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Oseltamivir

Phase 4FDA approved 1999

Influenza | Small molecule | Infectious Disease |Roche Holding AG|Trials Updated: Oct 16, 2018

Oseltamivir development status

FDA approval Oct 27, 1999 as Tamiflu
Approval holderRoche
ApplicationNDA021087
Highest phase Phase 4 (NCT01032837)
Phase scored for RHHBYPhase 3
Registered trials 41 across 20 sponsors since Mar 2006

Label indication TAMIFLU is an influenza neuraminidase inhibitor (NAI) indicated for: Treatment of acute, uncomplicated influenza A and B in patients 2 weeks of age and older who have been symptomatic for no more than 48 hours. ( 1.1 ) Prophylaxis of influenza A and B in patients 1 year and older. ( 1.2 ) Limitations of Use : Not a substitute for annual influenza vaccination. FDA label

Oseltamivir target and mechanism

ModalitySmall molecule

Also known as oseltamivir [Tamiflu], Oseltamivir IV, Tamiflu

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindCONTROLLED
Total Trials7
Total Enrollment500

FDA Designations

No designations recorded

Oseltamivir clinical trials

Oseltamivir · 7 trials · 3 indications

Phase 3 3Phase 1 4
NCT01050257A Study of Intravenously Administered Tamiflu (Oseltamivir) in Patients Over 13 Years of Age With InfluenzaInfluenza
COMPLETED118 Analytics
NCT00949533A Study on Emergence of Resistance With Oseltamivir (Tamiflu) in Participants With Seasonal InfluenzaInfluenza
COMPLETED37 Analytics
NCT00545532A Study of Oseltamivir (Tamiflu) for Treatment of Influenza in Immunocompromised Participants.Influenza, Human
COMPLETED228 Analytics
PHASE3COMPLETED
A Study of Intravenously Administered Tamiflu (Oseltamivir) in Patients Over 13 Years of Age With Influenza
InfluenzaUnlock trial analytics
PHASE3COMPLETED
A Study on Emergence of Resistance With Oseltamivir (Tamiflu) in Participants With Seasonal Influenza
InfluenzaUnlock trial analytics
PHASE3COMPLETED
A Study of Oseltamivir (Tamiflu) for Treatment of Influenza in Immunocompromised Participants.
Influenza, HumanUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With Adverse Events (AEs), Serious Adverse Events(SAEs, AEs Leading to Withdrawal, and Death
Up to 30 days

Safety was assessed by adverse events (AEs) as measured by the collection of AEs, vital signs, electrocardiograms and laboratory parameters. An AE was considered any unfavorable and unintended sign, symptom, or disease associated with the use of the study drug, whether or not considered related to the study drug. Preexisting conditions that worsened during the study were reported as adverse events. A serious adverse event is any experience that suggests a significant hazard, contraindication, side effect or precaution that: results in death, is life-threatening, required in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is medically significant. On treatment = AEs that started between the day of first dose and within 2 days after the last dose. Off treatment = AEs that started more than 2 days after the last dose of study drug.

Percentage of Participants Excreting Resistant Virus
Day 5

Resistant virus included new influenza A virus subtype hemagglutinin type 1 and neuraminidase type 1 (New AH1N1).

Percentage of Participants With Adverse Events
Baseline up to Day 40

An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events.

Percentage of Participants Who Developed Viral Resistance to Oseltamivir
Baseline up to Day 40

Resistance was defined as the presence of oseltamivir resistance mutations in viruses isolated from nasopharyngeal swab samples, identified by sequencing of the neuraminidase (NA) and hemagglutinin (HA) genes (genotypic resistance) and/or determination of the oseltamivir concentration at which the response is reduced by half (IC50) in an NA inhibition assay (phenotypic resistance). Reported are post-baseline phenotypic and genotypic resistance in adults \>/= 18 years and children and adolescents \<18 years in the modified Intent-to-Treat infected (mITTi) population.

