Adverse drug reactions : Neuraminidase inhibitors: widespread use for influenza may reveal more adverse effects

Both oseltamivir and zanamivir are safe drugs with relatively few adverse effects based on clinical trial data. A theoretical risk of bronchospasm with the use of inhaled zanamivir is of concern in those with respiratory disease and there is an unknown risk of very rare skin reactions to oseltamivir. Despite the concerns about neuropsychiatric events with the use of NAIs, and the inclusion of these in product literature, pharmacoepidemiogical studies and case report analysis cast doubt on such an association. Influenza infection is arguably the more plausible cause of neuropsychiatric events. Widespread use of NAIs, either for treatment or prophylaxis, may uncover further rare adverse reactions. Oseltamivir is currently a black triangle drug, under intensive surveillance by the Medicines and Healthcare products Regulatory Agency. All suspected adverse reactions, including non-serious ones, should be reported, even if the reaction is well recognised, or if the reporter is uncertain that the drug has caused it. In addition, any suspected adverse reactions in children to either drug should be reported to the MHRA via the Yellow Card Scheme.