About this guidance

About this guidance

NICE technology appraisal guidance is about the use of new and existing medicines and treatments in the NHS in England and Wales.

This guidance was developed using the NICE multiple technology appraisal process.

It replaces 'Flu treatment – zanamivir (review), amantadine and oseltamivir' (NICE technology appraisal 58).

The review and re-appraisal of amantadine, oseltamivir and zanamivir for the treatment of influenza has resulted in a change in the guidance. Specifically:

  • people with chronic neurological conditions and people with chronic liver disease are now considered 'at risk'

  • zanamivir is now recommended as a treatment option for children between the ages of 5 and 12 years in 'at-risk' groups if influenza is circulating and they can start treatment within 36 hours of first symptoms

  • oseltamivir and zanamivir are now recommended as treatment options for 'at-risk' people in long-term and residential nursing homes during localised outbreaks (when influenza is not circulating), if there is a high level of certainty that the causative agent is influenza.

This guidance has been prepared in the expectation that vaccination against influenza is undertaken in accordance with national guidelines. Vaccination has been established as the first-line intervention to prevent influenza and its complications, and the use of drugs described in this guidance should not in any way detract from efforts to ensure that all eligible people receive vaccination.

We have produced a summary of this guidance for patients and carers. Tools to help you put the guidance into practice and information about the evidence it is based on are also available.

Your responsibility

This guidance represents the views of NICE and was arrived at after careful consideration of the evidence available. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way which would be inconsistent with compliance with those duties.


© National Institute for Health and Clinical Excellence 2009. All rights reserved. NICE copyright material can be downloaded for private research and study, and may be reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the written permission of NICE.

  • National Institute for Health and Care Excellence (NICE)