Why Drug Interactions Matter with Xofluza

Xofluza (baloxavir marboxil) is a single-dose flu treatment, which means you only get one shot at getting the full benefit. If something interferes with how your body absorbs the medication, it may not work as well — and you can't simply take another dose.

That's why understanding Xofluza's drug interactions is especially important. The good news is that Xofluza has a relatively short list of interactions compared to many medications. The bad news is that some of the most common ones involve everyday items like dairy products and multivitamins.

How Do Xofluza Interactions Work?

The most significant interactions with Xofluza involve polyvalent cations — minerals like calcium, iron, magnesium, selenium, and zinc. These minerals can bind to Xofluza in your digestive system and significantly reduce how much of the medication actually gets absorbed into your bloodstream.

This is called a chelation interaction. Think of it like the mineral grabbing onto the medication and preventing your body from using it. Since Xofluza is a single-dose treatment, reduced absorption could mean reduced effectiveness against the flu.

Major Interactions: What to Avoid

The following substances can significantly reduce Xofluza levels in your blood and should be avoided around the time you take your dose:

Polyvalent Cation-Containing Supplements

• Calcium supplements
• Iron supplements
• Magnesium supplements
• Selenium supplements
• Zinc supplements
• Multivitamins containing any of the above minerals

Do not take these supplements at the same time as Xofluza. The prescribing information advises avoiding these products altogether when taking the medication. If you take a daily multivitamin or mineral supplement, skip it on the day you take Xofluza and talk to your doctor about when to resume.

Antacids Containing Polyvalent Cations

• Aluminum/magnesium antacids (such as Maalox, Mylanta)
• Calcium carbonate antacids (such as Tums)

If you have heartburn or acid reflux and normally take antacids, avoid them on the day you take Xofluza. Talk to your pharmacist about alternative heartburn relief options (like famotidine/Pepcid, which does not contain polyvalent cations).

Polyvalent Cation-Containing Laxatives

• Magnesium-based laxatives (such as milk of magnesia)

Avoid these around the time of your Xofluza dose.

Food and Drink Interactions

This is where many patients are caught off guard. Certain common foods and beverages can reduce Xofluza absorption:

• Dairy products: Milk, cheese, yogurt, ice cream — anything with significant calcium content.
• Calcium-fortified beverages: Many orange juices, plant-based milks (almond milk, oat milk, soy milk), and other drinks are fortified with calcium. Check the label.

Practical tip: Take Xofluza with plain water. Avoid dairy products and calcium-fortified drinks for several hours before and after your dose. Since it's a single dose, this is only a one-time precaution.

Vaccine Interaction

Xofluza has one notable interaction with a specific flu vaccine:

• Live attenuated influenza vaccine (LAIV/FluMist): Because Xofluza stops flu virus replication, it can also inhibit the weakened virus in the live nasal spray vaccine, making the vaccine less effective. Avoid taking Xofluza within 2 weeks before or 48 hours after receiving FluMist.

This does not apply to the standard injectable flu shot (inactivated influenza vaccine), which uses killed virus and is not affected by Xofluza.

Over-the-Counter Medications

Common OTC flu remedies are generally safe to take with Xofluza, with the exception of mineral-containing products noted above. The following are typically fine:

• Acetaminophen (Tylenol) — for fever and pain
• Ibuprofen (Advil, Motrin) — for fever, pain, and inflammation
• Dextromethorphan (Delsym) — for cough
• Guaifenesin (Mucinex) — for congestion
• Pseudoephedrine (Sudafed) — for nasal congestion

However, always check ingredient labels on combination cold/flu products. Some may contain added minerals or calcium. When in doubt, ask your pharmacist.

What to Tell Your Doctor

Before taking Xofluza 80 Mg Dose Pack, make sure your healthcare provider and pharmacist know about:

• All prescription medications you currently take
• All over-the-counter medications, including antacids, laxatives, and cold/flu products
• All vitamins and supplements, especially multivitamins and mineral supplements
• Any recent or upcoming vaccinations, particularly the nasal spray flu vaccine (FluMist)
• Any allergies to medications or their ingredients

Because Xofluza is typically prescribed during an urgent sick visit, it's easy to forget to mention your regular supplements. Take a moment to think through everything you take daily — or bring a list.

Final Thoughts

Xofluza 80 Mg Dose Pack has fewer drug interactions than many medications, but the ones it does have are important. The biggest thing to remember: avoid dairy products, calcium-fortified drinks, mineral supplements, and antacids containing calcium, magnesium, aluminum, iron, selenium, or zinc around the time you take your dose.

Since Xofluza is a single-dose treatment, these precautions only apply once. Take it with plain water, skip your multivitamin that day, and let the medication do its job.

For more information about Xofluza, see our guides on side effects, how it works, and how to save money. Ready to fill your prescription? Use Medfinder to find a pharmacy with Xofluza in stock.