{"id":10159,"date":"2025-03-01T14:02:56","date_gmt":"2025-03-01T19:02:56","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan199\/"},"modified":"2025-03-02T00:48:51","modified_gmt":"2025-03-02T05:48:51","slug":"dhan199","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan199\/","title":{"rendered":"php\/alerts\/dhan199 ~  Division of Public Health &#8211; &#8211; Health Alert  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n  <br>\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n    <!-- BEGIN readspeaker div -->\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan199.html\" title=\"Listen to this page using ReadSpeaker\">\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n      <\/a>\n\n    <\/div>\n\n    <!-- END readspeaker div -->\n\n\n\n    \n\n    <header class=\"pull-left\">\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->199 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->October 13, 2009 9:04 am <!--[END]--> <\/h2>\n\n    <\/header>\n\n  <\/div><br>\n\n \n\n  <div class=\"container\">\n\n    <div class=\"row\">\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n          <div class=\"panel sectionmenu_panel\">\n\n            <div class=\"panel-heading\">\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n            <\/div>\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; Programs<\/a><\/li>\n        <li><a href=\"\/dph\/ofclocations.html\">Office Locations<\/a><\/li>\n        <li><a href=\"\/dph\/contact.html\">Contact Info<\/a><\/li>\n      \n        <li><a href=\"\/calendars.html\" target=\"_blank\">Calendar<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#ServicesMenu\"><h2>Services <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"ServicesMenu\">\n        <li><a href=\"\/dph\/servicesaz.html\">A-Z Services<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/environmental.html\">Air &#038; Water Quality<\/a><\/li>\n        <li><a href=\"\/dph\/ss\/vitalstats.html\">Birth, Death, &#038; Marriage Records<\/a><\/li>\n        <li><a href=\"\/dph\/clinics.html\">Clinics<\/a><\/li>\n        <li><a href=\"\/dph\/healthdatastats.html\">Health Data &#038; Statistics<\/a><\/li>\n        <li><a href=\"\/dph\/php\/emsps.html\">Emergency Preparedness<\/a><\/li>\n        <li><a href=\"\/dph\/healthandwellness.html\">Health &#038; Wellness<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthyhomes.html\">Healthy Homes<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthywp.html\">Healthy Workplaces<\/a><\/li>\n        <li><a href=\"\/dph\/lab\/labs.html\">Laboratory<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/feir.html\">Restaurant Inspections<\/a><\/li>\n        <li><a href=\"\/dph\/screen.html\">Screening and Testing<\/a><\/li>\n        <li><a href=\"\/dph\/chca\/dphwichominf01.html\">WIC<\/a><\/li>\n        <li><a href=\"\/dph\/servicesadd.html\">Additional Services<\/a><\/li><li>\n      <\/li><\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n        <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\n        <li><a href=\"\/dph\/factsheetsaz.html\">A-Z Fact Sheets<\/a><\/li>\n        <li><a href=\"\/dph\/pubreportsaz.html\">A-Z Publications &#038; Reports<\/a><\/li>\n        <li><a href=\"\/dph\/diseasesandconditions.html\">Diseases &#038; Conditions<\/a><\/li>\n        <li><a href=\"\/dph\/faq.html\">FAQ&#8217;s<\/a><\/li>\n        <li><a href=\"\/dph\/php\/alerts.html\">Health Alerts<\/a><\/li>\n        <li><a href=\"\/dph\/healthylifestyles.html\">Healthy Lifestyles<\/a><\/li>\n        <li><a href=\"\/dph\/hipaa.html\">HIPAA<\/a><\/li>\n        <li><a href=\"\/dph\/regs.html\">Regulations<\/a><\/li>\n        <li><a href=\"\/dph\/forms.html\">Request Forms<\/a><\/li>\n        <li><a href=\"\/dph\/links.html\">Links &#038; Resources<\/a><\/li>\n        <li><a href=\"http:\/\/delaware.gov\/help\/foia_request.shtml\">FOIA Request Form<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li><a id=\"SocialMenuHeader\"><h2>Connect <i class=\"fa fa-thumbs-o-up fa-fw\"><\/i><\/h2><\/a>\n      <ul id=\"SocialMenu\">\n        <li class=\"facebook\"><a href=\"https:\/\/www.facebook.com\/DEPublicHealth\" target=\"_blank\" title=\"Division of Public Health Facebook Page\"><i class=\"fa fa-facebook-square fa-lg\"><\/i> Facebook<\/a><\/li>\n        <li class=\"twitter\"><a href=\"https:\/\/twitter.com\/Delaware_DHSS\" target=\"_blank\" title=\"Delaware Health and Social Services Twitter Account\"><i class=\"fa fa-twitter-square fa-lg\"><\/i> Twitter<\/a><\/li>\n        <!