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baloxavir marboxil (Xofluza)
Indications:
- treatment of influenza infection*
- prevention of influenza infection*
- post-exposure prevention of influenza for patients >= 12 years
* about as effective as oseltamivir (may be better) [2]
* must be taken within 2 days of exposure
Contraindications:
- CDC does not recommend use of baloxavir for treatment of influenza in pregnant women, breastfeeding mothers, or immunosuppressed persons [7]
Dosage:
tablets
granules for mixing in water
Pharmacokinetics:
- faster reduction of viral levels & viral shedding than oseltamivir, but little difference in alleviating symptoms
Drug interactions:
- should not be co-administered foods/beverages/supplements containing calcium, iron, magnesium, selenium, aluminum or zinc.
Mechanism of action:
- cap-dependent endonuclease inhibitor
General
antiviral agent
Database Correlations
PUBCHEM correlations
References
- Smith M, North American Correspondent.
Investigational Flu Drug a Near Match for Oseltamivir -
Clinical outcomes 'identical' but virology different.
MedPage Today. October 08, 2017
https://www.medpagetoday.com/MeetingCoverage/IDWeek/68407
- Hayden FG, Sugaya N, Hirotsu N
Baloxavir Marboxil for Uncomplicated Influenza in Adults and
Adolescents.
N Engl J Med 2018; 379:913-923. Sept 6, 2018
PMID: 30184455
https://www.nejm.org/doi/full/10.1056/NEJMoa1716197
- Brooks M
FDA OKs Xofluza, First New Flu Antiviral in Nearly 20 Years.
Medscape - Oct 24, 2018.
https://www.medscape.com/viewarticle/903911
- FDA News Release. Oct 24, 2018
FDA approves new drug to treat influenza.
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm624226.htm
- Brooks M
FDA Expands Xofluza Indication to People at High-Risk for
Flu Complications
Medscape - Oct 17, 2019.
https://www.medscape.com/viewarticle/920030
- Ikematsu H et al.
Baloxavir marboxil for prophylaxis against influenza in household contacts.
N Engl J Med 2020 Jul 23; 383:309.
PMID: 32640124
https://www.nejm.org/doi/10.1056/NEJMoa1915341
- Uyeki TM.
Baloxavir for postexposure prophylaxis against influenza in households.
N Engl J Med 2020 Jul 23; 383:389
PMID: 32640147
https://www.nejm.org/doi/10.1056/NEJMe2022702
- FDA News Release. Nov 23, 2020
FDA Expands Approval of Influenza Treatment to Post-Exposure Prevention.
https://www.fda.gov/news-events/press-announcements/fda-expands-approval-influenza-treatment-post-exposure-prevention
- Bronze MS
Fast Five Quiz: Influenza Practice Essentials
Medscape. November 3, 2021
https://reference.medscape.com/viewarticle/962197
- Nguyen HH, Bronze MS
Influenza Treatment & Management
Medscape. November 5, 2021
https://emedicine.medscape.com/article/219557-treatment