I have an expression that I like to use when describing adrug’s fall from grace—I call it going from panacea to panic. This descriptionsuits the latest media focus on the anti-viral flu drug, Tamiflu.          

Tamiflu was wrongly touted as a potential cure-all for thebird flu craze just two years ago, and its manufacturer, Roche, was ramping upto increase its supply at a time when H5N1 bird flu was responsible for thedeaths of millions of birds in Asia but only a rare human being, and hadn’tcome to the US at all—and still hasn’t. Nevertheless, two years ago people werebegging their doctors for prescriptions of this perishable and expensive drug,without any idea how or even if they were going to use it.                                                                                                      

At the same time, Tamiflu has real uses against the yearlyhuman flu that kills hundreds of thousands around the globe. Many millions ofdoses have been prescribed around the world, especially in Japan. It is notsurprising that rare side effects such as behavior abnormalities and anxietythat may be associated with Tamiflu have been reported in a country where thedrug is prescribed so freely.                                                                                                                                                     

It is a difficult decision whether or not to warn against arare side effect for a drug that is used so often, and perhaps over-prescribed.On the other hand, Tamiflu clearly has an important role. None of the fouranti-flu drugs currently on the market are cures—they are all intended todecrease the length and severity of symptoms in patients. But these drugs whenused judiciously can save lives—because there are many patients with chronicillnesses who are not strong enough to survive the full force of the flu.                                                                                                                                               

And of the four anti-flu drugs available, Tamiflu, aneuraminidase inhibitor, has the least amount of drug resistance, and stillappears to be the best tolerated.                                

In the face of indiscriminate use of a drug, warnings may beprudent, as long as they don’t convince people who really need the drug not totake it.

Marc Siegel, MD, is an internist and associate professor ofmedicine at New York University and the author of False Alarm: The Truth Aboutthe Epidemic of Fear

From the April 01, 2008 Issue of MM+M - Medical Marketing and Media