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Medications and More during pregnancy and breastfeeding

Antiviral Medications to Treat/Prevent Influenza (the Flu)

Selected References:

  • Abraham K, 2021. Maternal and Perinatal Outcomes of Influenza in Pregnancy after Treatment with Oseltamivir. J Glob Infect Dis. 13(1):20-26. 
  • American College of Obstetricians and Gynecologists (ACOG). 2018. Committee Opinion No. 753: Assessment and treatment of pregnant women with suspected or confirmed influenza. Obstet Gyn, 132(4):e169-e173. 
  • Antiviral drugs for influenza for 2023-2024. 2023. Med Lett Drugs Ther. 65(1689):177-182. 
  • Aoki FY, et al. 2013. The use of antiviral drugs for influenza: A foundation document for practitioners. Can J Infect Dis Med Microbiol, 24(Suppl C):1-15. 
  • Beau A-B, et al. 2014. Safety of oseltamivir during pregnancy: a comparative study using the EFEMERIS database. BJOG; 121(7):895-900.  
  • Centers for Disease Control and Prevention. 2011. Antiviral agents for the treatment and chemoprophylaxis of influenza. MMWR; 60(No. RR-1):1-25. 
  • Chambers CD, et al, OTIS Collaborative Research Group. 2019. Oseltamivir use in pregnancy: Risk of birth defects, preterm delivery, and small for gestational age infants. Birth Defects Res; 111(19):1487-1493. 
  • Chow EJ, et al. Clinical Effectiveness and Safety of Antivirals for Influenza in Pregnancy. Open Forum Infect Dis; 8(6):ofab138. 
  • Cizeron A, et al. 2021. Low rate of oseltamivir prescription among adults and children with confirmed influenza illness in France during the 2018-19 influenza season. J Antimicrob Chemother; 76(4):1057-1062. 
  • Dunstan H, et al. 2014. Pregnancy outcome following maternal use of zanamivir or oseltamivir during the 2009 influenza A/H1N1 pandemic: a national prospective surveillance study. BJOG; 121(7):901-906. 
  • Fodor E, et al. 2023. An Observational Study on the Pharmacokinetics of Oseltamivir in Lactating Influenza Patients. Clin Pharmacol Ther; 115(2):318-323.  
  • Graner S, et al. 2017. Neuraminidase inhibitors during pregnancy and risk of adverse neonatal outcomes and congenital malformations: population based European register study. BMJ; 356:j629. 
  • Greer LG, et al. 2010. Maternal and neonatal outcomes after antepartum treatment of influenza with antiviral medications. Obstet Gynecol; 115(4):711-716.  
  • Greer LG, et al. 2011. Pharmacokinetics of oseltamivir in breast milk and maternal plasma. Am J Obstet Gynecol; 204: 524.e1-4.  
  • Laibl VR and Sheffield JS. 2005. Influenza and pneumonia in pregnancy. Clinics in Perinatology; 32:727-738.  
  • Lian J, et al. 2022. Neonatal outcomes after neuraminidase inhibitor use during pregnancy: A meta-analysis of cohort studies. Br J Clin Pharmacol; 88(3):911-918. 
  • Mancilla-Galindo J, et al. 2021. All-cause mortality among patients treated with repurposed antivirals and antibiotics for COVID-19 in Mexico City: A real-world observational study. EXCLI J; 20:199-222. 
  • Saito S, et al. 2013. Outcomes of infants exposed to oseltamivir or zanamivir in utero during pandemic (H1N1) 2009. Am J Obstet Gynecol; 209 (2): 130.e1-9.  
  • Siston A, et al. 2010. Pandemic 2009 influenza A (H1N1) virus illness among pregnant women in the United States. JAMA; 3030(15):1517-1525.  
  • Svensson T, et al. 2011. Birth outcomes among women exposed to neuraminidase inhibitors during pregnancy. Pharmacoepidemiol Drug Saf; 20(10): 1030-1034.  
  • Tanaka T, et al. 2009. Safety of neuraminidase inhibitors against novel influenza A (H1N1) in pregnant and breastfeeding women. CMAJ; 181(1-2):55-58.  
  • The Centers for Disease Control and Prevention (CDC). 2025. Treating flu with antiviral drugs. https://www.cdc.gov/flu/treatment/antiviral-drugs.html.  
  • The CDC. 2026. Influenza antiviral medications: Summary for clinicians. https://www.cdc.gov/flu/hcp/antivirals/summary-clinicians.html  [Accessed April 2026].  
  • Van Bennekom CM, Kerr SM, Mitchell AA. 2019. Oseltamivir exposure in pregnancy and the risk of specific birth defects. Birth Defects Res; 111(19):1479-1486.  
  • Wentges-van Holthe N, et al. 2008. Oseltamivir and breastfeeding. Int J Infect Dis; 12:451.  
  • Wollenhaupt M, et al. 2014. The safety of oseltamivir in pregnancy: an updated review of post-marketing data. Pharmacoepidemiol Drug Saf; 23(10):1035-1042.  
  • Xie H-Y, et al. 2013. Infant outcomes among pregnant women who used oseltamivir for treatment of influenza during the H1N1 epidemic. Am J Obstet Gynecol; 208:293.e1-7. 

 

MotherToBaby cuenta con el apoyo de la Administración de Recursos y Servicios de Salud (HRSA) del Departamento de Salud y Servicios Humanos de los Estados Unidos (HHS) como parte de una adjudicación por un total de $6,000,000 con cero porcentaje financiado con fuentes no gubernamentales. Los contenidos son los del autor/es y no representan necesariamente los puntos de vista oficiales de, ni un respaldo, por HRSA, HHS o el Gobierno de los Estados Unidos.