[[(12aR)-12-[(11S)-7,8-Difluoro-6,11-dihydrodibenzo[b,e]thiepin-11-yl]-3,4,6,8,12,12a-hexahydro-6,8-dioxo-1H-[1,4]oxazino[3,4-c]pyrido[2,1-f][1,2,4]triazin-7-yl]oxy]methyl methyl carbonate

Baloxavir marboxil is an antiviral drug developed by Shionogi Co., a Japanese pharmaceutical company and Roche for the treatment of influenza A and influenza B infections. The drug was initially approved for use in Japan in February 2018 and approved by the FDA on October 24, 2018, for the treatment of acute uncomplicated influenza in patients 12 years of age and older who have been symptomatic for no more than 48 hours. Baloxavir marboxil, a cap-endonuclease inhibitor, has a unique mechanism of action when compared to the currently existing neuraminidase inhibitor drug class used to treat influenza infections.|Baloxavir is an inhibitor of the influenza cap-dependent endonuclease enzyme and is used as therapy of influenza A and B. Baloxavir is given as a single, one-time dose and has not been associated with serum enzyme elevations or with clinically apparent liver injury.|Baloxavir Marboxil is an orally bioavailable prodrug and influenza cap-dependent endonuclease (CEN) inhibitor, with antiviral activity. Upon administration of baloxavir marboxil, the agent is converted by hydrolysis to its active metabolite baloxavir. Baloxavir targets, binds to and inhibits the CEN activity of the influenza polymerase acidic (PA) protein, an influenza virus-specific enzyme in the viral RNA polymerase complex required for the initiation of influenza gene transcription. By inhibiting PA endonuclease, influenza virus mRNA replication is halted. This reduces viral load and prevents further influenza infection.