Xofluza vs. Tamiflu: How Do These Prescription Flu Medications Compare?
Key takeaways:
Tamiflu (oseltamivir) and Xofluza (baloxavir marboxil) are two well-known medications that can help treat and prevent the flu. They have many similarities, including effectiveness and common side effects. And they both work best when taken within 48 hours of your first flu symptoms.
Tamiflu is considered a safer choice than Xofluza for infants and pregnant women. Xofluza only requires one dose to work, so it may be a more convenient option.
Tamiflu and Xofluza are both available as brand-name medications. But you can also find Tamiflu as a lower-cost generic. GoodRx can help make your prescription more affordable.
Access savings on related medications
Table of contents
Every year, millions of people in the U.S. will get sick with the seasonal flu. This respiratory illness causes various symptoms, such as fever, severe body aches, and a cough. For certain people, the flu can also lead to complications that require hospitalization.
While you may do everything you can to try to prevent catching it, there’s still a chance you’ll get sick this flu season. Thankfully, there are two oral prescription medications that can help shorten the amount of time you’re sick: Xofluza (baloxavir marboxil) and Tamiflu (oseltamivir).
Tamiflu and Xofluza are two of the most well-known medications used to treat the flu. They’re both antiviral medications and have been shown to help you feel better quicker. But, what’s the difference between them, and is one better than the other?
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How does Tamiflu work?
When the influenza virus enters your body, it uses your cells to make copies of itself. You can think of your body as a virus copy machine. Tamiflu works by stopping those copies from leaving your cells and making you sicker.
Tamiflu is FDA approved to treat the flu in adults and children who are at least 2 weeks old. It’s also approved to prevent you from getting sick if you’ve been in close contact with someone who has the flu. When used for flu prevention, it can be given to adults and children ages 1 year and older.
Tamiflu is the first-choice flu antiviral for infants and pregnant women. There are many studies available that have found it safe and effective for these groups.
Curious about flu activity this season? Follow GoodRx’s live tracker to see weekly trends for flu-related prescriptions and how they compare with previous flu seasons.
Can you get the flu from a flu shot? A flu vaccine is the best way to stay healthy during flu season. Here’s why you may feel crummy for a day or so after getting vaccinated (spoiler alert: it’s not the flu).
The best flu vaccine for you: Pharmacists review the available flu vaccines and how effective they might be.
For Tamiflu to be most effective, you should start taking it within 48 hours (2 days) of first feeling symptoms. That’s why it’s important to see a healthcare professional for a flu test as soon as possible if you think you’re getting sick.
Typical dosage
You can take Tamiflu with or without food, and it’s available as both an oral capsule and liquid.
People 13 years of age and older typically take 75 mg of Tamiflu per dose. The Tamiflu dosage for children under 13 years old depends on the child’s age and body weight:
Child’s age | Child’s body weight | Tamiflu dose |
|---|---|---|
2 weeks to 1 year old | Any weight | 3 mg/kg of body weight |
1-12 years old | 33 lbs (15 kg) or less | 30 mg per dose |
1-12 years old | 33.2-50.6 lbs (15.1-23 kg) | 45 mg per dose |
1-12 years old | 50.8-88 lbs (23.1-40 kg) | 60 mg per dose |
1-12 years old | 88.2 lbs (40.1 kg) or more | 75 mg per dose |
If you’re taking Tamiflu to treat the flu, you’ll take one dose by mouth twice a day for 5 days. If you’re taking it to help prevent the flu, you’ll take it once a day for at least 10 days. If there’s an outbreak of the flu in your community, you can take Tamiflu once a day for up to 6 weeks, if needed. Some people may be advised to take it for longer. But Tamiflu isn’t approved to prevent the flu in children under 1 year old.
How does Xofluza work?
Xofluza works differently from Tamiflu. It actually stops the influenza virus from being able to make copies of itself. Xofluza is also FDA approved to both treat and prevent the flu. But it’s approved for different age groups than Tamiflu.
Xofluza is approved to treat and prevent the flu in adults and children ages 5 years and older. This includes people who are otherwise healthy, as well as those at high risk for flu complications.
Like Tamiflu, you should start taking Xofluza within 48 hours of first feeling symptoms in order for it to work its best. But unlike Tamiflu, Xofluza shouldn’t be given to very young children or pregnant women. There isn’t enough safety information available yet for experts to recommend it for these groups.
Typical dosage
The thing that many people like about Xofluza is that you only have to take one dose for it to work. That’s right. You take just one dose compared to the 10 or more required doses of Tamiflu.