-- <li class=\"googleplus\"><a href=\"#\"><i class=\"fa fa-google-plus-square fa-lg\"><\/i> Google +<\/a><\/li>\n        <li class=\"flickr\"><a href=\"#\"><i class=\"fa fa-flickr fa-lg\"><\/i> Flickr<\/a><\/li>\n        <li class=\"youtube\"><a href=\"#\"><i class=\"fa fa-youtube-square fa-lg\"><\/i> Youtube<\/a><\/li>\n        <li class=\"instagram\"><a href=\"#\"><i class=\"fa fa-instagram fa-lg\"><\/i> Instagram<\/a><\/li>\n        <li class=\"linkedin\"><a href=\"#\"><i class=\"fa fa-linkedin-square fa-lg\"><\/i> Linkedin<\/a><\/li>\n        <li class=\"pinterest\"><a href=\"#\"><i class=\"fa fa-pinterest-square fa-lg\"><\/i> Pinterest<\/a><\/li> -->\n      <\/ul>\n    <\/li>\n  <\/ul>\n\n              <\/div>\n\n            <\/div>\n\n          <\/div>\n\n        <\/div><br>\n\n      <\/div>\n\n\n\n      <div class=\"col-md-9\" id=\"main_content\"> \n\n  \n\n<h2 class=\"center\">Health\n\n<!--[type=EDIT name=\"DHANType\"]-->\n\n\n\n   Advisory<!--[END]-->\n\n<br>\n\n<!--[type=EDIT name=\"DHAN Heading\"]-->\n\n\n\nALTERNATIVES TO TAMIFLU ORAL SUSPENSION FOR PEDIATRIC PATIENTS<!--[END]-->\n\n<\/h2>\n\n\n\n<!--[type=HTMLEDIT name=\"Content\"]-->\n\n\n\n<p>\n\n\n  On September 30, 2009, the Center for Disease Control and Prevention (CDC) sent a message to the states that the FDA and Roche (maker of\n\n\n  Tamiflu\u00ae) acknowledge limited commercial and stockpiled supplies of Tamiflu\u00ae oral suspension.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Alternatives to Tamiflu\u00ae Oral Suspension for Pediatric Patients\n\n\n<\/h3>\n\n\n<p>\n\n\n  If pediatric formulations of Tamiflu are not available, pharmacists may compound Tamiflu\u00ae 75 mg capsules into an oral suspension\n\n\n  onsite. For the FDA -approved instructions for the emergency compounding of an oral suspension from Tamiflu\u00ae 75mg capsules, see the\n\n\n  FDA approved manufacturer package insert for oseltamivir (Tamiflu), available on the FDA Web site at <a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/UCM147992.pdf\">http:\/\/www.fda.gov\/downloads\/Drugs\/DrugSafety\/InformationbyDrugClass\/UCM147992.pdf<\/a>\n\n\n<\/p>\n\n\n<p>\n\n\n  Compounding an oral suspension from Tamiflu\u00ae 75mg capsules provides an alternative when commercially manufactured oral suspension\n\n\n  formulation is not readily available. Tamiflu\u00ae capsules 75 mg may be compounded using either of two vehicles: Cherry Syrup\n\n\n  (Humco\u00ae) or Ora-Sweet\u00ae SF (sugar-free) (Paddock Laboratories). Other supplies needed to compound include mortar and pestle and\n\n\n  amber glass or amber polyethyleneterephthalate (PET) bottle.\n\n\n<\/p>\n\n\n<p>\n\n\n  In addition, for children who may not be able to swallow capsules, Tamiflu\u00ae (30mg, 45mg and 75mg) capsules may be opened and mixed\n\n\n  with sweetened liquids, such as regular or sugar-free chocolate syrup, if oral suspension is not available.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Note on Tamiflu Oral Suspension Syringe\n\n\n<\/h3>\n\n\n<p>\n\n\n  The second issue that pharmacists and physicians may face is the need to ensure that the units of measure on the dosing dispenser and the\n\n\n  dosing instructions match. An oral dosing dispenser with 30 mg, 45 mg, and 60 mg graduations of Tamilfu\u00ae is provided in the packaging\n\n\n  for the manufacturer\u2019s product rather than graduations in milliliters (mL) or teaspoons (tsp).This can lead to patient or caregiver\n\n\n  confusion and dosing errors. When dispensing commercially manufactured Tamiflu\u00ae oral suspension, pharmacists should ensure the units\n\n\n  of measure on the dosing instructions match the dosing device provided. If prescription instructions specify administration using mL or\n\n\n  tsp, then the device included in the Tamiflu\u00ae product package should be removed and replaced with an appropriate measuring device,\n\n\n  