Percentage of Participants With Tissue Rejection or Graft Versus Host Disease (GVHD)
Baseline up to Day 40

The percentage of transplant patients in the safety population who experienced tissue rejection and/or GvHD is reported.

Steady State Area Under the Concentration-Time Curve From Time 0 to 12 Hours (AUC0-12) of Oseltamivir
Pre-dose (within 30 minutes prior to administration), 1.5, 4, 8 hours post-dose on Days 3 or 4
Steady State AUC0-12 of Oseltamivir Carboxylate
Pre-dose (within 30 minutes prior to administration), 1.5, 4, 8 hours post-dose on Days 3 or 4
Maximum Plasma Concentration (Cmax) of Oseltamivir
Pre-dose (within 30 minutes prior to administration), 1.5, 4, 8 hours post-dose on Days 3 or 4
Cmax of Oseltamivir Carboxylate
Pre-dose (within 30 minutes prior to administration), 1.5, 4, 8 hours post-dose on Days 3 or 4
Trough Plasma Concentration (Ctrough) of Oseltamivir
Pre-dose (within 30 minutes prior to administration) on Days 3 or 4
Ctrough of Oseltamivir Carboxylate
Pre-dose (within 30 minutes prior to administration) on Days 3 or 4
Time to Cessation of Viral Shedding, as Assessed by Polymerase Chain Reaction (PCR) or Culture Testing
From randomization to negative PCR/culture test result (up to Day 50)
Steady-state Area Under the Plasma Concentration Versus Time Curve From Time Zero to 12 Hours of Oseltamivir and Oseltamivir Carboxylate
15 minutes pre-dose; 1 hour +/- 15 minutes, 2-3, 5-7, 10-12 hours post-dose on Day 3 if two doses taken on Day 1 or 15 minutes pre-dose; 1 hour +/- 15 minutes, 2-3, 5-7, 10-12 hours post-dose on Day 4 if one dose taken on Day 1

Oseltamivir carboxylate is active metabolite of oseltamivir. AUC0-12 was estimated for oseltamivir and oseltamivir carboxylate by linear trapezoidal rule

Steady-state Maximum Observed Plasma Concentration of Oseltamivir and Oseltamivir Carboxylate
15 minutes pre-dose; 1 hour +/- 15 minutes, 2-3, 5-7, 10-12 hours post-dose on Day 3 if two doses taken on Day 1 or 15 minutes pre-dose; 1 hour +/- 15 minutes, 2-3, 5-7, 10-12 hours post-dose on Day 4 if one dose taken on Day 1

Oseltamivir carboxylate is an active metabolite of oseltamivir. Cmax was estimated for both oseltamivir and Oseltamivir carboxylate by non-compartmental analysis.

Steady-state Minimum Observed Plasma Concentration of Oseltamivir and Oseltamivir Carboxylate
15 minutes pre-dose; 1 hour +/- 15 minutes, 2-3, 5-7, 10-12 hours post-dose on Day 3 if two doses taken on Day 1 or 15 minutes pre-dose; 1 hour +/- 15 minutes, 2-3, 5-7, 10-12 hours post-dose on Day 4 if one dose taken on Day 1

Oseltamivir carboxylate is active metabolite of oseltamivir. Cmin was estimated for both oseltamivir and oseltamivir carboxylate by non-compartmental analysis

