You’re probably not surprised to hear that cases of the flu took a nosedive last year. The mask wearing, social distancing and hand-washing that people did to guard against COVID-19 also helped beat back the flu.

In fact, only 0.2% of flu tests came back positive during the 2020-21 flu season, says the Centers for Disease Control and Prevention (CDC). That’s a big change from the 3 seasons before the pandemic, when 26.2% to 30.3% of tests were positive.

But the flu isn’t going away. So it’s helpful to know your options if you get sick. There are 4 antiviral flu medications a doctor can prescribe. These are the ones approved by the U.S. Food and Drug Administration (FDA). They can be used to prevent an infection from becoming severe or to stop it from happening in the first place. This can be useful for someone who knows they’ve been exposed to the virus.

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In most cases, flu medications are meant for people who get a more severe case of the flu. They also can be given to those at a higher risk of serious complications, says the CDC. They include:

  • People age 65 and older
  • Children under age 2
  • People with chronic illnesses such as asthma, diabetes and heart disease
  • Pregnant people and those up to 2 weeks post-pregnancy
  • People with weakened immune systems
  • Native Americans and Alaskan Native persons

How do antiviral flu medications work?

The flu is caused by strains of the influenza virus that infect the nose, throat and lungs. Antiviral flu medications fight those viruses in your body.

These medications can help make flu symptoms less severe and prevent serious complications that might require a hospital stay. They may even shorten the amount of time you’re sick by 1 or 2 days.

The catch is that the medications work best when you start them early. So they need to be taken within 2 days of feeling sick, says Karen Kier, PhD. She’s a professor of clinical pharmacy at Ohio Northern University in Ada, Ohio.

Most antiviral flu medications help prevent copies of the virus from spreading throughout the body. One interferes with the virus’s ability to make those copies in the first place. Aside from helping to ease or curb flu symptoms, some of these medications can help keep you from getting sick from the flu if you’re exposed to someone who is.

What you need to know about each antiviral flu medication

The 4 FDA-approved antiviral flu medications are:

These medications come in different forms. And each is approved for different ages and different needs.

Rapivab

Rapivab is a bit different from other antiviral flu medications. It’s a one-time dose given through an IV (intravenous therapy) by a health care provider. It’s approved to treat the flu in people age 6 months and older who’ve been symptomatic for no more than 2 days.

Unlike Tamiflu and Relenza, Rapivab isn’t approved for flu prevention. Kier says it’s mainly given to people who can’t take pills, have trouble swallowing or have nausea or vomiting. Its most common side effect is diarrhea.

Relenza

Relenza comes in powder form and is breathed in through an inhaler. It’s approved to treat the flu in people age 7 and older and to prevent the flu in those age 5 and older.

Because it’s inhaled, it’s usually not recommended for people with breathing problems, Kier says. On the plus side, it can be helpful for people who have a hard time swallowing.

Relenza needs to be taken twice a day for 5 days. Possible side effects include headaches, nausea, vomiting, nose irritation and diarrhea.

Tamiflu

Tamiflu is used to help lessen flu symptoms in people age 2 weeks and older. And it’s approved to help prevent the flu after exposure (even if you don’t have symptoms yet) in those age 1 and up.

It comes in pill or liquid form. Like Relenza, it must be taken twice a day for 5 days. Possible side effects include nausea, vomiting, nosebleeds, headaches and fatigue.

Xofluza

Xofluza comes in pill form and requires only 1 dose. “That could be an advantage if you or your doctor was concerned about taking the full 5 days of Tamiflu or Relenza,” Kier says.

It’s approved to treat and prevent the flu in people age 12 and older. It’s not recommended for people who are pregnant or breastfeeding, those with a complicated or progressive illness (such as multiple sclerosis or cancer that’s not in remission) or people who are being hospitalized. That’s because there’s no information about use of the medication in these patients, the CDC says.

Common side effects include diarrhea, bronchitis, nausea, sinusitis and headaches.

There is no generic version of Xofluza, so it can be more expensive than the other prescription flu medications.

With flu season already underway, you’d be smart to do what you can now to avoid it. (Hint: Get the flu vaccine.) And if you’re in a high-risk group, make a game plan with your doctor about what you’ll do if you get sick.

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Additional sources
Summary of flu season statistics:
Centers for Disease Control and Prevention
Flu antiviral medication overview: Centers for Disease Control and Prevention
Basics on how flu antivirals work: Cleveland Clinic