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Oseltamivir (also Tamiflu) is an oral antiviral drug against influenza (flu). It was the second inhibitor of the viral neuraminidase to be developed, after zanamivir, and the first to be taken as an oral tablet. It was originally synthesised from shikimic acid extracted from the star anise plant. Oseltamivir is a prodrug that requires metabolism in the liver to the active form, oseltamivir carboxylate. This binds at the active site of the neuraminidase enzyme, preventing it from cleaving sialic acid to release the virus particle from the host cell. Oseltamivir can reduce the duration of influenza symptoms by 0.5–1 days. Debate is ongoing about whether it also reduces the risk of complications, such as pneumonia. Nausea and vomiting are the main adverse events. Resistance to oseltamivir has been observed in some strains of influenza virus, especially H1N1 strains.