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Drug Interactions between baloxavir marboxil and influenza virus vaccine, live

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

influenza virus vaccine, live baloxavir marboxil

Applies to: influenza virus vaccine, live and baloxavir marboxil

ADJUST DOSING INTERVAL: Antiviral agents that are active against influenza A and/or B viruses may conceivably interfere with the immunogenicity of live influenza virus vaccine by inhibiting the replication of vaccine virus. However, the potential for interaction has not been evaluated.

MANAGEMENT: Live influenza virus vaccine should not be administered until at least 48 hours after the cessation of antiviral therapy. Antiviral agents should not be administered until two weeks after immunization with live influenza virus vaccine unless medically indicated. If antiviral agents and live influenza virus vaccine are administered concomitantly, revaccination should be considered when appropriate. The product labeling for zanamivir recommends waiting 24 hours after cessation of the drug before administration of live influenza virus vaccine.

References (9)
  1. (2022) "Product Information. Flumadine (riMANTAdine)." Forest Pharmaceuticals
  2. (2001) "Product Information. Relenza (zanamivir)." Glaxo Wellcome
  3. (2001) "Product Information. Tamiflu (oseltamivir)." Roche Laboratories
  4. (2022) "Product Information. FluMist (influenza virus vaccine, live)." Medimmune Inc
  5. (2022) "Product Information. Influenza Virus Vaccine, H1N1, Live (influenza virus vaccine, H1N1, live)." Medimmune Inc
  6. (2015) "Product Information. Rapivab (peramivir)." BioCryst Pharmaceuticals Inc
  7. (2015) "Product Information. FluMist Quadrivalent (influenza virus vaccine, live)." AstraZeneca Pharma Inc
  8. (2018) "Product Information. Xofluza (baloxavir marboxil)." Genentech
  9. Grohskopf LA, Sokolow LZ, Broder KR, Walter EB, Fry AM, Jernigan DB (2018) "Prevention and control of seasonal influenza with vaccines: Recommendations of the Advisory Committee on Immunization Practices-United States, 2018-19 influenza season." MMWR Recomm Rep, 67, p. 1-20

Drug and food interactions

Moderate

baloxavir marboxil food

Applies to: baloxavir marboxil

GENERALLY AVOID: Coadministration with foods or medications that contain polyvalent cations such as dairy products, calcium-fortified beverages, certain laxatives, antacids, or oral supplements may decrease the plasma concentrations and therapeutic efficacy of baloxavir. The proposed mechanism is chelation of baloxavir by polyvalent cations, forming a complex that is poorly absorbed from the gastrointestinal tract. A significant decrease in baloxavir exposure was observed in monkeys when the prodrug, baloxavir marboxil, was coadministered with calcium, aluminum, magnesium, or iron. However, clinical data in humans are lacking.

When baloxavir marboxil was administered with food, baloxavir peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 48% and 36%, respectively, relative to administration under fasting. These changes are not considered clinically significant.

MANAGEMENT: Baloxavir marboxil may be taken with or without food. However, coadministration with dairy products, calcium-fortified beverages, or polyvalent cation-containing laxatives, antacids, or oral supplements (e.g., calcium, iron, magnesium, selenium, or zinc) should be avoided.

References (2)
  1. Cerner Multum, Inc. "Australian Product Information."
  2. (2018) "Product Information. Xofluza (baloxavir marboxil)." Genentech

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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