Baloxavir marboxil may form chelates with polyvalent cations (e.g., calcium, aluminum, or magnesium). Coadministration with products containing polyvalent cations may reduce plasma concentrations of baloxavir marboxil [see Clinical Pharmacology (12.3)], which may reduce the efficacy of baloxavir marboxil. Avoid coadministration of baloxavir marboxil with dairy products, calcium-fortified beverages, laxatives containing polyvalent cations, antacids, or oral supplements (e.g., calcium, iron, magnesium, selenium, or zinc).
The concomitant use of baloxavir marboxil with intranasal live attenuated influenza vaccine (LAIV) has not been evaluated. Coadministration of antiviral drugs may inhibit viral replication of LAIV, thereby decreasing the effectiveness of LAIV vaccination. The interaction between inactivated influenza vaccine and baloxavir marboxil has not been evaluated.
FDA,2025.05