When the flu is hitting hard, you may have friends and family that are getting sick. Here is the information you need to know about current treatment options for the flu.
Your best protection from catching the flu is to get a flu vaccine (more information here). The vaccine does not work 100% of the time, but there are other simple steps you can take to prevent flu, such as washing your hands with soap frequently and avoiding contact with sick family, friends or coworkers.
If you have the flu, there are several prescription medications available including: oral oseltamivir (Tamiflu), inhaled zanamivir (Relenza), or the intravenous drug peramivir (Rapivab), or the newer oral tablet baloxavir marboxil (Xofluza).[1] However, studies show that these medications only help you recover one day faster from the flu. Even more important, all of these medications are effective only if they are taken within the first two days of having symptoms. Rather than going to the doctor’s office to get examined and get a prescription and get it filled, it might make more sense to stay home and rest and drink plenty of fluids.
Over the counter (OTC) medications don’t cure the flu but they can help you feel better by treating symptoms such as aches, coughs, and sore throats. A list of safe options can be found here. Antibiotics do NOT work against the flu because it is caused by a virus and not by bacteria.
Despite ads promoting these drugs, many doctors believe that none of them work well enough to justify the high cost of the drug. For example, a recent review of scientific evidence on FDA-approved antivirals found that they showed little benefit for cases that aren’t severe.[2] Since Tamiflu is the best known, this article focuses on it, but this information is also similar for all 4 of these drugs. Here is the info that you need to help you decide if you want to try any of them for yourself or a loved one.
Is Tamiflu (Oseltamivir) Effective for Treating the Flu?
Tamiflu is a prescription antiviral medication used for treatment of the flu and to prevent catching the flu if you have been near someone sick. It has been heavily advertised, but there is lots of controversy over whether or not it is actually effective.
On average patients who start taking Tamiflu within 48 hours of getting sick will recover one day faster than patients who do not take anything. Roche, the maker of Tamiflu, claims that Tamiflu also reduces the number of patients who have serious complications from the flu, such as pneumonia (by 44%) or hospitalization (by 63%).[3] However, the most recent research, which included data from 15 studies of more than 6,000 adolescent and adults with the flu (half of whom were prescribed Tamiflu and half were not), found no difference in hospitalization, either among all patients, or all adults over 65, or who were considered at greater risk of hospitalization. The average age of patients in the study was 45. Although many patients took Tamiflu exactly as directed, some stopped taking it because it caused nausea or vomiting. [4]
In another study, when Tamiflu was used to prevent the flu in people exposed to confirmed cases of flu, it was able to reduce their likelihood of getting sick by as much as 55%.[5]
Tamiflu has been approved for use in adults, infants as young as 2 weeks, children, and pregnant women.[6]
Is Tamiflu Safe?
The most common side effects of Tamiflu and the other 3 drugs are:
- Nausea
- Vomiting
- Diarrhea
- Stomach pains
- Dizziness
- Headaches
The more serious side effects include:
- Seizures
- Sudden confusion
- Delirium
- Hallucinations
- Unusual behavior
- Self-injury
The serious side effects are very rare, but tend to occur more often in children, so if your child is taking any of these drugs and you notice any of these symptoms, speak to your doctor immediately and discontinue use.[7]
You should also stop using any of these drugs immediately and seek medical attention if you have any signs of allergic reaction, including hives, difficulty breathing, swelling of the lips, tongue or throat or skin rash.
To help the FDA determine how common these side effects are, it is important to report any side effects to the FDA by calling 1-800-FDA-1088.
With all these risks, and so little benefit, why take any of these drugs? As a patient, you should weigh the risks and benefits before deciding if any are right for you. If you can start taking them quickly within 48 hours of getting flu symptoms and a positive flu test, it is more likely to work, but still may only shorten your flu by one day. Patients such as pregnant women, infants, or patients with a weakened immune system are more at risk of complications from the flu and might be more likely to benefit, but should talk to their doctors to weigh the risks and benefits before deciding.
Other Treatments
As mentioned above, there are 4 FDA-approved antiviral medications to treat the flu virus.
There is more information on Tamiflu, but none of the other 3 are proven to be significantly better than Tamiflu at treating the flu, and have similar serious side effects and timing limitations.
Inhaled zanamivir (Relenza) is FDA approved for the treatment of flu in children and adults ages 7 and older.[7] Rapivab is given intravenously in a hospital, doctors office or clinic, and was approved by the FDA in December 2014 for patients 18 and older with uncomplicated flu.[8] However, it was shown to only reduce fever 12 hours earlier than placebo, which means it usually provides even less relief than Tamiflu. Relenza is inhaled and can cause serious breathing problems in patients. Xofluza (baloxavir marboxil) was approved by the FDA in 2018 and is an oral tablet used to treat the flu in children and adults ages 5 and older. Xofluza may be slightly more effective than Tamiflu, but it is more expensive and can be harder to get.[2] Similar to Tamiflu, all of these drugs must be taken within 2 days of the first flu symptoms in order to work.
You may wonder why the FDA approved these flu treatments that have such modest benefits. It is important to understand that when the FDA approves a drug or device, that doesn’t mean the scientists there recommend it for patients to use. It only means that they think it has some benefit for some patients, and that the average patient is more likely to benefit than to be harmed. However, as with many other medications, some patients will not benefit at all, and some may be very seriously harmed.
All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.
- FDA. (2024). Influenza (Flu) Antiviral Drugs and Related Information. FDA. https://www.fda.gov/drugs/information-drug-class/influenza-flu-antiviral-drugs-and-related-information
- https://www.medscape.com/viewarticle/most-antivirals-have-little-benefit-patients-nonsevere-2025a10001td?form=fpf
- Dobson J, Whitley RJ, Pocock S, Monto AS. Oseltamivir treatment for influenza in adults: a meta-analysis of randomized controlled trials. The Lancet. 2015
- Hanula, R., Bortolussi-Courval, É., Mendel, A., Ward, B. J., Lee, T. C., & McDonald, E. G. (2024). Evaluation of Oseltamivir Used to Prevent Hospitalization in Outpatients With Influenza: A Systematic Review and Meta-Analysis. JAMA Internal Medicine, 184(1), 18–27. https://doi.org/10.1001/jamainternmed.2023.0699
- Jefferson, T., Jones, M., Doshi, P., Spencer, E. A., Onakpoya, I., & Heneghan, C. J. (2014). Oseltamivir for influenza in adults and children: Systematic review of clinical study reports and summary of regulatory comments. The BMJ, 348, g2545. https://doi.org/10.1136/bmj.g2545
- CDC. (2025, January 14). Treating Flu with Antiviral Drugs. Influenza (Flu). https://www.cdc.gov/flu/treatment/antiviral-drugs.html
- http://www.rxlist.com/tamiflu-side-effects-drug-center.html
- http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm188870.html
- http://www.drugs.com/newdrugs/fda-approves-rapivab-peramivir-influenza-infection-4134.html