Baloxavir marboxil

Administration
  • Type: Antiviral
  • Dosage Forms: 20 mg, 40 mg tab
  • Routes of Administration: PO
  • Common Trade Names: Xofluza

Indications

Adult Dosing
  • 40-79.9 kg: 40 mg PO x1
    • Start within 48 hours of symptom onset
    • Avoid co-administration with dairy products, calcium supplements
  • >80 mg: 80 mg PO x1
    • Start within 48 hours of symptom onset
    • Avoid co-administration with dairy products, calcium supplements

Pediatric Dosing
  • Approved for use in pediatric patients 12 and older
  • 40-79.9 kg: 40 mg PO x1
    • Start within 48 hours of symptom onset
    • Avoid co-administration with dairy products, calcium supplements
  • >80 mg: 80 mg PO x1
    • Start within 48 hours of symptom onset
    • Avoid co-administration with dairy products, calcium supplements

Special Populations

Renal Dosing
  • Adult and Pediatric:
    • CrCl>50: no adjustment
    • CrCl<50 or HD/PD: not defined

Hepatic Dosing
  • Adult and Pediatric:
    • Child-Pugh Class A or B: no adjustment
    • Child-Pugh Class C: not defined

Contraindications
  • Allergy to class/drug
  • Pregnancy
  • Breastfeeding

Adverse Reactions

Serious

Common
  • Nausea (Especially in older patients)

Pharmacology
  • Half-life: 79.1 hours
  • Metabolism: liver (CYP450)
  • Excretion: Feces (predominant), urine[1]

Mechanism of Action
  • Inhibits viral polymerase acidic protein endonuclease activity, which inhibits viral replications

Comments

Only approved for patients >12 years old and >40kg in weight, no current safety data exists for pregnancy and breastfeeding.[2] More expensive but one time dosing. Genentech, its creator, states a recent phase III trial has shown it to be effective for prophylaxis but not currently FDA indicated for this.[3]

See Also

References
  1. Baloxavir marboxil [monograph]. Epocrates Version. 20.2 [iPhone]. Epocrates, Inc, San Francisco, CA. Available from https://online.epocrates.com/. Accessed March 18, 2020.
  2. https://www.cdc.gov/flu/treatment/baloxavir-marboxil.htm
  3. https://www.gene.com/download/pdf/xofluza_prescribing.pdf
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