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Side effects of oseltamivir in end-stage renal failure patients
Diana Choo1, Mohammad Hossain, Ping Liew
1Institute of Medicine, University Brunei Darussalam, Bandar Seri Begawan, Brunei Darussalam.
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.
Insights
Oseltamivir prophylaxis in dialysis patients showed mild side effects and high compliance, suggesting its effectiveness in preventing H1N1 infections. This chemoprophylactic regimen is well-tolerated and suitable for future use.
Area of Science:
- Infectious Disease Epidemiology
- Nephrology
- Public Health
Background:
- End-stage renal disease patients face increased H1N1 morbidity and mortality risks.
- A 75 mg Oseltamivir (Tamiflu) prophylactic regimen was implemented for renal replacement therapy patients in Brunei Darussalam.
- The Oseltamivir regimen served as a temporary measure before a nationwide vaccination program.
Purpose of the Study:
- To evaluate side effects of the Oseltamivir prophylactic regime in dialysis patients.
- To identify factors influencing side effect profiles and compliance.
- To assess the effectiveness of Oseltamivir chemoprophylaxis in preventing H1N1.
Main Methods:
- A cross-sectional study involving 333 dialysis patients.
- Questionnaires were distributed to participants post-regimen.
- Data collected on side effects, compliance, and influencing factors.
Main Results:
- 25.7% of participants reported mild side effects, with nausea, abdominal pain, and dizziness being most frequent.
- No significant associations found between side effects and patient demographics or dialysis parameters.
- 11.2% non-compliance, primarily due to perceived side effects and forgetfulness.
Conclusions:
- The 75 mg Oseltamivir every 5 days regimen is mild, tolerable, and effective for dialysis patients.
- High compliance rates were achieved, with no reported H1N1 cases.
- This prophylactic dosing regimen is recommended for future use in haemodialysis and continuous ambulatory peritoneal dialysis patients.
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