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Tamiflu vs. Xofluza: Which One Should You Take?

By Rosanna Sutherby, PharmD

October 15, 2020

Ask A Pharmacist

October is the official start of influenza (flu) season in the Northern Hemisphere. If you have not yet received a flu shot, it's not too late to get one. Each year over 40,000,000 people in the United States become ill with the flu. Symptoms may prevent you from participating in your daily activities, including work or school, for up to a week or longer. For the last 10 years, Tamiflu had been the gold standard for alleviating or shortening the duration of flu symptoms. Xofluza arrived on the scene in October 2018. Read on for a comparison of these two antivirals.

What Are Tamiflu and Xofluza?

Tamiflu (oseltamivir) and Xofluza (baloxavir marboxil) are antiviral drugs used to treat infections caused by flu viruses. Tamiflu may also be used to prevent infection if you have been exposed to someone who has the flu. However, Tamiflu is not a substitute for an annual flu shot, as recommended by the CDC.

How Do Tamiflu and Xofluza Work?

Tamiflu works by blocking the release of flu virus particles into your body. Xofluza works by interfering with flu virus reproduction. Tamiflu and Xofluza do not work against infections caused by bacteria or viruses other than influenza A or influenza B.

How Do You Take Tamiflu and Xofluza?

Tamiflu and Xofluza work best if you take them within 48 hours of having flu symptoms. Symptoms of the flu include:

Chills
Cough
Fatigue
Fever
Headache
Muscle aches
Pain when moving the eyes
Runny nose
Sore throat
Sneezing
Stuffy nose

Tamiflu can treat flu infection in people 2 weeks of age or older and prevent the flu in those who are 1 year of age or older. Your doctor will determine your dose according to your age or weight.

If you are taking Tamiflu to treat the flu, you would typically take the medication twice a day for five days. Be sure to take Tamiflu for the full five days of treatment even if you feel better. If you stop the medicine too soon, the infection may not clear up completely, and your symptoms may return.

To prevent the flu after exposure, Tamiflu is typically used once a day for at least 10 days. The medication works better if you take it within 48 hours of being exposed to the flu virus.

Xofluza is used for flu treatment in people 12 years of age or older. Your doctor will dose this medication according to your weight. Xofluza is not typically used in patients who weigh less than 40 kg (88 pounds).

The dose of Xofluza is 40 mg or 80 mg taken as a single, one-time dose.

You can take Tamiflu and Xofluza with or without food; however, taking these medications with food may help prevent or alleviate an upset stomach.

What Are the Side Effects of Tamiflu and Xofluza?

The most common side effects seen with Tamiflu include:

Diarrhea
Nausea
Stomach pain
Vomiting

The most common side effects seen with Xofluza include:

Bronchitis
Diarrhea
Headache
Inflammation of the nose and throat
Nausea

What Medications Interact With Tamiflu and Xofluza?

If you plan to receive the live attenuated flu vaccine FluMist, do not administer the vaccine within 48 hours of taking Tamiflu or Xofluza. If you have had the FluMist vaccine, you should not take Tamiflu or Xofluza until at least two weeks after your vaccine.

Medications, supplements, or foods containing the following minerals may decrease the effects of Xofluza:

Aluminum
Calcium
Iron
Magnesium
Selenium
Zinc

Which Is Better – Tamiflu or Xofluza?

You'll want to consider several factors when deciding between Tamiflu and Xofluza. Both drugs are used to treat flu infection, but if you want to prevent becoming ill with the flu after being exposed to the virus, Tamiflu is a better choice.

Another aspect to look at when comparing Tamiflu and Xofluza is age. Xofluza is only indicated for ages 12 years and older, whereas Tamiflu can treat family members as young as 2 weeks of age.

When comparing how well Tamiflu and Xofluza work, studies show that both drugs reduce flu symptoms by about 1 day compared to placebo (no medication). However, it may be easier to complete the entire Xofluza one-dose treatment versus taking Tamiflu twice a day for five days. Additionally, because Xofluza works differently from Tamiflu, it may work against flu viruses resistant to Tamiflu.

Another factor to consider when choosing between Tamiflu and Xofluza is whether there are other medications that you normally take. Tamiflu generally does not interact with other medicines. However, you may need to avoid certain supplements, vitamins, or foods if you take Xofluza.

Cost can be an important factor when comparing drugs. A full treatment of Xofluza consists of two tablets versus ten capsules for a complete treatment of Tamiflu. However, the cost of a full Tamiflu treatment is generally less than the cost of a full Xofluza treatment.

How Much Do Tamiflu and Xofluza Cost?

The average retail price for ten generic Tamiflu (oseltamivir) 75 mg capsules is about $106. Xofluza is not available as a generic. The average retail price for an 80 mg one-time dose of Xofluza is about $185.

If your insurance does not cover your medicine or the price is too high even with your insurance, you can use a free prescription discount card to save up to 80% or more off the retail price of your flu medication.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She is a certified immunizer and utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients' concurrent conditions and potential drug interactions.

References:

https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm

https://www.wellrx.com/OSELTAMIVIR%20PHOSPHATE/drug-information/

https://www.wellrx.com/XOFLUZA/drug-information/

https://www.cdc.gov/flu/professionals/acip/summary/summary-recommendations.htm

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee3c9555-60f2-4f82-a760-11983c86e97b

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e49e1a61-1b7c-4be5-ac84-af6240b511e7

https://www.wellrx.com/health-conditions/about/health-condition/influenza/~default/

https://www.mayoclinic.org/drugs-supplements/oseltamivir-oral-route/description/drg-20067586

https://www.mayoclinic.org/drugs-supplements/baloxavir-marboxil-oral-route/description/drg-20452251

https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/021087s062lbl.pdf

https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/210854s000lbl.pdf