Tamiflu dosage confusion could harm kids

Experts observed that the label for Tamiflu prescribes a dosage of three-quarters of a teaspoon, while the dropper -- device used to measure the dose -- packed with drug is marked at 30, 45, and 60 milligrams, which is very confusing.

Raising the concern, several medical professionals from Northwestern University Feinberg School of Medicine in Chicago, Emory University in Atlanta and Weill Cornell School of Medicine in New York City had issued a warning, which first appeared in a letter published in the Sept. 23 issue of the New England Journal of Medicine, in lieu of the conflict.

Discovery of the conflict
The issue was first found by Kara Jacobson, mother of a 6-year-old girl who got infected with the H1N1 influenza and was prescribed a dosage of three-quarters of teaspoon twice a day.

But as the dropper is marked in milligrams, Jacobson and her husband had to consult the medical guide -- issued for prescribers of the drug -- to find the mathematical formula for converting teaspoons to milligrams.

After around 30 minutes of calculations, they were able to figure out that three-quarters of a tablespoon was equivalent to 45 milligrams on the liquid drug’s dropper.

Kara Jacobson is the co-author of the warning letter and a senior research associate at Emory's Rollins School of Public Health, Georgia.

Doctors’ take on the misleading prescriptions
The medical professionals are concerned that not every parent would be able to understand or perform the complex calculations of converting the teaspoons to milligrams. Resulting this, they might end up giving an incorrect dose to their children.

"It's an egregious error that there is a conflict in the prescription labeling instructions and the dosage device that comes in the exact same box," said co-author Dr. Michael Wolf of Northwestern University's Feinberg School of Medicine. "It's incredibly confusing to parents."

Jacobson and her husband recommend that if a prescription calls for teaspoons then the dropper should be marked in teaspoons.

However, Roche, the company that manufactures the drug, has sent a warning to the pharmacists instructing them to prescribe the dosage of the liquid drug in milligrams.

Tamiflu lowers the spread of flu virus
Tamiflu is used for the treatment and prevention of swine flu influenza and works by slowing the spread of the flu virus between cells in the body. It is often prescribed to children who develop strains of the H1N1 influenza.

The drug had been approved by the Food Drug Administration (FDA) in 1999.