Oseltamivir (Tamiflu [Genentech/Roche] and generic) is in limited supply nationwide due to increased demand. The US government is making additional supply of oseltamivir available to jurisdictions, including through state and national stockpiles, and the US CDC has issued the following antiviral prioritization
When antivirals are available, a clinical diagnosis of influenza without testing is adequate to support empiric outpatient antiviral treatment. However, if oseltamivir is unavailable or if availability is limited, influenza testing is highly recommended to guide antiviral use.
If oseltamivir is unavailable, other antivirals such as oral baloxavir marboxil (Xofluza; Genentech), inhaled zanamivir (Relenza; GSK), or intravenous peramivir (Rapivab; Seqirus) can be used for outpatient treatment. Limited data exist on the use of these antivirals in hospitalized patients.
When availability of oseltamivir or other antivirals is limited, treatment should be prioritized for hospitalized patients and for outpatients who are at high risk of complications (e.g., at extremes of age [younger than 2 years or ≥ 65 years]), have uncontrolled chronic disease or immunocompromise of any cause, or are pregnant (or ≤ 2 weeks postpartum). Persons with clinically mild influenza who are not at increased risk of complications can be managed with supportive care without antiviral treatment.
Outpatient treatment should be prioritized for persons who test positive for influenza within 2 days of symptom onset and for persons with progressive or severe influenza who do not require hospitalization, even if they test positive for influenza > 2 days from symptom onset.