What Antiviral Medications Work for the Flu? Here Are 4 FDA-Approved Options
Key takeaways:
Antiviral medications can be an effective treatment for the flu. They can also help prevent getting the flu if you’ve been exposed to the virus that causes it.
Tamiflu (oseltamivir) is the most commonly prescribed antiviral medication for the flu. Xofluza (baloxavir marboxil), Relenza (zanamivir), and Rapivab (peramivir) are other antiviral options.
There are ways to save on antiviral medications for the flu. Many options are available as lower-cost generics or have copay savings opportunities. GoodRx can help make your prescription more affordable.
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Table of contents
You have a fever, chills, and severe muscle aches — all typical symptoms of the flu (influenza). A quick test at a healthcare professional’s office confirms you’re sick with this viral illness. You’re prescribed an antiviral for the flu.
If it’s your first time taking one, you likely have questions about antiviral medications for the flu. For starters, how do they work? Below, we’ll answer some common questions about flu antivirals, as well as discuss four specific medications.
What are antiviral medications?
Antiviral medications are prescription-only medications that can fight viruses. There are many types of antivirals available. They can treat various health conditions caused by viruses, such as shingles, cold sores, and even COVID-19. Antivirals for the flu target influenza, the virus that causes the flu.
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Antiviral medication names
There are currently four recommended antivirals for influenza infections:
How do antiviral medications work to treat the flu?
There are currently two antiviral classes that are recommended to treat the flu: neuraminidase inhibitors and endonuclease inhibitors. They work differently to treat the flu.
Flu recovery timeline: Learn the stages of the flu and what to expect as you recover.
Tamiflu vs. Xofluza: Pharmacists compare these two antiviral medications for the flu.
What is it like to take Tamiflu? Read three people’s experiences with this flu medication.
The table below shows which antiviral medications for the flu belong to which class.
Neuraminidase inhibitors | Endonuclease inhibitors |
• Tamiflu • Relenza • Rapivab | • Xofluza |
The influenza virus has two major proteins on its surface: hemagglutinin and neuraminidase. Neuraminidase helps the virus spread from cell to cell inside your body. Neuraminidase inhibitors stop this protein from working properly. This stops the virus from leaving infected cells to spread to uninfected cells.
Endonuclease inhibitors target a different protein: cap-dependent endonuclease (CEN). The flu virus uses CEN to make copies of itself. Endonuclease inhibitors work by blocking CEN so the virus can’t make copies of itself to spread to uninfected cells.
Keep in mind: Neither type of flu antiviral directly kills the virus. But by stopping the flu virus from multiplying or spreading, it gives your immune system time to catch up and clear the infection.
Do antiviral drugs work to prevent getting the flu?
Yes. In addition to treating the flu, antiviral drugs are effective for flu prevention. But they’re only recommended in certain situations. And they only work against strains of the flu that aren’t resistant to antivirals. Getting an annual flu vaccine is still the best way to protect yourself against the flu. Routine hand washing and wearing a mask are other ways you can help protect yourself.
Three antivirals are FDA approved to prevent getting sick with the flu: Tamiflu, Xofluza, and Relenza. These three medications are recommended or considered in the following situations:
If you’ve been in close contact with someone who has the flu, it’s been less than 2 weeks since you received your flu vaccine, and you’re at high risk for flu-related complications.
If you have a high risk of flu-related complications, and you’re unable to receive the flu vaccine.
If you’ve been exposed to someone with the flu, and you have a weakened immune system (immunocompromised).
If you’ve been in close contact with someone who has the flu, and you’re pregnant or gave birth less than 2 weeks ago.
What antiviral medications can you take for the flu?
As listed above, there are four antiviral drugs that are recommended to treat the flu. Below, we’ll review the basics of each medication.
1. Tamiflu (oseltamivir)
Tamiflu is a commonly prescribed option for treating the flu in adults. It’s the first-choice medication for treating the flu during pregnancy. It’s also the preferred option for kids, as it can be safely given to children as young as 2 weeks old. It lessens symptom severity and shortens the length of symptoms by about 1 day.