Area Under the Concentration Versus Time Curve From Time Zero to Last Measurable Plasma Concentration (AUClast) of Oseltamivir and Oseltamivir Carboxylate on Day 1
Day 1: 15 minutes pre-infusion start, 1, 2, 3, 4, 6, 8, 12 hours post start of infusion.
AUClast of Oseltamivir and Oseltamivir Carboxylate on Day 2
Day 2: 15 minutes pre-infusion start, 2, 4, 8 hours after start of infusion
AUClast of Oseltamivir and Oseltamivir Carboxylate on Day 3
Day 3 (with or after fifth dose): 15 minutes pre-infusion start, 2, 4, 8 hours after start of infusion
AUClast of Oseltamivir and Oseltamivir Carboxylate on Day 4
Day 4: 15 minutes pre-infusion start, 2, 4, 8 hours after start of infusion
AUClast of Oseltamivir and Oseltamivir Carboxylate on Day 5
Day 5: 15 minutes pre-infusion start, 2, 4, 8 hours after start of infusion
Maximum Observed Plasma Concentration (Cmax) of Oseltamivir and Oseltamivir Carboxylate Day 1
Day 1: 15 minutes pre-infusion start, 1, 2, 3, 4, 6, 8, 12 hours post start of infusion
Cmax of Oseltamivir and Oseltamivir Carboxylate Day 2
Day 2: 15 minutes pre-infusion start, 2, 4, 8 hours after start of infusion
Cmax of Oseltamivir and Oseltamivir Carboxylate Day 3
Day 3 (with or after fifth dose): 15 minutes pre-infusion start, 2, 4, 8 hours after start of infusion
Cmax of Oseltamivir and Oseltamivir Carboxylate Day 4
Day 4: 15 minutes pre-infusion start, 2, 4, 8 hours after start of infusion
Cmax of Oseltamivir and Oseltamivir Carboxylate Day 5
Day 5: 15 minutes pre-infusion start, 2, 4, 8 hours after start of infusion
Maximum Plasma Concentration (Cmax) of Oseltamivir in HD Participants During Days 1 to 5
Blood samples 0, 1, 2, 4, 8, 12, 20, 32, 42, 48, 49, 90 hours from Day 1 (D1) dose

Plasma samples were obtained up to 90 hours post-dose during the first dose analysis (Days 1 to 5), and the maximum observed concentration was recorded. The Cmax was averaged among all participants and expressed in nanograms per milliliter (ng/mL).

Cmax of Oseltamivir in HD Participants During Days 38 to 43
Blood samples 0, 1, 2, 4, 8, 12, 20, 32, 42, 48, 49, 90 hours from Day 38 (D38) dose

Plasma samples were obtained up to 90 hours post-dose during the second dose analysis (Days 38 to 43), and the maximum observed concentration was recorded. The Cmax was averaged among all participants and expressed in ng/mL.

Cmax of Metabolite Oseltamivir Carboxylate in HD Participants During Days 1 to 5
Blood samples 0, 1, 2, 4, 8, 12, 20, 32, 42, 48, 49, 90 hours from D1 dose

Plasma samples were obtained up to 90 hours post-dose during the first dose analysis (Days 1 to 5), and the maximum observed concentration was recorded. The Cmax was averaged among all participants and expressed in ng/mL.

Cmax of Metabolite Oseltamivir Carboxylate in HD Participants During Days 38 to 43
Blood samples 0, 1, 2, 4, 8, 12, 20, 32, 42, 48, 49, 90 hours from D38 dose

Plasma samples were obtained up to 90 hours post-dose during the second dose analysis (Days 38 to 43), and the maximum observed concentration was recorded. The Cmax was averaged among all participants and expressed in ng/mL.

Area Under the Concentration-Time Curve (AUC) of Oseltamivir in HD Participants During Days 1 to 5
Blood samples 0, 1, 2, 4, 8, 12, 20, 32, 42, 48, 49, 90 hours from D1 dose

Plasma samples were obtained up to 90 hours post-dose during the first dose analysis (Days 1 to 5), and the AUC was determined from 0 to 12 hours (AUC12) and up to the last measurable concentration (AUClast). Values were averaged among all participants and expressed in nanograms by hours per milliliter (ng\*h/mL).

AUC of Oseltamivir in HD Participants During Days 38 to 43
Blood samples 0, 1, 2, 4, 8, 12, 20, 32, 42, 48, 49, 90 hours from D38 dose

Plasma samples were obtained up to 90 hours post-dose during the second dose analysis (Days 38 to 43), and the AUC12 and AUClast were determined. Values were averaged among all participants and expressed in ng\*h/mL.

