Nurses Compass
Drug Guide
Baloxavir Marboxil
Classification
Therapeutic: Antiviral for influenza
Pharmacological: Cap-dependent endonuclease inhibitor
FDA Approved Indications
- Treatment of acute uncomplicated influenza in patients 12 years and older who have been symptomatic for no more than 48 hours
Mechanism of Action
Inhibits the cap-dependent endonuclease enzyme, which is essential for viral replication, thereby blocking influenza virus proliferation.
Dosage and Administration
Adult: 40 mg as a single dose for patients ≥80 kg; 20 mg as a single dose for patients 40–80 kg.
Pediatric: Not approved for children under 12 years.
Geriatric: No specific dose adjustment required; use with caution in the elderly due to potential comorbidities.
Renal Impairment: No dose adjustment necessary.
Hepatic Impairment: Limited data; use with caution; no specific recommendations available.
Pharmacokinetics
Absorption: Rapidly absorbed after oral administration.
Distribution: Widely distributed in body tissues.
Metabolism: Metabolized primarily by hepatic aldehyde oxidase, with minor contribution from xanthine oxidase.
Excretion: Excreted mainly via urine as metabolites.
Half Life: Approximately 80 hours.
Contraindications
- Hypersensitivity to baloxavir marboxil or any component of the formulation.
Precautions
- Use with caution in patients with severe renal or hepatic impairment. Consider the potential resistance development, especially if used outside recommended guidelines.
Adverse Reactions - Common
- Diabbhoea (Infrequent)
- Headache (Common)
- Subclinical decreases in neutrophil counts (Rare)
Adverse Reactions - Serious
- Allergic reactions, including anaphylaxis (Rare)
- Skin rash or dermatitis (Rare)
Drug-Drug Interactions
- Polyvalent cation-containing products (antacids, calcium, magnesium, aluminum, iron) reduce absorption.
- Other antivirals may have interactions; consult current guidelines.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor for signs of influenza and any adverse drug reactions.
Diagnoses:
- Risk for adverse drug reactions
- Impaired comfort related to side effects.
Implementation: Administer as prescribed within 48 hours of symptom onset. Educate patient on the importance of completing the dosage.
Evaluation: Assess symptom resolution and monitor for adverse effects.
Patient/Family Teaching
- Take medication as directed and within 48 hours of symptom onset.
- Report any allergic reactions or side effects promptly.
- Maintain hydration and rest.
- Discuss the importance of vaccination and infection prevention strategies.
Special Considerations
Black Box Warnings: N/A
Genetic Factors: No specific genetic considerations.
Lab Test Interference: No known interference with laboratory tests.
Overdose Management
Signs/Symptoms: Nausea, vomiting, dizziness, or other side effects.
Treatment: Supportive care; no specific antidote. Consult poison control or emergency services.
Storage and Handling
Storage: Store at room temperature, below 30°C (86°F).
Stability: Stable for up to 24 months when stored properly.