Tamiflu is available as an oral capsule and liquid, with generic versions available for both. It should be started within 48 hours (2 days) of first experiencing symptoms to be most effective.
To treat the flu, most adults and children age 13 and older take 75 mg of Tamiflu twice a day for 5 days. To prevent the flu, the standard dose is 75 mg once a day for at least 10 days. People with kidney problems would receive lower doses.
The Tamiflu dose for children under 13 is based on their body weight. If used for flu treatment, children would receive 2 doses per day for 5 days. If used for flu prevention, children would receive 1 dose per day for at least 10 days.
Can you take Tamiflu and ibuprofen together?
Yes, most people can take Tamiflu and ibuprofen (Advil, Motrin) together. There are no known drug interactions between these two medications. But people with kidney problems should speak with a healthcare professional before taking this combination.
Tamiflu is broken down by the kidneys. That’s why people with kidney problems may be prescribed lower doses of it. Ibuprofen is also broken down by the kidneys and has a risk of kidney damage. Combining the two may put extra stress on the kidneys for people who already have kidney problems.
Quiz: Test your knowledge about Tamiflu
2. Xofluza (baloxavir marboxil)
Xofluza is a newer antiviral drug for the flu, earning FDA approval in 2018. It has some advantages over Tamiflu. It shortens the length of flu symptoms by a little less than a day and lowers the risk of flu-related complications more than other antivirals for the flu. It also seems to have a lower risk of side effects. But it’s not recommended if you’re pregnant or nursing.
Xofluza can be prescribed for adults and children age 5 and older. It comes as an oral tablet and liquid. You should start this prescription flu medicine within 48 hours of first developing flu symptoms for it to be most effective.
Xofluza doses are based on your body weight. But regardless of your specific dose, one dose is all you need to take. This is the only single-dose oral flu antiviral currently available. Xofluza doses are the same for flu treatment and prevention.
3. Relenza (zanamivir)
Relenza is an antiviral medication that’s available as an oral inhaler. It shortens the length of symptoms by a little less than 1 day in adults if started within 48 hours of developing symptoms. But it doesn’t appear to lower the risk of flu-related complications or hospitalizations.
Relenza can be used for flu treatment in adults and children age 7 and older. The Relenza dose for flu treatment is 2 puffs (10 mg) inhaled every 12 hours for 5 days. The medication can be used for flu prevention by adults and children age 5 and older. The dose for flu prevention is 2 puffs (10 mg) inhaled once a day for at least 10 days.
Relenza shouldn’t be used if you have chronic lung conditions, like asthma or chronic obstructive pulmonary disease (COPD).
4. Rapivab (peramivir)
Rapivab is an IV antiviral medication. It needs to be administered by a healthcare professional and would likely only be given in a healthcare facility.
Rapivab can be given to adults and children age 6 months and older within 48 hours of developing symptoms. The medication is given as a one-time IV infusion that takes 15 to 30 minutes to complete. As a reminder, it can only be used to treat the flu — not prevent it.
The Rapivab dose for adults and children age 13 and older is 600 mg. Your dose may be lower if you have kidney problems. The dose for children age 6 months through 12 years is based on their body weight but would be no more than 600 mg.
What are common side effects of antiviral medications?
The common side effects of antiviral medications for the flu vary. But they can all cause digestive-related side effects, such as nausea or diarrhea. The table below lists the common side effects for each of the four recommended flu antivirals.
Common Tamiflu side effects | Common Xofluza side effects | Common Relenza side effects | Common Rapivab side effects |
• Nausea • Vomiting • Diarrhea • Diaper rash in infants • Headache • Muscle pain | • Diarrhea • Bronchitis (inflamed airways) • Nausea • Swelling of the sinuses • Headache | • Nausea • Swelling of the sinuses • Dizziness • Ear, nose, or throat infections | • Constipation • Trouble sleeping • Vomiting in children • Raised blood pressure • Raised blood glucose (sugar) • Decreased white blood cell count |
What are some alternatives to the antiviral medication Tamiflu?