AUC of Metabolite Oseltamivir Carboxylate in HD Participants During Days 1 to 5
Blood samples 0, 1, 2, 4, 8, 12, 20, 32, 42, 48, 49, 90 hours from D1 dose

Plasma samples were obtained up to 90 hours post-dose during the first dose analysis (Days 1 to 5), and the AUC was determined from 0 to 42 hours (AUC42) and up to the last measurable concentration (AUClast). Values were averaged among all participants and expressed in ng\*h/mL.

AUC of Metabolite Oseltamivir Carboxylate in HD Participants During Days 38 to 43
Blood samples 0, 1, 2, 4, 8, 12, 20, 32, 42, 48, 49, 90 hours from D38 dose

Plasma samples were obtained up to 90 hours post-dose during the second dose analysis (Days 38 to 43), and the AUC42 and AUClast were determined. Values were averaged among all participants and expressed in ng\*h/mL.

Cmax of Oseltamivir in CAPD Participants During Days 1 to 6
Blood samples 0, 1, 2, 4, 8, 12, 24, 48, 72, 120 hours from D1 dose

Plasma samples were obtained up to 120 hours post-dose during the first dose analysis (Days 1 to 6), and the maximum observed concentration was recorded. The Cmax was averaged among all participants and expressed in ng/mL.

Cmax of Oseltamivir in CAPD Participants During Days 36 to 43
Blood samples 0, 1, 2, 4, 8, 12, 24, 48, 72, 120, 168 hours from Day 36 (D36) dose

Plasma samples were obtained up to 168 hours post-dose during the second dose analysis (Days 36 to 43), and the maximum observed concentration was recorded. The Cmax was averaged among all participants and expressed in ng/mL.

Cmax of Metabolite Oseltamivir Carboxylate in CAPD Participants During Days 1 to 6
Blood samples 0, 1, 2, 4, 8, 12, 24, 48, 72, 120 hours from D1 dose

Plasma samples were obtained up to 120 hours post-dose during the first dose analysis (Days 1 to 6), and the maximum observed concentration was recorded. The Cmax was averaged among all participants and expressed in ng/mL.

Cmax of Metabolite Oseltamivir Carboxylate in CAPD Participants During Days 36 to 43
Blood samples 0, 1, 2, 4, 8, 12, 24, 48, 72, 120, 168 hours from D36 dose

Plasma samples were obtained up to 168 hours post-dose during the second dose analysis (Days 36 to 43), and the maximum observed concentration was recorded. The Cmax was averaged among all participants and expressed in ng/mL.

AUC of Oseltamivir in CAPD Participants During Days 1 to 6
Blood samples 0, 1, 2, 4, 8, 12, 24, 48, 72, 120 hours from D1 dose

Plasma samples were obtained up to 120 hours post-dose during the first dose analysis (Days 1 to 6), and the AUC12 and AUClast were determined. Values were averaged among all participants and expressed in ng\*h/mL.

AUC of Oseltamivir in CAPD Participants During Days 36 to 43
Blood samples 0, 1, 2, 4, 8, 12, 24, 48, 72, 120, 168 hours from D36 dose

Plasma samples were obtained up to 168 hours post-dose during the second dose analysis (Days 36 to 43), and the AUC12 and AUClast were determined. Values were averaged among all participants and expressed in ng\*h/mL.

AUC of Metabolite Oseltamivir Carboxylate in CAPD Participants During Days 1 to 6
Blood samples 0, 1, 2, 4, 8, 12, 24, 48, 72, 120 hours from D1 dose

Plasma samples were obtained up to 120 hours post-dose during the first dose analysis (Days 1 to 6), and the AUC was determined from 0 to 48 hours (AUC48) and up to the last measurable concentration (AUClast). Values were averaged among all participants and expressed in ng\*h/mL.

