Every year, millions of people in the U.S. will get sick with the seasonal flu, a respiratory illness that causes symptoms like fever, body aches, and a dry cough. For certain people, the flu can also lead to complications that require hospitalization. While you may do everything you can to try to prevent catching it, there’s still a chance you’ll get sick this flu season. Thankfully, there are two oral prescription medications that can help shorten the amount of time you are sick: Tamiflu and Xofluza.
Tamiflu (oseltamivir) and Xofluza are two of the most well-known medications used to treat the flu. They are both antiviral medications and have been shown to help you feel better quicker. But, what’s the difference between them and is one better than the other?
How does Tamiflu work?
When a virus enters your body, it uses your cells to make copies of itself — you can think of your body as a virus copy machine. Tamiflu works by stopping those copies from leaving your cells and making you more sick. It is approved to both treat the flu and prevent you from getting it if you’ve been in close contact with someone who has the flu, such as a family member. You have to start taking it within 48 hours of first feeling symptoms for it to work, so it’s important to see a healthcare provider for a flu test as soon as possible if you think you’re sick.
Typical dosing
Tamiflu can be taken with or without food, and is available as both a capsule and a liquid. It can be given to adults and children as young as 2 weeks old. The strength given to people over 13 years old is 75 mg. The strength for children under 13 years old depends on the child’s weight.
If you are using Tamiflu to treat the flu, you’d take it by mouth twice a day for 5 days. If you are taking it to help protect you from getting the flu, you’d take it by mouth once a day for at least 10 days. If there is an outbreak of the flu in your community, you can take it once a day for up to 6 weeks, if needed.
How does Xofluza work?
Xofluza works differently from Tamiflu. It actually stops the influenza virus from being able to make copies of itself. Currently, it’s only approved to treat the flu (not prevent it). Like Tamiflu, Xofluza also needs to be started within 48 hours of first feeling symptoms in order to work. Right now, it can only be prescribed to people 12 years of age or older.
Typical dosing
The thing people like most about Xofluza is that you only have to take one dose for it to work. That’s right. You take one dose compared to the 10 doses of Tamiflu. You will either be prescribed 20 mg or 40 mg tablets depending on your weight, and you take the tablets by mouth at the same time.
While you can take Xofluza with or without food, you should separate it from dairy products or anything containing calcium (like vitamins, antacids, and foods or beverages with calcium added to them) by a few hours.
Unfortunately, there is no liquid version of Xofluza available yet and the tablets cannot be crushed, so this might cause some problems if you can’t swallow pills.
Which medication is more effective?
Both of these medications will help you feel better about 1 to 2 days faster than if you didn’t take anything. Experts have found that people who take Xofluza feel better about 8 hours faster than those who take Tamiflu, though those results were not significant (meaning the difference could have happened by chance). If you’re looking to feel better as fast as possible, Xofluza might be the better option but not by much.
Unfortunately, however, all that glitters is not gold. After being approved by the FDA in 2018, scientists are already seeing mutated strains of the flu that are resistant to Xofluza (meaning the virus outsmarted the medication so it no longer works). There are also mutated strains that are resistant to Tamiflu, which was approved in 1999.
All in all, whether you take Xofluza or Tamiflu, you can expect about the same result.
What are common side effects of Tamiflu?
Tamiflu doesn’t cause many side effects. The most common side effects are nausea and vomiting. You can help prevent these by taking your doses with something to eat, preferably a full meal. Some people might also have a headache after taking Tamiflu.
What are common side effects of Xofluza?
Xofluza has more possible side effects than Tamiflu, but they happen much less frequently. Actually, in studies, those people who took placebo pills (pills with no medication in it) had side effects more often than those who took Xofluza! While diarrhea and nausea are the side effects you would most likely experience, it’s also possible for Xofluza to cause bronchitis, sinus problems, or a headache.
How much do they cost?
This is the part that might end up being the deciding factor for you and your healthcare provider when it comes to choosing Tamiflu or Xofluza. Tamiflu is available as a generic, so its price is much lower. If your insurance doesn’t cover it, you may be able to save with GoodRx. The lowest price for a course of the generic version of Tamiflu, oseltamivir, is currently about $26.
Xofluza, on the other hand, is pretty pricey since it has no generic available yet. The average retail price for 2 tablets of 40 mg each is currently $182, and the lowest GoodRx price is about $156. Be sure to check with your insurance provider to see if both medications are covered and what your copays would be.
Are they available over the counter?
Unfortunately, neither Tamiflu nor Xofluza are available over the counter. Because there is such a short window of time when you can take these for them to still be effective, a healthcare provider will need to write a prescription for you. To help prevent medication resistance from forming, your provider will most likely want to run a test to make sure you have the flu before prescribing anything. There are many viruses that cause similar symptoms to the flu, and these medications won’t help those infections.
Can Xofluza or Tamiflu help treat COVID-19?
COVID-19 is a rapidly developing situation, so it’s possible the information in this section could change. As of September 2020, this is the most up-to-date information available.
Because both Xofluza and Tamiflu are antiviral drugs, scientists and healthcare providers wondered if they could also help treat COVID-19. Unfortunately, neither have shown any promise with this. SARS-CoV-2 (the virus that causes COVID-19) does not have the same structure as the influenza virus. Xofluza and Tamiflu attack structural parts that are unique to the flu.
The bottom line
Both Xofluza and Tamiflu are effective medications used to treat the flu. While Xofluza is less likely to cause side effects, Tamiflu can be given to children under 12 and its generic version is typically much cheaper than Xofluza. No matter which medication you end up taking, though, just remember to stay home until you’re better to help prevent spreading the flu to others. Rest up, and feel better soon!
