When your little one (or big kid) comes down with the flu, it can be downright heartbreaking to watch them wrestle with those nasty symptoms — even though you know those struggles are pretty much par for the course.

But when the flu is severe, your instinct may alert you to the need for something more than sympathy — treatment.

Tamiflu is an antiviral drug that’s prescribed to help the body fight seasonal influenza. Children may also be given Tamiflu to either prevent or treat the flu under the care of their pediatrician. While the drug may not take away symptoms entirely, the idea is that it can help lessen the severity and duration of sickness.

But is this drug safe for kids? Here’s what you need to know about Tamiflu and its benefits, as well as some other ways you can prevent the flu in your household.

Tamiflu goes by the generic name Oseltamivir. It was approved in 1999 for use in children ages 2 weeks old and up. Its side effects are typically mild, so it’s considered safe for use. However, your child’s doctor may not prescribe it in every case of flu, regardless of its safety.

Antiviral drugs work by preventing flu viruses from reproducing in the body. While antivirals are different from antibiotics, which fight bacterial infections, they’re similar in that they must also be prescribed by a physician versus purchased over the counter (OTC).

Related: What parents should know about flu and COVID-19

Your pediatrician may consider prescribing Tamiflu if your child has flu symptoms, like:

  • fever/chills
  • cough
  • runny nose
  • sore throat
  • body aches
  • fatigue

That said, it will not work on just any type of virus, so it isn’t a good choice if your child doesn’t test positive for influenza A or B.

Rest, fluids, and OTC fever reducers (like Children’s Tylenol) may help kids with more mild cases of flu get better within a week.

If your child has severe symptoms, Tamiflu may help. It may also be particularly helpful if your child is at the highest risk for complications from the flu.

According to the Centers for Disease Control and Prevention (CDC), risk factors include being under 5 years old — particularly those under 2 years old — as well as having chronic health conditions, like asthma, diabetes, or heart/lung diseases.

Related: How to handle school sick days

Doctor knows best

Always follow the dosing instructions prescribed by your child’s doctor.

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Tamiflu is most effective when started within the first 2 days of illness. Some pediatricians may even suggest that high-risk children start taking it after confirmed exposure to a person with the flu before any symptoms have started.

And while timing is important, experts from the CDC say that certain children — those who are at high risk of complications or who are hospitalized — may benefit from taking Tamiflu even beyond 2 days after the onset of illness.

The drug is taken orally in either pill or liquid form. Treatment duration is generally 5 days total. The dosage depends on your child’s age/weight.

General dosage recommendations are as follows for treatment, but only your child’s doctor can determine what they need. Their doctor will also translate the milligrams per kilogram (mg/kg) recommendation into a dose in milliliters (mL) specific to your child.

Ages 1 and under3 mg/kg twice daily
Over age 1 but 15 kg or less30 mg twice daily
16–23 kg45 mg twice daily
24–40 kg60 mg twice daily
More than 40 kg75 mg twice daily

Related: When to take your child to the hospital for the flu

Studies on both children and adults show that antiviral drugs, like Tamiflu, may prevent the flu from resulting in respiratory failure and death. In particular, these drugs may reduce the risk of pneumonia or other health issues that lead to hospitalization.

Overall, antivirals may make your child’s symptoms less severe and shorten the overall duration of sickness by 1 to 1 1/2 days. This means your little one may be able to return to their daily life — school, activities, playdates — sooner than if they didn’t take the drug.

Keeping others in mind

Before sending your child back to school, confirm with their pediatrician that they are no longer contagious.

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When used early, Tamiflu may also prevent ear infections from developing as the flu progresses. It may even reduce the need to use antibiotics to treat other flu-related bacterial complications in children ages 1 to 12 years old.

Related: Quick tips for treating kids with the cold or flu

Without insurance, the price of antivirals can be expensive — especially if you have more than one child who may need the medication. The cost for Tamiflu without insurance may be just over $100.

With insurance, of course, it may just be your usual copay. And you may also try using platforms like GoodRx, where the price may be as low as $25.

The Food and Drug Administration (FDA) emphasizes that Tamiflu is most effective when taken within 48 hours of your child developing symptoms. So, if you mistook those early coughs or sneezes for the common cold, you may have missed the ideal treatment window.

Another downside you may have heard about is that Tamiflu may not be effective with certain strains of flu. The CDC has only identified one case where the virus was resistant to Tamiflu, though. It was with the H1N1 strain in 2009.

Otherwise, the CDC monitors the predominant flu strains each year and recommends the use of antivirals accordingly.

The main side effects associated with Tamiflu include nausea and vomiting.

The FDA notes that uncommon side effects have been reported in children ages 16 years old and younger, however. They may include:

  • hallucinations
  • confusion
  • convulsions
  • other neurologic or psychiatric issues

It’s important to understand that these side effects are rare.

Watch your child for signs of behavioral changes. Contact their doctor right away if you notice anything outside of their normal. And if you notice signs of difficulty breathing, dehydration, or worsening symptoms, seek medical attention immediately.

Related: How serious are the side effects of Tamiflu?

Tamiflu is also called a neuraminidase inhibitor, as it blocks the viral enzyme neuraminidase, which is responsible for allowing the flu virus to invade cells in the respiratory system. As a result, your child’s pediatrician may prescribe Tamiflu before symptoms start to actually prevent the flu.

That said, Tamiflu isn’t widely prescribed for prevention unless your child or baby is very high risk. Instead, experts agree that the best method for flu prevention for children ages 6 months and up is to get the seasonal flu shot each year.

Other ways to prevent the flu include:

  • avoiding close contact with people who have the flu
  • encouraging people to cover coughs/sneezes
  • practicing good hygiene (washing hands, surfaces, etc.)

Related: How to prevent the flu: Natural ways, after exposure, and more

There are three other antiviral medications that are approved by the FDA for use in children. The type your child is offered will depend on their age and medical history.

  • Relenza (zanamivir): This medication is for use in children ages 7 years and up. It’s administered via oral inhalation using a Diskhaler inhaler. Your doctor may not recommend using Relenza if your child has an underlying respiratory disease, such as asthma or chronic lung disease.
  • Rapivab (peramivir): This medication is for use in children ages 2 years and up. It’s administered intravenously.
  • Xofluza (baloxavir): This medication is for use in older children ages 12 years and up. It’s a single dose and administered by mouth.

Related: Why seeing a doctor within 48 hours of developing flu symptoms is critical

Contact your pediatrician as soon as possible if your child develops flu symptoms or has been in contact with somebody who tested positive for the flu. The sooner you administer antiviral medications like Tamiflu, the more effective they may be at helping the body fight the virus.

If you have concerns about this drug, ask your doctor about the benefits and risks specific to your child’s age and medical history. Otherwise, you can help prevent the flu by getting the flu shot each year, washing hands frequently, and avoiding close contact with people who are sick.