Tamiflu vs. Xofluza: Differences Between the Flu Medications

According to the Centers for Disease Control and Prevention (CDC), the seasonal flu activity usually begins in October and can last until May. Since flu season has arrived in the middle of the COVID-19 pandemic, it is more important than ever to get a flu shot. The CDC recommends that everyone receive the flu shot by the end of October.

If you wait too long to get a shot, you may come down with the flu. If you begin to experience flu symptoms such as fever, chest congestion, body aches, cough, fatigue, headache, or a stuffy nose, it’s time to contact your health care provider to schedule a telehealth or in-office visit.

If you’re diagnosed with the flu, you may be prescribed one of two widely used antivirals, Xofluza or Tamiflu, which are designed to reduce the severity of flu symptoms and shorten the period of recovery. Here’s a look at the differences and similarities between Tamiflu and Xofluza.

Tamiflu and Xofluza to Treat the Flu

Tamiflu and Xofluza are both FDA approved to treat influenza (the flu). The flu is a viral respiratory infection, which infects millions of Americans each year. Both drugs are most effective if taken as soon as symptoms appear. Individuals who have a high risk of severe illness or complications from the flu may also take Tamiflu to prevent infection.

What is the difference between Tamiflu and Xofluza?

Tamiflu was FDA approved in 1999. The drug works by inhibiting the neuraminidase enzyme, which is expressed on the viral surface and helps release the virus from the infected cells, thereby effectively stopping the virus from moving to other cells.

Tamiflu is approved for the treatment of flu in patients as young as 14 days old. Tamiflu is also approved for the prevention of flu in patients 1 year and older who have been exposed to the flu but are not showing symptoms.

Xofluza received FDA approval in 2018. This antiviral works by blocking the polymerase acidic protein, which is an essential component in the virus replication process, resulting in blocking the virus from making copies of its own. It effectively stops the virus before it has the power to become worse. Xofluza is only approved as a treatment for flu in patients 12 years and older who weigh at least 88 pounds (40 kilograms).

Is Tamiflu or Xofluza more effective for treating the flu?

In clinical trials both Tamiflu and Xofluza have proven to be effective at reducing the severity of flu symptoms. Both are also effective in shortening the duration of symptoms. If you think you have the flu, contact your health care provider to discuss which flu medication may be best for you, considering potential side effects, underlying health conditions, and other medications you’re taking.

Tamiflu and Xofluza Dosage

The dosage and duration of Tamiflu and Xofluza are different. For Tamiflu, the standard schedule is twice daily for five days for flu treatment. When used for prevention, the schedule is once daily for seven to ten days.

Tamiflu dosage is dependent on the patient’s weight for children and whether the patient has other chronic or acute conditions, such as kidney disease or pneumonia.

Xofluza is available as a standard one-day schedule, so it’s advantageous for people who prefer a shorter course of medication.

Side effects of Tamiflu and Xofluza

Both Tamiflu and Xofluza may produce side effects, so discuss any concerns you have with your health care provider. Most side effects are mild, and only affect a small percentage of those who take the medications.

The most commonly reported side effects of Tamiflu include:

• Headache
• Nausea
• Vomiting

Rare, but potentially serious side effects of Tamiflu include:

• Skin rashes
• Delirium
• Abnormal behavior

The most commonly reported side effects of Xofluza include:

• Nausea
• Headache
• Diarrhea
• Bronchitis
• Sinusitis

Rare, but potentially serious side effects of Xofluza may include:

• Red, itchy skin
• Bacterial infections

If you experience any serious side effects from Tamiflu or Xofluza, contact your healthcare provider immediately.

Cost Comparison of Tamiflu and Xofluza

Both Tamiflu and Xofluza require a prescription, so you cannot purchase them over the counter. Most insurance plans will typically cover Xofluza and Tamiflu, though you’ll need to confirm your coverage, and copay responsibility.

Depending upon your coverage, you may want to forgo using your insurance and use a RxSaver prescription drug coupon in its place. Using a coupon to purchase oseltamivir phosphate (the generic for Tamiflu), or Xofluza may reduce the price to less than your copay.

Tamiflu and Xofluza Drug Interactions

Most medications come with some risk of drug interactions. Tamiflu and Xofluza may interact with medications, and also with certain flu vaccinations.

Flu Vaccine Interaction

Tamiflu and Xofluza may interact with the live, attenuated flu vaccine because they are antiviral medications. To maximize the efficacy of the flu shot, do not take Xofluza or Tamiflu for at least 14 days after receiving the flu shot. Wait at least two days after beginning to take Tamiflu or Xofluza to receive the flu shot.

Medication Interaction

Your healthcare provider needs to know all medication you’re currently taking before prescribing Tamiflu or Xofluza. Some of the medications that may interact with Tamiflu include:

• Alimta
• Methotrexate
• Probenecid
• Entecavir
• Warfarin

Medications that contain polyvalent cations may interact with Xofluza, reducing the effectiveness of it. Speak with your healthcare provider to learn if any antacids, laxatives, or supplements containing iron, calcium, zinc, selenium, or calcium may interact with Xofluza.

Warnings About Tamiflu and Xofluza

Individuals with allergies to the ingredients in Tamiflu and Xofluza should not take either antiviral medication. Individuals with moderate to end-stage chronic kidney disease should not take Tamiflu. Pregnant women need to discuss benefits and risks with their doctor before taking Tamiflu or Xofluza.

Staying Healthy During Flu Season

By getting your annual flu shot, you can help maintain health during the flu season. Other simple measures to take to increase your chances of staying healthy during flu season include eating a balanced diet, exercising regularly, getting plenty of sleep, washing your hands frequently, and avoiding close contact with others. Wearing a mask to prevent COVID-19, may also help prevent you from getting the flu.

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Tamiflu: 30 mg / 30 capsules
Oseltamivir: 30 mg / 30 capsules
Xofluza: 40 mg / 2 tablets

*Lowest online price at national pharmacy chains Costco, CVS, RiteAid, Walgreens and Walmart as of 9/21/2021. Prices vary by location and pharmacy, see RxSaver.com for actual pricing in your area.