AUC of Metabolite Oseltamivir Carboxylate in CAPD Participants During Days 36 to 43
Blood samples 0, 1, 2, 4, 8, 12, 24, 48, 72, 120, 168 hours from D36 dose

Plasma samples were obtained up to 168 hours post-dose during the second dose analysis (Days 36 to 43), and the AUC48 and AUClast were determined. Values were averaged among all participants and expressed in ng\*h/mL.

Secondary Endpoints

Pharmacokinetics
Days 1, 3
Percentage of Participants With Viral Shedding by Culture or RT-PCR
Days 1, 4, 6, 11, 15 and 30
Percentage of Participants With Viral Shedding by Culture
Days 1, 4, 6, 11, 15, 30
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Oseltamivir (TAMIFLU®) 100 mgEXPERIMENTALOseltamivir (TAMIFLU®) 100 mg intravenous (IV) infused over 2 hours, two times a day (every 12 hours) for 5 days. At the discretion of the investigator after 3 days of treatment (6 doses), participants could either continue IV treatment or switch to 75 mg oral oseltamivir twice daily to complete the 5 days of treatment. If necessary, after completing the 5 days of treatment, participants could receive additional treatment with study drug (IV or oral) for up to 5 days.
Oseltamivir (TAMIFLU®) 200 mgEXPERIMENTALOseltamivir (TAMIFLU®) 200 mg intravenous (IV) infused over 2 hours, two times a day (every 12 hours) for 5 days. At the discretion of the investigator after 3 days of treatment (6 doses), participants could either continue IV treatment or switch to 150 mg oral oseltamivir twice daily for 5 days. If necessary, after completing the 5 days of treatment, participants could receive additional treatment with study drug (IV or oral) for up to 5 days.
Oseltamivir Open LabelEXPERIMENTALModerate/Severe renal impaired participants received open label oseltamivir IV or oseltamivir capsules at reduced doses for 5 days as per protocol. If necessary, after completing the 5 days of treatment, participants could receive additional treatment with study drug as per protocol.
Standard DoseEXPERIMENTALOseltamivir capsule will be administered orally at a dose of 75 mg BID in adult participants and children will receive oseltamivir powder for oral suspension dose (at 12 milligrams/ milliliter \[mg/mL\]) based on their body weight with a starting dose of 30 mg BID to a maximum dose of 75 mg BID; for 5 days.
Double DoseACTIVE_COMPARATOROseltamivir capsule will be administered orally at a dose of 150 mg BID in adult participants and children will receive oseltamivir powder for oral suspension dose (at 12 mg/mL) based on their body weight with a starting dose of 60 mg BID to a maximum dose of 150 mg BID; for 5 days.
Conventional doseEXPERIMENTALImmunocompromised participants will receive oseltamivir syrup at a dose ranging from 30 to 75 mg based on body weight, twice daily for children (1 to 12 years old) and oseltamivir capsules 75 mg twice daily for adults/adolescents greater than or equal to (\>/=) 13 years old or placebo-matched to oseltamivir twice daily over 10 days.
Oseltamivir: Standard doseEXPERIMENTALParticipants will receive standard dose of oseltamivir capsules or suspension orally for 5 to maximum of 20 days depending on weight. Infants \<1 year of age will receive oseltamivir at a dose of 3 milligrams per kilogram (mg/kg).
Oseltamivir: Triple doseEXPERIMENTALParticipants will receive three times the standard dose of oseltamivir capsules or suspension orally for 5 to maximum of 20 days depending on weight and age. Infants \<1 year will receive standard dose at 3 mg/kg.
Oseltamivir 3 mgEXPERIMENTALinfants 3 to \<12 months
Oseltamivir 2.5 mgEXPERIMENTALinfants 1 to \<3 months of age
Oseltamivir 2 mgEXPERIMENTALinfants 0 to 30 days (post natal) of age
Single armEXPERIMENTAL -
Regimen A: Oseltamivir with HDEXPERIMENTALParticipants will receive 30 milligrams (mg) of oseltamivir via oral suspension approximately 1 hour after alternating HD sessions. Sessions will occur three times per week within the 6.5-week study period, and participants will receive a total of 9 doses of oseltamivir.
Regimen B: Oseltamivir with CAPDEXPERIMENTALParticipants will receive 30 mg of oseltamivir via oral suspension once weekly after dialysis exchange. CAPD sessions will occur four times every 24 hours, and participants will receive a total of 6 doses of oseltamivir within the 6-week study period.

