Difference between revisions of "Baloxavir marboxil"

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==Administration==
 
==Administration==
*Type:  
+
*Type: [[Antiviral]]
*Dosage Forms:
+
*Dosage Forms: 20 mg, 40 mg tab
*Routes of Administration:
+
*Routes of Administration: PO
*Common Trade Names:  
+
*Common Trade Names: Xofluza
 +
 
 +
==Indications==
 +
* [[Influenza]]
  
 
==Adult Dosing==
 
==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==
 
==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==
 
==Special Populations==
===[[Drug pregnancy categories|Pregnancy Rating]]===
+
*[[Pregnancy Category]]: Not assigned (insufficient data)
*
+
*[[Lactation risk]]: Avoid use while breastfeeding
 
 
===Lactation risk===
 
*
 
  
 
===Renal Dosing===
 
===Renal Dosing===
*Adult:
+
*Adult and Pediatric:  
*Pediatric:
+
**CrCl>50: no adjustment
 +
**CrCl<50 or HD/PD: not defined
  
 
===Hepatic Dosing===
 
===Hepatic Dosing===
*Adult:
+
*Adult and Pediatric:
*Pediatric:
+
**Child-Pugh Class A or B: no adjustment
 +
**Child-Pugh Class C: not defined
  
 
==Contraindications==
 
==Contraindications==
 
*Allergy to class/drug
 
*Allergy to class/drug
 +
*Pregnancy
 +
*Breastfeeding
  
 
==Adverse Reactions==
 
==Adverse Reactions==
 
===Serious===
 
===Serious===
 
+
*[[Anaphylaxis]]
 +
*[[Angioedema]]
 +
*[[Erythema multiforme]]
 +
*[[Urticaria]]
  
 
===Common===
 
===Common===
 
+
*Nausea (Especially in older patients)
  
 
==Pharmacology==
 
==Pharmacology==
*Half-life:  
+
*Half-life: 79.1 hours
*Metabolism:  
+
*Metabolism: liver (CYP450)
*Excretion:  
+
*Excretion: Feces (predominant), urine<ref>Baloxavir marboxil [monograph]. Epocrates Version. 20.2 [iPhone]. Epocrates, Inc, San Francisco, CA. Available from https://online.epocrates.com/. Accessed March 18, 2020.</ref>
  
 
==Mechanism of Action==
 
==Mechanism of Action==
 
+
*Inhibits viral polymerase acidic protein endonuclease activity, which inhibits viral replications
  
 
==Comments==
 
==Comments==
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==See Also==
 
==See Also==
 
+
*[[Influenza]]
 +
*[[Antiviral]]
 +
*[[Tamiflu]]/[[Oseltamivir]]
  
 
==References==
 
==References==

Latest revision as of 14:49, 18 March 2020

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