Can't Find Oseltamivir? Here Are Your Alternatives

If your doctor prescribed Oseltamivir (generic Tamiflu) but your pharmacy is out of stock, don't panic — and don't wait. There are three other FDA-approved antiviral medications for the flu that may be available.

The 2025–2026 flu season shortage has made Oseltamivir hard to find in many areas. But time is critical: flu antivirals work best when started within 48 hours of symptoms. If you can't get Oseltamivir quickly, an alternative may be your best option.

Alternative 1: Baloxavir Marboxil (Xofluza)

Baloxavir, sold as Xofluza, is often the most convenient alternative to Oseltamivir. Here's what makes it different:

• Single dose. You take just one dose by mouth — no 5-day course required.
• Different mechanism. Baloxavir is a cap-dependent endonuclease inhibitor, meaning it works differently than Oseltamivir. This can be an advantage if there's concern about neuraminidase inhibitor resistance.
• Approved for ages 5+ for treatment and ages 1+ for post-exposure prophylaxis.
• Effectiveness. Clinical trials show Baloxavir reduces symptom duration similarly to Oseltamivir.

Downsides of Xofluza

• Cost. Xofluza is brand-name only and can cost $100–$180 without insurance. However, the manufacturer (Genentech/Roche) offers a savings program.
• Resistance. Some influenza A strains can develop resistance to Baloxavir during treatment, though this hasn't been a major clinical concern.
• Not for everyone. Not approved for children under 5 for treatment.

Alternative 2: Zanamivir (Relenza)

Zanamivir, sold as Relenza, is an inhaled antiviral in the same neuraminidase inhibitor class as Oseltamivir.

• How it works: Inhaled via a Diskhaler device, twice daily for 5 days (treatment).
• Approved for: Treatment in patients 7 years and older; prophylaxis in patients 5 years and older.
• Advantage: Available when oral medications are in shortage, as it's a completely separate supply chain.

Downsides of Relenza

• Not for respiratory conditions. Zanamivir is not recommended for patients with asthma, COPD, or other chronic lung diseases due to risk of bronchospasm.
• Inhaler required. Some patients find the Diskhaler device difficult to use, especially young children and elderly patients.
• Availability. Relenza is less commonly stocked, so your pharmacy may need to special-order it.

Alternative 3: Peramivir (Rapivab)

Peramivir, sold as Rapivab, is the only FDA-approved intravenous (IV) flu antiviral.

• Single IV infusion. Given once in a clinic, urgent care, or hospital setting over 15–30 minutes.
• Approved for ages 6 months+.
• Best for: Patients who can't take oral medications (severe vomiting, hospitalized patients) or when oral antivirals are unavailable.

Downsides of Rapivab

• Requires a healthcare facility. You can't pick this up at a pharmacy — it's administered by IV.
• Cost. The infusion plus facility fees can be expensive, though insurance often covers it when clinically appropriate.
• Less commonly used. Many outpatient clinics don't stock it routinely.

Comparing the Alternatives at a Glance

• Easiest to take: Xofluza (single oral dose)
• Most similar to Oseltamivir: Relenza (same drug class, similar duration)
• Best for severe cases or when you can't swallow pills: Rapivab (IV)
• Most widely available during the shortage: Varies by area — use MedFinder to check

What About Over-the-Counter Remedies?

Over-the-counter cold and flu medications (like Tylenol, ibuprofen, or decongestants) can help with symptoms, but they do not fight the influenza virus itself. Only prescription antivirals like Oseltamivir and its alternatives actually shorten the duration of the flu and reduce the risk of serious complications.

If you're in a high-risk group (elderly, pregnant, immunocompromised, or have chronic conditions), getting a prescription antiviral is especially important.

How to Get an Alternative Prescribed

1. Contact your prescriber. Call your doctor's office or the telehealth service that prescribed Oseltamivir. Explain that it's unavailable and ask for an alternative.
2. Visit urgent care. If you can't reach your doctor quickly, an urgent care clinic can prescribe an alternative.
3. Use telehealth. Many telehealth platforms can switch your prescription. Learn more about finding a doctor who prescribes flu antivirals.

Don't Wait — Act Now

The clock is ticking. Flu antivirals are most effective within 48 hours of symptom onset. If you can't find Oseltamivir, switch to an alternative as soon as possible.

For help locating Oseltamivir or its alternatives, visit MedFinder. For more on the current shortage, read our shortage update for patients.