10 Common Questions About Tamiflu Interactions

If you're sick with the flu and it's been less than 48 hours (2 days) since your symptoms started, your prescriber may recommend Tamiflu (oseltamivir). Tamiflu is a prescription antiviral medication that can treat and prevent influenza (flu) infections. Taking Tamiflu can shorten the time you feel sick and help make symptoms milder.

It's common to have questions when you start a new medication, such as whether there are any drug interactions to be aware of. Below, we'll answer 10 questions about Tamiflu interactions so you can safely get started with this flu medication.

1. What does Tamiflu interact with?

Tamiflu is generally safe to take with most medications. But one interaction stands out: FluMist, the nasal spray flu vaccine.

Tamiflu can lower the effectiveness of FluMist because FluMist contains live, weakened strains of the flu virus. Tamiflu attacks the weakened virus in the vaccine just like it attacks the flu virus that makes you sick. This means that your immune system won't recognize and learn from the vaccine as effectively if Tamiflu is in your system.

If you received FluMist less than 2 weeks ago, let your prescriber know. They may still recommend Tamiflu for you. But they may suggest receiving a second dose of FluMist after you finish taking Tamiflu. Just be sure to wait at least 2 days after your last dose of Tamiflu to get FluMist.

2. Does Tamiflu interact with other vaccines?

If you recently got an injectable flu vaccine, no worries! Tamiflu doesn't interact with the flu shot. Injectable flu vaccines contain either inactivated (dead) virus strains or pieces of the flu virus (recombinant flu vaccine). Because these vaccines don't contain live viruses, Tamiflu doesn't interfere with them.

Tamiflu doesn't appear to affect other live virus vaccines, such as the measles, mumps, and rubella (MMR) vaccine. There's also no evidence that Tamiflu interacts with other inactivated vaccines, such as the tetanus, diphtheria, and pertussis (Tdap) vaccine. Tamiflu is only known to attack flu viruses. It doesn't affect other viruses.

3. Can you take Tamiflu and acetaminophen (Tylenol)?

Most people can take Tamiflu and acetaminophen (Tylenol) together. There's no known interaction between these medications. Tylenol can help relieve certain flu symptoms, such as fever and body aches. In fact, taking Tamiflu and Tylenol can be a safe and helpful way for many people to manage flu symptoms.

Keep in mind, though, that acetaminophen isn't safe for everyone. If you have liver problems or drink alcohol regularly, talk to your healthcare team before taking acetaminophen. These situations can raise your risk of liver damage if you take acetaminophen. But Tamiflu doesn't raise this risk further.

4. Can you take ibuprofen with Tamiflu?

Most people can take ibuprofen (Advil, Motrin) with Tamiflu. These medications don't directly interact. That means Tamiflu doesn't change how ibuprofen works or is broken down in the body, and vice versa.

However, certain people need to be extra careful when combining Tamiflu and ibuprofen. Speak with a healthcare professional if you have kidney problems or take other medications that affect the kidneys, such as diuretics ("water pills").

The kidneys are responsible for clearing Tamiflu and ibuprofen from the body. If you have existing kidney problems, taking both medications can put extra stress on your kidneys. Similarly, if you're already taking medications that impact the kidneys, adding Tamiflu and ibuprofen can strain them even further.

Good to know: This information also applies to taking Tamiflu with other nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen (Aleve) and aspirin.

5. Can you take Tamiflu and NyQuil?

Yes, most people can safely take NyQuil products with Tamiflu.

NyQuil products vary in their ingredients and dosages. They may contain some or all of the following:

• Acetaminophen

• Dextromethorphan to help quiet a cough

• Guaifenesin to help thin mucus

• An antihistamine, such as doxylamine, to help with runny nose and sleep

None of these medications are known to interact with Tamiflu. However, it's important to read the over-the-counter (OTC) label when taking combination cold medications like NyQuil. They may contain ingredients similar or identical to other medications you're taking. For instance, many OTC cold medications contain acetaminophen. This can make it easy to take too much acetaminophen by accident when you're not feeling well.

6. Can you take Tamiflu and Paxlovid together?

Yes, you can take Tamiflu and Paxlovid (nirmatrelvir / ritonavir) together.

It's possible to be sick with the flu and COVID-19 at the same time. In this case, you may be prescribed treatments for both. Paxlovid is a first-choice treatment for certain people with mild to moderate COVID symptoms. It interacts with many medications, but Tamiflu isn't one of them. It's safe to take Paxlovid and Tamiflu at the same time.

7. Can you take Tamiflu with amoxicillin and other antibiotics?

Yes, you can take Tamiflu with amoxicillin (Amoxil) and other antibiotics. But keep in mind that antibiotics don't treat the flu. Still, if you have the flu along with a bacterial infection, you may need to take both medications at once. There are no known interactions between Tamiflu and antibiotics, so the combination is considered safe.

8. Can you take Tamiflu and Benadryl together?

Yes, most people can take Tamiflu and Benadryl (diphenhydramine) together. They don't interact with each other. But you may want to be cautious about taking Benadryl if you have the flu.

Fatigue is a common flu symptom, and drowsiness is a very common side effect of Benadryl. Taking Benadryl may worsen the tired feeling the flu is causing. On the other hand, some people find this side effect helpful when they're sick, as it can be hard to sleep when you don't feel well.

9. Can you take Tamiflu with Mucinex or Delsym?

Yes, you can take Tamiflu with OTC cough medications, such as Mucinex (guaifenesin) or Delsym (dextromethorphan). They don't interact with Tamiflu. Just read all OTC labels carefully. Some products in the Mucinex and Delsym lines contain multiple ingredients that might be in other products you're taking.

10. Can you take Tamiflu and clopidogrel together?

You can most likely take Tamiflu and clopidogrel (Plavix) together. However, information on this Tamiflu interaction is conflicting.

There's some weak evidence that the antiplatelet medication clopidogrel may make Tamiflu less effective. However, experts debate whether this interaction actually exists. So you may see information online warning about combining Tamiflu and clopidogrel. But Tamiflu's manufacturer and other expert organizations don't list clopidogrel as a confirmed Tamiflu interaction.

It's best to double-check with your prescriber or pharmacist for guidance if you take clopidogrel. They can weigh your personal risks and health history when providing an answer.

How can I find out more about Tamiflu interactions?

If you're unsure if taking Tamiflu with your medications is safe, contact your prescriber or pharmacist. It's a good idea to provide them with an up-to-date list of all prescription and OTC medications you take. Be sure to include vitamins and herbal supplements on this list. This will help them identify any potential interactions.

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