Tamiflu is usually the go-to choice for most prescribers when it comes to flu treatment. But what if you’re allergic to it? Or perhaps there’s a shortage of it during the peak of flu season? These are times when you might need to explore Tamiflu alternatives.
The four flu antivirals discussed earlier are similarly effective when it comes to flu treatment. So your prescriber would consider other factors, such as a person’s age or personal preference, if they need to pick a Tamiflu alternative.
The most likely Tamiflu alternative you’d be prescribed is Xofluza. This single-dose oral flu antiviral is convenient and has a low risk of side effects. And like Tamiflu, it can both treat and prevent the flu.
If you need a Tamiflu alternative for your child and they’re between the ages of 6 months and 5 years, they’d likely receive Rapivab. This is the only other recommended antiviral medication for the flu that’s FDA approved for children under age 5. Rapivab could also be an option if you’re hospitalized for the flu and you’re already receiving other IV medications.
Relenza might be your prescriber’s choice if you’re not able to take oral medications. This inhaled option bypasses the digestive tract. It’s also less invasive than Rapivab and doesn’t require you to go to a hospital or infusion center to receive it.
How to save on antiviral medications for the flu
There are many ways to save on antiviral medications for the flu. GoodRx can help you navigate your options, which may include GoodRx discounts, copay savings cards, and patient assistance programs.
Since Rapivab is typically only given in clinic or hospital settings, these types of savings opportunities aren’t available for it. It’s best to consult your medical insurance plan for coverage details, if applicable. Below, you’ll find ways to save on other prescription flu medicines.
Save on Tamiflu. GoodRx can help you save over 75% off the average retail price of the generic version. Generic Tamiflu’s price at certain pharmacies is as low as $24.63 with a free GoodRx discount.
Save on Xofluza. If you have commercial insurance, you may be eligible to pay as little as $30 for Xofluza using a savings card from the manufacturer.
Save on Relenza. If you’re uninsured, you may be eligible for Relenza’s patient assistance program, which offers the medication free of cost.
Do antiviral medications treat COVID?
Yes, certain antiviral medications can treat COVID. But they’re different from antiviral medications for the flu. The medications discussed above are not effective against COVID.
Paxlovid (nirmatrelvir / ritonavir) is the first-choice antiviral for mild to moderate COVID. This oral medication is FDA approved for adults at high risk of developing severe COVID. It’s also FDA authorized for high-risk adolescents age 12 and older who weigh at least 88 lbs.
Lagevrio (molnupiravir) is another COVID antiviral pill available for mild to moderate COVID. It’s FDA authorized for adults at high risk of developing severe illness. But it’s only recommended if other COVID treatments aren’t appropriate to take. For instance, if you’re unable to take Paxlovid due to a drug interaction, Lagerio may be an alternative.
Veklury (remdesivir) is another FDA-approved COVID antiviral. This IV infusion has the advantage of being safe for children from birth to age 18 who weigh at least 3.3 lbs. But it may be less convenient for adults or adolescents to receive compared to COVID antiviral pills. Veklury needs to be given in a hospital or other similar healthcare facility. You can get Paxlovid or Lagevrio at retail pharmacies with a valid prescription.
Frequently asked questions
Each antiviral medication for the flu has different recommended treatment lengths. For instance, most people take Tamiflu for 5 days for flu treatment, but a course of Xofluza is complete after a single dose. No matter which antiviral you’re taking, it’s important to take it as prescribed for the entire treatment course. Stopping them early can cause your symptoms to worsen and may mean a longer recovery time for you.
