiviral medication that has been in high demand since a flu outbreak in 2005.

Clinicians have prescribed liquid Tamiflu to children diagnosed with swine flu to help reduce the severity of symptoms more quickly. The shortage has been caused in part by Swiss drugmaker Roche (manufacturer of Tamiflu) which has focused primarily on making the medicine in capsule form. The company says that producing capsules is the most efficient way to manufacture the medicine in high volume.

The recent wave of swine flu cases, particularly among children, has created an unanticipated demand for liquid Tamiflu. In response, the Food and Drug Administration (FDA) and the Centers for Disease Control (CDC) have suggested that pharmacists mix the powder from capsules with syrup to make a liquid for children if Roche's version is unavailable. 

Pharmacists make the liquid formulation using a combination of adult dose Tamiflu tablets and syrup. While the formula is simple, pharmacists say this process--known as compounding--is much more time consuming than filling an ordinary prescription. According to the CDC, Tamiflu is highly effective, especially when taken within the first 48 hours of developing symptoms. Some pharmacies are running out of Tamiflu capsules and syrup, which can send parents on urgent hunts to several drug stores. One mother reported that she had to go to at least seven stores before she could find one that could fill a Tamilfu prescription for her child.

More than 100 children have reportedly died from swine flu in the U.S. so far this year. The CDC and The Harvard School of Public Health estimate that as many as 5.7 million Americans contracted swine flu in its first wave earlier this year. Meantime, many communities around the country are reporting that they do not have sufficient H1N1 vaccine supplies to meet demand.

To learn more:
- see this story in The Washington Post
- check out this Bloomberg News article

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