Saturday, November 28, 2009

Japan: Tamiflu shortages for kids give birth to doses with ice cream


Doctors and pharmacists are racking their brains to work out creative formulas to cope with shortages of Tamiflu influenza treatment for small children who have been principally hit by the raging H1N1 flu epidemic, with some coming up with doses of adult formula mixed with ice cream.

Tamiflu is administered typically in sweetened dry syrup for small children and in capsules for adults, which are deemed too bitter for small children.

For this flu season, Chugai Pharmaceutical Co, the sole manufacturer and marketer of Tamiflu in Japan, has planned to produce enough of the antiviral drug for 12 million people, around three times more than last season. It includes the dry syrup formula for around 3.6 million, which Chugai started making in September.

According to the Ministry of Health, Labor and Welfare, about 80% of flu patients in Japan are underage children chiefly comprising students in primary and lower secondary schools.

In that age bracket, patients have been increasing particularly among those aged 7 or younger, resulting in demand for the Tamiflu dry syrup far outstripping projected supply.

A Chugai spokesman said, ‘‘Since the beginning of November, we haven’t been able to catch up in supply. We’re producing at full capacity and aren’t in a position to boost supply any further.’‘

Against this backdrop, the health ministry issued information to clinics and hospitals in early November, telling them they ‘‘may re-administer Tamiflu removed from capsules for pediatric formulas and quantities in the event there are no other alternatives.’‘

Because of its bitter taste, doctors and pharmacists are suggesting doses mixed with ice cream or yogurt, for instance.

Kazutaka Hosoda, a doctor at Navitas Clinic in Tachikawa on the outskirts of Tokyo, points to potential problems with re-administering the adult version for children, saying, ‘‘Redoing preparations takes time and some children may not be able to consume the treatment because it may be too bitter.’‘

If a child stops taking the drug because of such problems, there may be a risk that the flu virus develops resistance to it, he added.

Hosoda said there are effective drugs other than Tamiflu and he prescribes Chinese medicines.

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