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Baloxavir marboxil

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Baloxavir marboxil, Xofluza

  • Indications
  1. Influenza
    1. Alternative to Oseltamivir (Tamiflu)
  • Mechanism
  1. Cap-dependent endonuclease inhibitor
  2. Some RNA Viruses (including Influenza) replicate via cap snatching
    1. Virus extracts first 15-20 of host RNA residues which is used as 5' cap on virus RNA
    2. Virus RNA polymerase has endonuclease functionality used in cap snatching
  • Dosing
  1. One single oral dose
  • Efficacy
  1. May shorten Influenza symptoms by up to 1 day if started within 48 hours
  2. No evidence for benefit in high risk patients (under age 2, over age 65, pregnancy)
  • Adverse Effects (in 1-3% of patients)
  • Drug Interactions
  1. Agents that decrease absorption (e.g. calcium, aluminum or iron salts)
  • References
  1. (2018) Presc Lett 25(12): 67