Xofluza vs. Tamiflu: 5 Similarities and Differences to Consider

Every year, millions of people in the U.S. get sick with the seasonal flu. Symptoms such as fever, body aches, and cough can last for several days. And for some people, the flu can cause serious complications.

Xofluza (baloxavir marboxil) and Tamiflu (oseltamivir) are two prescription antiviral flu medications. Both can help you recover from the flu sooner. They can also help prevent you from getting the flu if you’ve been exposed to it.

But Xofluza and Tamiflu aren’t interchangeable. They differ in how they work, how many doses you need to take, and who can safely take them. Here are five things to consider when comparing Xofluza versus Tamiflu.

1. Xofluza and Tamiflu fight the flu virus in different ways

When the influenza virus enters your body, it takes over your cells to make copies of itself. It then releases these copies to take over more cells and continue the process. Tamiflu and Xofluza both stop this process, but in slightly different ways.

Tamiflu works by blocking an enzyme (protein) called neuraminidase. This enzyme helps release newly formed virus particles from infected cells. By blocking it, Tamiflu makes it harder for the infection to spread to other cells.

Xofluza works differently. It blocks an enzyme called endonuclease. This enzyme helps the influenza virus make copies of itself. So Xofluza stops the virus from replicating and spreading.

2. Xofluza requires just 1 dose, while you’ll typically take Tamiflu for 5 days

One of the biggest differences between Xofluza and Tamiflu is how you take them.

Xofluza requires just 1 dose to treat or prevent the flu. It comes in tablets and an oral liquid. Your Xofluza dose is based on your body weight, and you can take it with or without food. But you shouldn’t take Xofluza with dairy or products that contain calcium. This includes certain vitamins, antacids, and calcium-fortified food and drinks. These products can prevent your body from absorbing Xofluza properly.

Tamiflu requires more doses than Xofluza. You’ll typically take Tamiflu twice a day for 5 days to treat the flu. To prevent the flu, you’ll typically take Tamiflu once daily for at least 10 days. Tamiflu comes as a capsule and an oral liquid. You can take it with or without food, and unlike Xofluza, Tamiflu doesn’t interact with calcium.

If you have trouble remembering to take medication or simply prefer fewer doses, Xofluza may be more convenient.

3. Tamiflu is preferred over Xofluza for young children and during pregnancy

Tamiflu and Xofluza are approved for different age groups.

Xofluza is FDA approved to treat and prevent the flu in adults and children ages 5 and older. Tamiflu is FDA approved to treat the flu in adults and children ages 2 weeks and older. It’s also approved to prevent the flu in adults and children ages 1 and older. This makes Tamiflu the preferred antiviral to treat and prevent the flu in infants and young children.

Another important difference between Xofluza and Tamiflu is their use during pregnancy.

Tamiflu is the preferred flu antiviral if you’re pregnant. There’s a large amount of safety information available on its use during pregnancy. And Tamiflu reduces the risk of flu-related complications, which are more concerning if you get the flu while you’re pregnant.

Xofluza, on the other hand, isn’t recommended during pregnancy. There isn’t enough information available to know whether it’s safe or effective.

4. Xofluza and Tamiflu offer similar benefits for treating the flu

When it comes to helping you recover from the flu, there isn’t a major difference between Xofluza and Tamiflu.

Both medications can help you feel better about 1 to 2 days sooner than you would without antiviral treatment. And both work best when you start taking them within 48 hours (2 days) of developing flu symptoms.

In one study, people who took Xofluza recovered about 8 hours sooner than people who took Tamiflu. But this difference wasn’t statistically significant, meaning it could have been due to chance.

5. Xofluza seems less likely to cause side effects than Tamiflu, but both are well tolerated

Both Xofluza and Tamiflu are generally well tolerated. But side effects may be less likely with Xofluza.

The most common Tamiflu side effects are nausea and vomiting. Taking Tamiflu with food can typically help reduce these effects.

Xofluza side effects include diarrhea, nausea, and sinus problems. But side effects appear to be less common overall after taking Xofluza than Tamiflu. In fact, during studies, people taking a placebo (pill with no medication) actually reported side effects more often than people taking Xofluza.

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 find 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. The price of 10 generic oseltamivir 75 mg capsules at certain pharmacies is as low as $21.96 with a free GoodRx discount.

• Save with a copay savings card. If you have commercial insurance, you can pay as little as $35 for a dose of Xofluza with a copay savings card from the manufacturer. Manufacturer savings are also available if you’re uninsured or underinsured.

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Written by:

Christina Aungst, PharmD, MWC

Christina Aungst, PharmD, MWC is a senior pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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