From the Guidelines
Tamiflu (Oseltamivir) is generally preferred over Xofluza (Baloxavir) for the treatment of influenza, especially in hospitalized children, due to its established efficacy and longer treatment duration. According to the American Academy of Pediatrics (AAP) 1, oseltamivir is considered the antiviral drug of choice for the management of illness caused by influenza virus infections, particularly in hospitalized children. This is because of the cumulative experience of this drug in children, relative cost, and ease of administration.
Key Differences Between Tamiflu and Xofluza
- Treatment Duration: Tamiflu requires a 5-day treatment course, whereas Xofluza is a single-dose option 1.
- Efficacy: Outcomes in patients treated with baloxavir are generally similar to those for NAIs, such as oseltamivir 1.
- Convenience: Xofluza may be preferred for patients who are at high risk of complications from influenza, such as the elderly or those with underlying medical conditions, due to its convenience and potential for improved adherence.
- Dosing: The recommended dose of Xofluza is a single dose of 40mg for patients weighing 40kg or more, while Tamiflu is dosed at 75mg twice daily for 5 days 1.
Patient-Specific Factors to Consider
- Disease Severity: Patients with severe influenza or those who are hospitalized may require Tamiflu due to its established efficacy and longer treatment duration.
- Medical History: Patients with underlying medical conditions, such as chronic respiratory disease, may require closer monitoring and individualized treatment decisions.
- Potential for Medication Interactions: The choice between Xofluza and Tamiflu should be individualized based on patient-specific factors, including potential for medication interactions.
In summary, while Xofluza may be a convenient option for some patients, Tamiflu remains the preferred choice for the treatment of influenza, especially in hospitalized children, due to its established efficacy and longer treatment duration 1.
From the FDA Drug Label
In Trial T0831, there was no difference in the time to alleviation of symptoms between subjects (age ≥ 20 years) who received XOFLUZA (54 hours) and those who received oseltamivir (54 hours) In Trial T0832, there was no statistically significant difference in the median time to improvement of influenza symptoms in the subjects who received XOFLUZA (73 hours) and those who received oseltamivir (81 hours)
The efficacy of Tamiflu (Oseltamivir) and Xofluza (Baloxavir) is similar in terms of time to alleviation or improvement of influenza symptoms.
- In adults and adolescents, both treatments resulted in similar times to alleviation or improvement of symptoms.
- No statistically significant difference was observed between the two treatments in the median time to improvement of influenza symptoms. 2 2
From the Research
Comparison of Tamiflu (Oseltamivir) and Xofluza (Baloxavir)
- Both Tamiflu (Oseltamivir) and Xofluza (Baloxavir) are used to treat acute uncomplicated influenza in patients 12 years of age and older who have been symptomatic for ≤ 48 hours 3, 4, 5, 6, 7
- Xofluza (Baloxavir) has been shown to reduce influenza viral load more rapidly than Tamiflu (Oseltamivir) 3, 6
- Xofluza (Baloxavir) is a single-dose oral antiviral, whereas Tamiflu (Oseltamivir) is typically taken twice daily for 5 days 5, 7
- Both drugs have similar efficacy in improving influenza symptoms, with Xofluza (Baloxavir) displaying similar efficacy to Tamiflu (Oseltamivir) in clinical trials 3, 4, 7
- Xofluza (Baloxavir) has activity against influenza A and B viruses, including strains resistant to neuraminidase inhibitors 3, 4, 6
Mechanism of Action
- Xofluza (Baloxavir) works by inhibiting the cap-dependent endonuclease activity of the PA protein, which is essential for viral replication 3, 4, 5, 6
- Tamiflu (Oseltamivir) works by inhibiting the neuraminidase enzyme, which is involved in the release of viral particles from infected cells 3, 6