Is Tamiflu safe during pregnancy?

What does the evidence say about Tamiflu during pregnancy?

1. Doctors consider oral oseltamivir the preferred antiviral for the flu during pregnancy, and starting it within the first two days of symptoms works best at heading off serious complications. 1
2. A study comparing more than 300 pregnant women who took oseltamivir to women who didn't found no meaningful difference in miscarriage or preterm birth rates. 2
3. A review of nearly 3,000 pregnancies exposed to oseltamivir over 13 years found miscarriage and preterm birth happening at rates at or below what's typically seen in the general population. 3
4. A Danish study of nearly a million pregnancies found no added risk from oseltamivir beyond the risk that comes from having the flu itself. 4
5. Drug-level testing across all three trimesters shows the standard adult dose reaches effective levels throughout pregnancy, so there's no need for a special pregnancy dose. 5

Is Tamiflu safe in each trimester?

• First trimester. If flu symptoms show up in the first trimester, starting oseltamivir within the first two days still matters more than which trimester you're in. A study that looked specifically at first-trimester use didn't find a higher rate of birth defects.
• Second trimester. Pregnancy's higher risk for rough flu complications doesn't ease up in the second trimester. The standard adult dose works the same way in your body now as before pregnancy, so your provider can prescribe it right away if you test positive.
• Third trimester. Drug-level studies show oseltamivir still reaches effective levels in the third trimester, even though it clears from your body a bit faster. There's no special pregnancy dose to ask about, just start it quickly if flu symptoms show up.