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DrugXofluza™ (baloxavir) [Genentech, Inc.]

June 2019

Therapeutic Area - Antivirals

Approval criteria

  • Patient must be 12 years of age or older AND
  • Patient must be at least 40 kg AND
  • Patient must have acute, uncomplicated influenza AND
  • Patient has been symptomatic for no more than 48 hours AND
  • Patient is:
    • NOT on concurrent neuraminidase inhibitors (e.g., Tamiflu, Relenza) AND
    • NOT pregnant AND
    • NOT hospitalized AND
  • Xofluza is NOT prescribed for influenza prophylaxis AND
  • If patient is 12 years of age or older, prescriber must provide a reason oseltamivir is not clinically appropriate for the patient (i.e., the convenience of the patient, prescriber, or other health care provider will not be considered)

Quantity limits

  • 40 mg dose: one 2 x 20 mg blister card OR
  • 80 mg dose: one 2 x 40 mg blister card AND 
  • Patient’s body weight (in kg) must be provided at time of request


MHCP Provider Call Center 651-431-2700 or 800-366-5411

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