Interventions

NameTypeDescription
Oseltamivir IVDRUGOseltamivir IV infusions over 2 hours two times a day (every 12 hours) for 5 days for patients with moderate renal impairment. Patients with severe renal impairment received once daily dosing and patients on renal replacement therapy received dose/frequency according to protocol.
Oseltamivir OralDRUGOseltamivir (TAMIFLU®) capsules taken orally for 5 days. Twice daily (every 12 hours) for patients with moderate renal impairment, once daily for patients with severe renal impairment and dose frequency according to protocol for patients on renal replacement therapy.
OseltamivirDRUGStandard dose (30 - 75 mg orally bid) or double dose (60 - 150 mg orally bid); for 5 days
placeboOTHERPlacebo matched to oseltamivir po twice daily for 10 days
TamifluDRUGoral repeating dose
oseltamivir [Tamiflu]DRUG5-day course (10 doses), intravenous administration, may be switched to oral administration at the discretion of the investigator; up to 5 additional days of treatment possible.
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Eligibility Criteria

Age Range13 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites96

Inclusion Criteria: * Adult and adolescent patients, 13 years of age and older * Diagnosis of influenza * ≤ 144 hours between the onset of influenza-like illness and first dose of study drug Non-randomized, open-label treatment group: * Patients with moderate/severe renal impairment or renal fail...

Countries:United StatesDenmarkFranceHungaryItalyLithuaniaPolandRomaniaSpainBrazilArgentinaBelgiumBulgariaCanadaChileColombiaCzechiaEstoniaGermanyGuatemalaIsraelLatviaMexicoSouth AfricaSwitzerlandUkraineUnited KingdomFinlandGreeceLebanonNew Zealand
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Frequently asked questions about Oseltamivir

What is oseltamivir used for?

Oseltamivir is an antiviral small molecule studied for the treatment of influenza, including human influenza infection, and it has also been evaluated in patients with end stage renal disease who require dialysis. Clinical research has covered both adults and children with confirmed influenza infection.

Who makes oseltamivir?

Oseltamivir is developed by Roche Holding AG, which trades under the ticker RHHBY. The company has sponsored clinical studies of both oral and intravenous formulations of the drug across multiple countries.

What phase is oseltamivir in?

Oseltamivir has been studied in Phase 1 and Phase 3 clinical trials. Four trials are recorded in total, all of them completed, with no active trials ongoing. The studies enrolled 228 participants combined.

What clinical trials is oseltamivir in?

Completed oseltamivir trials include NCT02617784, a Phase 1 multiple-dose study in hemodialysis and peritoneal dialysis patients with end stage renal disease, NCT01715909, a Phase 1 pharmacokinetic study in immunocompromised children with influenza, NCT01050257, a Phase 3 intravenous study in patients over 13 years, and NCT01033734, a Phase 1 intravenous study in children.

Is oseltamivir the same as Tamiflu?

Yes, oseltamivir is also known as Tamiflu, and an intravenous form is referred to as Oseltamivir IV. Trial titles for NCT01050257 and NCT01033734 use the Tamiflu name for the intravenously administered formulation of oseltamivir.

What does oseltamivir target?

Oseltamivir is a small molecule antiviral agent directed against influenza virus. It is being studied for influenza treatment in adults and children, including immunocompromised children with confirmed influenza infection, and separately in patients with end stage renal disease undergoing dialysis.