Will Xofluza Help You Recover from the Flu Faster?

According to the CDC, seasonal influenza activity remains elevated across most of the country. Doctors often prescribe oseltamivir, also known by the brand name Tamiflu, to try to help patients recover more quickly. But Xofluza (baloxavir) was approved by the FDA in the fall of 2018. A new study suggests that Xofluza is more effective than Tamiflu (JAMA Internal Medicine, Jan. 13, 2025). How good is it?

The FDA’s Official Prescribing Information for Xofluza:

Here is what the FDA required the company to say about the latest influenza medicine:

“XOFLUZA is indicated for treatment of acute uncomplicated influenza in patients 5 years of age and older who have been symptomatic for no more than 48 hours and who are otherwise healthy or at high risk of developing influenza-related complications.

“XOFLUZA is indicated for the reduction of influenza transmission from patients 5 years of age and older who have been symptomatic for no more than 48 hours.

“XOFLUZA is indicated for post-exposure prophylaxis of influenza in persons 5 years of age and older following contact with an individual who has influenza.”

How Good Is  Xofluza At Speeding Recovery?

Investigators reviewed data from 73 trials of baloxavir involving 34,332 participants (JAMA Internal Medicine, Jan. 13, 2025). Their conclusions are hardly overwhelming or convincing.

It would be best if we let the authors of this article speak for themselves:

“All antivirals had little or no effect on admission to hospital for low-risk patients.”

So, if you are relatively healthy, it not clear that Xofluza would will keep you out of the hospital.

What about symptom relief? The authors state:

“For time to alleviation of symptoms, baloxavir likely reduced symptom duration; oseltamivir [Tamiflu] and zanamivir [Relenza] likely had no important effect; and umifenovir may have reduced symptom duration. Baloxavir did not increase adverse events related to treatment but may have resulted in resistance in approximately 10% of those treated. Oseltamivir likely increased risk of adverse events related to treatment.”

The Bottom Line:

The authors of this overview conclude:

“Baloxavir likely reduces time to alleviation of symptoms by 1.02 days, does not increase adverse events related to treatment, but it may be associated with the emergence of resistance in approximately 10% of those treated. “

Did that sink in? Xofluza would apparently shorten the duration of the flu by about one day. Not all that impressive, eh?

What about Tamiflu?

“Oseltamivir was found to have little or no effect on mortality and admission to hospital, likely has no important effect on time to alleviation of symptoms, and likely increases risk of adverse events related to treatment. All other antiviral drugs are either likely not to be beneficial or have uncertain effects on patient-important outcomes.”

The key words are:

“…likely has no important effect on time to alleviation of symptoms…”

How Much Does Xofluza Cost?

The dose this antiviral medicine according to the official prescribing information is:

“XOFLUZA should be taken as a single dose as soon as possible and within 48 hours of influenza symptom onset for treatment of acute uncomplicated influenza, reduction of influenza transmission, or following contact with an individual who has influenza.”

So, one and done when it comes to Xofluza. And how much would that 1 pill cost? According to GoodRx.com, one tablet of Xofluza has a retail price of around $200. With a coupon, you might get that down to around $180. Is that worth it to buy one day quicker recovery? That’s a question that only you can answer.

More Xofluza Details Including Side Effects:

This medication works on a completely different viral enzyme than Tamiflu and Relenza. Consequently, flu viruses may not yet have developed substantial resistance to the drug. That said, the investigators writing in JAMA Internal Medicine stated:

“Baloxavir did not increase adverse events related to treatment but may have resulted in resistance in approximately 10% of those treated.”

Side effects of baloxavir include diarrhea, bronchitis, nausea and sinusitis.

What Should You Do About the Flu?

Because Xofluza, like older flu medicines, is most effective when taken within the first 48 hours of symptoms, you should discuss it with your doctor now, before flu season gets worse. In addition, it makes sense to continue careful hand washing throughout the season, possibly combined with wearing a face mask. (You can learn more about the relevant research on these preventive approaches here.) In addition, you might consider drinking green tea or even gargling with it, as we describe here.

Be sure to get the sleep you need, and keep your vitamin D levels up. You can learn about how to make ginger tea by watching our new YouTube video at this link. And if you like natural approaches, here is a link to our eGuide to Colds, Coughs and the Flu. All of our Health eGuides can be found under this tab.

Please share your own experience with Xofluza, Tamiflu or a different flu survival strategy.