In a review of 26 clinical trials, researchers found that the four CDC-recommended antivirals all helped to shorten the length of time people experienced symptoms. But Relenza seemed to shorten the length of symptoms the most. Researchers also found that Xofluza helped to lower the risk of flu-related complications, such as pneumonia.
There are no over-the-counter (OTC) medications that can treat the flu. But they can help relieve symptoms while your immune system fights off the infection. Popular OTC flu medications include expectorants, such as guaifenesin (Mucinex), and cough suppressants, such as dextromethorphan (Delsym). Pain relievers, such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin), can be helpful for lessening body aches and reducing fever.
The bottom line
When the flu strikes, antiviral medications can help shorten the length of time you’re sick. They can also help prevent you from getting sick after being exposed to the influenza virus. Tamiflu (oseltamivir) and Xofluza (baloxavir marboxil) are oral antiviral medications for the flu. Relenza (zanamivir) is an antiviral inhaler. And Rapivab (peramivir) is an IV infusion that can be given in a clinic or hospital setting.
Discuss which option would be right for you with a healthcare professional. And don’t forget to check out GoodRx for ways to save on these antiviral medications for the flu.
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References
Alovgen. (2024). Oseltamivir phosphate for oral suspension- oseltamivir phosphate powder, for suspension [package insert]. DailyMed.
American College of Obstetricians and Gynecologists. (2024). Influenza in pregnancy: Prevention and treatment.
BioCryst Pharmaceuticals. (2024). Rapivab- peramivir solution [package insert]. DailyMed.
Centers for Disease Control and Prevention. (2022). Influenza antiviral drug resistance.
Centers for Disease Control and Prevention. (2022). Recommendations for obstetric health care providers related to use of antiviral medications for the treatment and prevention of influenza.
Centers for Disease Control and Prevention. (2023). Influenza antiviral medications: Summary for clinicians.
Centers for Disease Control and Prevention. (2024). Antigenic characterization.
Centers for Disease Control and Prevention. (2024). People at increased risk for flu complications.
Centers for Disease Control and Prevention. (2024). Treating flu with antiviral drugs.
Committee on Infectious Diseases. (2024). Recommendations for prevention and control of influenza in children, 2024–2025: Policy statement. Pediatrics.
Epic Pharma. (2024). Oseltamivir phosphate capsule [package insert]. DailyMed.
Fukao, K., et al. (2019). Baloxavir marboxil, a novel cap-dependent endonuclease inhibitor potently suppresses influenza virus replication and represents therapeutic effects in both immunocompetent and immunocompromised mouse models. PLoS One.
Genentech, Inc. (2024). Xofluza- baloxavir marboxil tablet, film coated; Xofluza- baloxavir marboxil granule, for solution [package insert]. DailyMed.
Gilead Sciences. (2024). Veklury- remdesivir injection; Veklury- remdesivir injection, powder, lyophilized, for solution [package insert]. DailyMed.
GlaxoSmithKline. (2023). Relenza- zanamivir powder [package insert]. DailyMed.
Goodsell, D., et al. (2009). Molecule of the month: Influenza neuraminidase. PDB-101.
Heneghan, C. J., et al. (2014). Zanamivir for influenza in adults and children: Systematic review of clinical study reports and summary of regulatory comments. The BMJ.
Liu, J., et al. (2021). Comparison of antiviral agents for seasonal influenza outcomes in healthy adults and children: A systematic review and network meta-analysis. JAMA.
McKimm-Breschkin, J. L. (2012). Influenza neuraminidase inhibitors: antiviral action and mechanisms of resistance. Influenza and Other Respiratory Viruses.
U.S. Food and Drug Administration. (2017). Tamiflu: Consumer questions and answers.
U.S. Food and Drug Administration. (2020). FDA expands approval of influenza treatment to post-exposure prevention.
U.S. Food and Drug Administration. (2022). Influenza (flu) antiviral drugs and related information.
Uyeki, T. M., et al. (2019). Clinical practice guidelines by the Infectious Diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenza. Clinical Infectious Diseases.
