Xofluza (baloxavir) is a prescription drug used to treat or help prevent influenza (“flu”) in certain people. This drug can interact with other medications and supplements. For example, Xofluza can interact with antacids and calcium supplements.
Xofluza is used in adults and certain children to:
Xofluza contains the active ingredient baloxavir marboxil. (An active ingredient is what makes a drug work.) Xofluza comes as an oral tablet and an oral suspension (a type of liquid mixture).
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Xofluza’s possible interactions. And for more information about Xofluza, including details about its uses, see this article.
Before you take Xofluza, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Xofluza interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Xofluza?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with Xofluza. Keep in mind that this table doesn’t include all drugs that may interact with Xofluza. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug group | Drug examples | What can happen |
| Certain laxatives | • magnesium citrate (Citroma) • magnesium hydroxide (Phillips’ milk of magnesia) | can make Xofluza less effective |
| Certain antacids | • calcium carbonate (TUMS) • aluminum hydroxide/magnesium hydroxide (Maalox, Mylanta) | can make Xofluza less effective |
Certain other factors could raise your risk of harm if you take Xofluza. In such cases, your doctor may not prescribe Xofluza for you. These are known as contraindications. Xofluza’s contraindication is described below.
If you’ve had an allergic reaction. If you’ve had an allergic reaction to Xofluza or any of its ingredients, your doctor likely won’t prescribe Xofluza. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Xofluza isn’t known to interact with alcohol. But Xofluza and alcohol can cause some similar side effects, such as diarrhea and nausea. So, you may be more likely to experience these side effects if you drink alcohol with Xofluza treatment.
If you drink alcohol and have questions about consuming it before or after taking Xofluza, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Xofluza.
Interaction with certain laxatives
Xofluza can interact with certain laxatives, which are used to relieve occasional constipation.
Examples of laxatives that may interact with Xofluza include:
- magnesium citrate (Citroma)
- magnesium hydroxide (Phillips’ milk of magnesia)
What could happen
Taking Xofluza with certain laxatives can make Xofluza less effective. These laxatives contain ingredients that attach to Xofluza in the digestive tract. When this occurs, your body absorbs less Xofluza than usual. This reduces the level of the drug in your body, which can make Xofluza less effective.
What you can do
Before or after your Xofluza dose, you should avoid taking laxatives that interact with it.
Xofluza is a one-dose treatment. If you experience constipation on the day you take Xofluza, talk with your doctor or pharmacist. They can suggest other ways to manage constipation. This may include increasing your intake of water and dietary fiber or taking another type of laxative that doesn’t interact with Xofluza.
If you take laxatives and have questions about taking Xofluza with them, talk with your doctor or pharmacist.
Interaction with certain antacids
Xofluza can interact with certain antacids, which are used to relieve heartburn and indigestion (upset stomach). These include antacids that contain aluminum, calcium, or magnesium.
Examples of these medications include:
- calcium carbonate (TUMS, Pepto Kids)
- aluminum hydroxide/magnesium hydroxide (Maalox, Mylanta)
What could happen
Taking Xofluza with certain antacids can make Xofluza less effective. These antacids contain ingredients that attach to Xofluza in the digestive tract. When this occurs, it reduces the level of Xofluza in your body. This can make the drug less effective.
What you can do
Before or after your Xofluza dose, you should avoid taking antacids that interact with it.
Xofluza is a one-dose treatment. If you experience heartburn or indigestion on the day you take Xofluza, talk with your doctor or pharmacist. They can suggest other ways to manage your symptoms, such as avoiding certain foods.
If you take antacids and have questions about taking Xofluza with them, talk with your doctor or pharmacist.
Xofluza may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below doesn’t include all other possible interactions with Xofluza.
Does Xofluza interact with supplements?
Before you take Xofluza, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Xofluza and herbs
There are currently no reports of Xofluza interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products with Xofluza.
Xofluza interactions with vitamins, minerals, and other dietary supplements
Xofluza can interact with certain minerals, such as:
These minerals are found in many multivitamins and other dietary supplements, including:
- multivitamins, such as Centrum Silver
- magnesium supplements, such as MagOx
- calcium supplements, such as Caltrate
- iron supplements, such as ferrous sulfate
- immune support supplements, such as Zicam and Cold-EEZE
These minerals can attach to Xofluza in the digestive tract. When this occurs, it reduces the level of Xofluza in your body. This could make the drug less effective.
Because of this risk, you should not take Xofluza with vitamin or mineral supplements that contain these ingredients. If you take supplements and have questions about taking them before or after Xofluza, talk with your doctor.
Does Xofluza interact with food?
Yes, certain foods interact with Xofluza and should not be eaten with the drug. These include:
- dairy products, such as milk, coffee creamer, and yogurt
- beverages fortified with calcium, such as some types of orange juice
If you take Xofluza with these foods, it could reduce the level of the drug in your body. This may make Xofluza less effective.
If you have questions about eating certain foods with Xofluza, talk with your doctor.
Does Xofluza interact with vaccines?
There are currently no reports of Xofluza interacting with specific vaccines.
But it’s important to note that Xofluza could make live vaccines less effective. (Live vaccines are a weakened form of the bacterium or virus that they’re meant to protect you from.) One example is Flumist, the intranasal flu vaccine, which contains a weakened form of the flu virus.
Because Xofluza is an antiviral drug, it’s thought that the drug could kill the virus in the vaccine. This could make the vaccine less effective for protecting against flu.
Because of this risk, if you’ve taken Xofluza in the past 2–3 weeks and want to get a flu vaccine, your doctor will likely recommend the flu shot instead of the intranasal flu vaccine. The flu shot isn’t a live vaccine.
Also, if you already received the intranasal flu vaccine in the past 2–3 weeks, tell your doctor before they prescribe Xofluza. They’ll determine the best treatment option for you.
If you have questions about getting certain vaccines after your Xofluza treatment, talk with your doctor.
Does Xofluza interact with lab tests?
There are currently no reports of Xofluza interacting with lab tests. If you have questions about having certain lab tests during your treatment with Xofluza, talk with the healthcare professional ordering the test.
Does Xofluza interact with cannabis or CBD?There are currently no reports of Xofluza interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Xofluza.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Xofluza. Before taking Xofluza, talk with your doctor about your health history. They’ll determine whether Xofluza is right for you.
Health conditions or other factors that might interact with Xofluza include:
Allergic reaction. If you’ve had an allergic reaction to Xofluza or any of its ingredients, your doctor will likely not prescribe Xofluza. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Pregnancy or breastfeeding. It’s not known whether Xofluza is safe to take during pregnancy or while breastfeeding. The Centers for Disease Control and Prevention (CDC) recommends that pregnant people take certain antiviral drugs to treat the flu, but the CDC
Taking certain steps can help you avoid interactions with Xofluza. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a
medication list . - What to do if you start taking a new drug during your Xofluza treatment.
It’s also important to understand Xofluza’s
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Taking Xofluza exactly as prescribed can also help prevent interactions.
If you still have questions about Xofluza and its possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Is it safe to take Xofluza if I’ve recently had an infection, such as COVID-19?
- How long will I need to avoid consuming dairy products after taking Xofluza?
- Do I need to space out when I take my medications or vitamins throughout the day to avoid interactions with Xofluza?
To learn more about Xofluza, see these articles:
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.