Spot shortages of Tamiflu for children are frustrating parents

A crowd wraps around the outside of the Fairfax Government Center, where swine flu shots were being administered.
A crowd wraps around the outside of the Fairfax Government Center, where swine flu shots were being administered. (Tracy A Woodward/the Washington Post)
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By Rob Stein
Washington Post Staff Writer
Thursday, October 29, 2009

First it was the rush for hand sanitizer. Then it was the quest for the vaccine. Now, as increasing numbers of children are coming down with swine flu, more parents are facing yet another anxiety-provoking chase: the hunt for liquid Tamiflu for kids.

Spot shortages of the liquid form of the antiviral medicine are forcing mothers and fathers to drive from pharmacy to pharmacy, often late into the evening after getting a diagnosis and prescription from a pediatrician, in search of the syrup recommended for the youngest victims of the H1N1 pandemic.

"It was so frustrating," said Cheryl Copeland of Silver Spring, who finally found some of the medication for her 5-year-old son, William, at an independent drug store Monday after having no luck at a CVS and Rite Aid. "There was a moment when the first pharmacist said, 'We don't have it. There's been a run on it,' when I said to myself, 'Where on Earth am I going to find it?' "

The drug can make the flu milder, go away more quickly and may cut the risk of potentially life-threatening complications. The shortages are being caused by a surge in demand because of the second wave of swine flu sweeping the country, combined with a decision by Roche, the Swiss company that makes the medication, to focus on producing it in capsule form.

In response, the government has shipped to states hundreds of thousands of five-day courses from the Strategic National Stockpile, which is on standby in case there are disease outbreaks or bioterrorism attacks. Officials have also instructed doctors to suggest that pharmacists mix the powder from capsules with syrup to make a liquid for children if the company's version is unavailable.

The Food and Drug Administration and the federal Centers for Disease Control and Prevention have also posted the formula for pharmacists to follow, including guidelines for the correct dosing by each child's weight.

Federal health officials are confident that enough Tamiflu is available in the capsule or liquid forms to make sure children can be treated promptly.

"For the most part, patients are getting treated," said Greg Burel, director of the CDC's Division of Strategic National Stockpile. "There have been shortages in sporadic spots, but generally it's still available."

Roche is still producing the liquid form of the drug. But after consulting with U.S. and World Health Organization officials, the firm focused on making capsules when it increased production to meet an expected rise in demand after the H1N1 virus emerged in the spring. That allows it to produce 25 times the amount of medication it would have otherwise made, officials said.

"The bottom line is looking at how the company could ramp up as quickly as possible to get as much medicine out as possible. This was the best way to do it," said Roche spokeswoman Kristina Becker, noting that the company has been increasing production capacity since 2005, after the avian flu virus emerged in Asia.

The company also makes lower-dose capsules that children can take or parents can open to mix with a syrup to help them take it. But they should do this carefully following a doctor's instructions to ensure the proper dose, officials said.

'The earlier the better'

Health and Human Services Secretary Kathleen Sebelius released 300,000 courses of the liquid formula from the national stockpile earlier this month, including some that the FDA had to test for potency because their expiration dates had passed.

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