Xofluza comes as both an oral tablet and a liquid. The dosage for Xofluza depends on your body weight. And it’s the same for both flu treatment and prevention.
The recommended Xofluza dosages are as follows:
Body weight | Tablet dose | Oral liquid dose |
176 lbs (80 kg) or more | 80 mg | 40 mL |
44-176 lbs (20-80 kg) | 40 mg | 20 mL |
Less than 44 lbs (20 kg) | Only use liquid form | 2 mg/kg of body weight |
You can take Xofluza with or without food. But you should separate it from dairy products or anything containing calcium (such as vitamins, antacids, and foods or beverages with added calcium).
Which medication is more effective?
Whether you take Xofluza or Tamiflu, you can expect a similar result.
Both of these medications will help you feel better about 1 to 2 days faster than if you didn’t take anything. Experts have found that people who take Xofluza feel better about 8 hours faster than those who take Tamiflu. However, those results weren’t statistically significant (meaning the difference could have happened by chance). If you’re looking to feel better as fast as possible, Xofluza might be the better option — but not by much.
What are common side effects of Tamiflu?
Tamiflu doesn’t cause many side effects. The most common side effects are nausea and vomiting. You can help lessen or prevent these by taking Tamiflu with food, preferably a full meal. Less common side effects include headache and diarrhea.
What are common side effects of Xofluza?
Xofluza has more possible side effects than Tamiflu, but they happen much less frequently. Actually, in studies, those people who took placebo pills (pills with no medication in them) reported side effects more often than those who took Xofluza.
Diarrhea and bronchitis (tight airways) were the side effects most commonly reported during Xofluza’s clinical trials. People also reported nausea, sinus problems, and headaches.
How can you save on Tamiflu and Xofluza?
Tamiflu and Xofluza are available as brand-name medications. But you can also find Tamiflu as a lower-cost generic. GoodRx can help you navigate the many ways to save on your prescription.
Save with GoodRx. GoodRx can help you save over 70% off the average retail price of the generic version of Tamiflu. Generic oseltamivir’s price at certain pharmacies is as low as $24.63 with a free GoodRx discount.
Save with a copay savings card. If you have commercial insurance and meet eligibility requirements, Xofluza’s price is as little as $30 if you use the manufacturer’s savings card.
Can you get medications like Xofluza and Tamiflu over the counter?
Unfortunately, neither Tamiflu nor Xofluza are available over the counter (OTC). All antiviral medications for the flu require a prescription from a healthcare professional. Telehealth services are available to help get you connected with a prescriber from the comfort of your home. GoodRx Care offers flu treatment services to help you get a prescription as quickly as possible.
The only OTC alternatives to Tamiflu or Xofluza are medications to help manage your flu symptoms. These include:
Pain and fever reducers, such as acetaminophen (Tylenol)
Decongestants, such as pseudoephedrine (Sudafed)
Antihistamines for runny nose and to help you sleep, such as diphenhydramine (Benadryl)
Cough medications, such as dextromethorphan (Delsym)
You can take OTC flu medications along with an antiviral treatment. Just be sure to OK the ingredients with your prescriber or pharmacist first.
Can Xofluza or Tamiflu help treat COVID-19?
No. Tamiflu and Xofluza aren’t effective for treating COVID-19. SARS-CoV-2 (the virus that causes COVID) doesn’t have the same structure as the influenza virus. Xofluza and Tamiflu attack structural parts that are unique to the influenza virus. So they aren’t effective against any other type of infection.
The bottom line
Both Xofluza (baloxavir marboxil) and Tamiflu (oseltamivir) are effective medications used to treat and prevent the flu. Xofluza may be less likely to cause side effects, and only requires a single dose. But Tamiflu is preferred for pregnant women and very young children.
No matter which medication you end up taking, they work best if you start them within 48 hours of your first flu symptoms. Also, remember to stay home until you’re feeling better to help prevent spreading the flu to others. Rest up, and feel better soon!
Why trust our experts?
References
Centers for Disease Control and Prevention. (2022). Influenza antiviral drug baloxavir marboxil.
Centers for Disease Control and Prevention. (2024). Key facts about seasonal flu vaccine.
Centers for Disease Control and Prevention. (2024). People at increased risk for flu complications.
Committee on Infectious Diseases. (2023). Recommendations for prevention and control of influenza in children, 2023–2024. Pediatrics.
Genentech, Inc. (2024). Xofluza [package insert].
Ng, K. E. (2019). Xofluza (baloxavir marboxil) for the treatment of acute uncomplicated influenza. Pharmacy and Therapeutics.
Redpharm Drug. (2019). Tamiflu-oseltamivir phosphate capsule [package insert].
