Side effects of oseltamivir in end-stage renal failure patients.

Choo D, Hossain M, Liew P, Chowdhury S, Tan J.

Nephrol Dial Transplant (2010) 0: 1–6. (EPUB December 30, 2010). doi: 10.1093/ndt/gfq737. 

Background. Patients with end-stage renal disease who developed H1N1 infections have an increased risk of morbidity and mortality. In light of the high incidence of H1N1 infections in renal replacement therapy patients in Brunei Darussalam, an Oseltamivir (Tamiflu) prophylactic dosing regimen of 75 mg every 5 days for renal replacement therapy patients was initiated by the Ministry of Health in August 2009. The regime was used to serve as a bridge towards an anticipated nationwide vaccination programme that was due in September 2009. This study aimed to evaluate the side effects, factors that might influence the side effects profile and compliance of the dialysis patients that had undergone the month-long chemoprophylactic regime. Methods. A cross-sectional study was carried out on the dialysis patients that had undergone the oseltamivir prophylactic regime, which involved distribution of questionnaires to participants after the regime was completed. Results. Three hundred and thirty-three patients participated in this study. 25.7% of sample participants reported at least one side effect (experienced during the regime). 97% of participants were found to have reported three side effect types or less. The most frequent side effects reported were nausea (9.4%), abdominal pain (9.1%) and dizziness (9.1%). Age, gender, dialysis types, serum haemoglobin, serum albumin and dialysis clearance measurements were found to have no significant associations with the frequency of participants that had reported side effects. 11.2% of sample participants made up the non-compliant group. The top two reasons for not completing the medication were participants’ perceived side effects (24.3%) and forgetting to take their medications (56.8%). Conclusions. Side effects were found to be mild and tolerable by participants, with no life-threatening events. The study showed that high compliance of this regime can be achieved. These results, together with no incidence of H1N1 cases in the sample participants, showed that the dosing regimen of 75 mg every 5 days in both haemodialysis and continuous ambulatory peritoneal dialysis patients is both tolerable and effective and should be considered for future prophylactic regimes.

Correspondence: Jackson Tan. Department of Renal medicine, RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam. drjacksontan@yahoo.co.uk