As expected, Tamiflu is beginning to cause problems. Dr Crippen has just been asked by an eminent man from the main stream media for his opinion. This is what I said:

I have not yet prescribed Tamiflu and I doubt I shall.

The John Radcliffe work is in line with our more anecdotal experiences though I have yet to see a child who is dehydrated.

I know of no hard evidence prior to this JR study showing that Tamiflu has dangerous side effects but, anecdotally, there is no doubt that it does have significant side effects and that these are particularly common in children. I am getting calls from people, both adults and children, who have obtained Tamiflu from the various “swine lines” that the government has set up, and who are getting mild to moderate symptoms which may be side effects. This is still not scientific proof. Remember that swine flu itself causes gut symptoms.

My biggest worry is this.

When a drug has got through clinical trials, passed FDA tests and so on, it is then deemed to be safe to go out on “general release.” Normally, you then build up experience of the drug over a few years. Occasionally, unexpected side effects, that did not emerge in clinical trials, appear. Remember TRILUDAN (terfenadine) the hay fever treatment that turned out to have cardiac side effects? Or Opren, the arthritis drug? Both drugs were heavily promoted by Big Pharma. With Tamiflu, there has been no gradual build up of experience in the UK. We are going from a situation in which it was rarely prescribed (in my practice we have 18,000 patients and ten doctors and none of us had EVER prescribed this drug until six weeks ago) to one in which literally millions, including children, may take it. If Tamiflu were a proven life-saving treatment for a life-threatening condition, then of course it should be prescribed. But that is not the case. Far from it.

The present position is that we are dealing with a common virus that, in the overwhelming majority of cases, causes a mild, self-limiting illness. As always, there are many other viral illnesses around. It is impossible therefore to diagnose swine flu with accuracy. The best you can say to someone is that “you may have it” or “you probably do not have it.” Tamiflu is of uncertain efficacy, but has been heavily promoted by Big Pharma. It is a very big earner. (Have you investigated the possibility of input from Donald Rumsfeld in the USA? There’s a can of worms if you have not) Tamiflu has also been enthusiastically adopted by the government because media hysteria (so, it’s your fault!!) has put them into a position where they have to be seen to be doing something and this is all they have to offer. Given that the condition is almost universally mild, given that Tamiflu is of uncertain efficacy (best reports on Cochrane review suggest reducing duration of symptoms by 18-24 hours, and there are no data about reducing mortality), given the diagnostic uncertainty and now given the increasing number of side effects, I am continuing to advise my patients not to take it.

I would not take it myself and I would not give it to my children. How then can I possibly prescribe it?

I find that nearly all patients are happy with this advice. I have not been pressured into prescribing it. Of course, a lot of people will already have obtained it themselves. Some of them have phoned in with side effects. Most, I suspect, have not had problems; or, if they have, they have not contacted me.

Finally, there is a huge problem with data. The government is logging all people who have been given Tamiflu as having swine flu and therefore the swine flu numbers are likely to be grossly inflated.

This is of course a personal opinion but is it is one based on a lot of experience.