such as an oral syringe if the prescribed dose is in milliliters (mL). When dispensing Tamiflu\u00ae oral suspension for children younger\n\n\n  than 1 year of age, the oral dosing dispenser that is included in the product package should always be removed. Pharmacists and health\n\n\n  care providers should provide an oral syringe that is capable of accurately measuring the prescribed milliliter (mL) dose, and counsel\n\n\n  the caregiver how to administer the prescribed dose. Oseltamivir is authorized for emergency use in children younger than 1 year of age\n\n\n  under an Emergency Use Authorization (EUA) issued by FDA. For the EUA, see <a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/tamiflu-hcp.pdf\">http:\/\/www.cdc.gov\/h1n1flu\/eua\/pdf\/tamiflu-hcp.pdf<\/a>.\n\n\n<\/p>\n\n\n<p>\n\n\n  The Delaware Division of Public Health (DPH) remains committed in our support of the on-going H1N1 response efforts. This includes\n\n\n  ensuring that those who need antiviral treatment have access to the appropriate medication. The Division of Public Health (DPH) surveyed\n\n\n  pharmacies throughout Delaware and concluded there is a shortage of Tamiflu\u00ae oral suspension in the market at both pharmacies and\n\n\n  distributors. Given this finding, the Division of Public Health (DPH) is working directly with the pharmaceutical community to release\n\n\n  from its limited in-state stockpile of Tamiflu\u00ae oral suspension to some pharmacies and hospitals in Delaware.\n\n\n<\/p>\n\n\n<p>\n\n\n  Medical providers prescribing antiviral medications are encouraged to following the CDC\u2019s Interim Recommendations for the Use of\n\n\n  Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season at <a href=\"http:\/\/www.cdc.gov\/h1n1flu\/recommendations.htm\">http:\/\/www.cdc.gov\/h1n1flu\/recommendations.htm<\/a>.\n\n\n<\/p>\n\n\n<p>\n\n\n  If you have questions regarding this Health Alert contact the Delaware Division Public Health at (302) 223-1720.\n\n\n<\/p>\n\n\n<p class=\"text-center\">\n\n\n  ****\n\n\n<\/p>\n\n\n<p>\n\n\n  You are receiving this email because you are a registered member of the Delaware Health Alert Network.\n\n\n<\/p>\n\n\n<p>\n\n\n  If you are not a member and would like to subscribe, please complete the form found online at:\u00a0 <a href=\"\/main\/mailforms\/dph_hanform.aspx\">http:\/\/dhss.delaware.gov\/main\/mailforms\/dph_hanform.aspx<\/a>.\n\n\n<\/p><br>\n\n\n<br>\n\n\n<p class=\"smalltext\"><a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\"><img loading=\"lazy\" decoding=\"async\" alt=\"Download Adobe Acrobat Reader\" height=\"21\" src=\"\/wp-content\/uploads\/dhss\/img\/getacro60.gif\" width=\"60\"><\/a> Please note: Some of the files available on this page are in Adobe PDF format which requires Adobe Acrobat Reader.  A free copy of Adobe Acrobat Reader can be downloaded directly from <a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\">Adobe <\/a>. If you are using an assistive technology unable to read Adobe PDF, please either view the corresponding text only version (if available) or visit Adobe&#8217;s <a href=\"http:\/\/access.adobe.com\">Accessibility Tools page<\/a>.<\/p>\n\n\n\n<!--[END]-->\n\n  \n\n        <div class=\"panel panel-danger\">\n\n          <div class=\"panel-heading\">    \n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n       <\/div>\n\n       <div class=\"panel-body\">\n\n      <ul>\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n            <\/ul>\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n          <\/div> \n\n        <\/div><br>  \n\n\n\n      <\/div>\n\n    <\/div>\n\n  <\/div><!-- \/container -->\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #199 October 13, 2009 9:04 am Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10159","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10159","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10159"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10159\/revisions"}],"predecessor-version":[{"id":11335,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10159\/revisions\/11335"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10159"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}