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Drug Interactions between FluMist and rabies immune globulin, human

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

rabies immune globulin, human influenza virus vaccine, live

Applies to: rabies immune globulin, human and FluMist (influenza virus vaccine, live)

Consumer information for this interaction is not currently available.

ADJUST DOSING INTERVAL: Administration of immune globulin preparations with, shortly before, or after live vaccines may impair the immune response to the vaccination(s). Injected live, attenuated virus vaccines (e.g., measles/mumps/rubella (MMR), measles/mumps/rubella/varicella (MMRV), varicella) may be affected by circulating antibodies present in immune globulin therapy or other blood products. The passive transfer of these antibodies may prevent replication of the vaccine virus, potentially reducing the vaccine's efficacy. In general, there appears to be minimal to no interaction between immune globulin preparations or blood products and the yellow fever vaccine, some live oral vaccines (e.g., rotavirus vaccine, oral typhoid vaccine), the live attenuated influenza vaccine (LAIV), and the Bacille Calmette-Guerin (BCG) vaccine. As this interaction is dependent upon the antibodies present in the immunoglobulin or blood product, it may be affected by the source used to create the product. Additionally, the vaccinations impacted may vary from country to country. Data on the immunogenicity and safety of all different vaccinations after the administration of all different immune globulin preparations are not available.

MANAGEMENT: In general, administration of a live vaccine should be delayed until the passive antibody received from the immune globulin product has degraded, which is product- and dose-dependent. If rapid protection is required, vaccination should proceed, but additional dose(s) of the vaccine and/or laboratory testing to ensure vaccine efficacy may be advised. According to the Advisory Committee on Immunization Practices (ACIP), the Ty21a typhoid, yellow fever, LAIV, and rotavirus vaccines may be administered at any time before, concurrently with, or after the administration of any immune globulin preparation or blood product. Local guidelines and prescribing information for the products involved should be consulted for further recommendations.

References

  1. "Product Information. Sandoglobulin (immune globulin intravenous)." Sandoz Pharmaceuticals Corporation PROD
  2. "Product Information. Bayrab (rabies immune globulin, human)." Bayer PROD (2001):
  3. "Product Information. Varivax (varicella virus vaccine)." Merck & Co., Inc (2022):
  4. "Product Information. Attenuvax (measles virus vaccine)." Merck & Co., Inc (2022):
  5. CDC. Centers for Disease Control and Prevention/ "Recommendations of the advisory committtee on immunization practices (ACIP): use of vaccines and immune globulins in persons with altered immunocompetence." MMWR Morb Mortal Wkly Rep 42(RR-04) (1993): 1-18
  6. "Product Information. H-BIG (hepatitis B immune globulin)." Allscrips Pharmaceutical Company
  7. "Product Information. Cytogam (cytomegalovirus immune globulin)." CSL Behring LLC (2002):
  8. "Product Information. Varicella Zoster Immune Globulin (varicella zoster immune globulin)." American Red Cross Blood Services (2002):
  9. "Product Information. WinRho SDF (RHo (D) immune globulin)." Apothecon Inc (2022):
  10. "Product Information. Bayhep B (hepatitis B immune globulin)." Bayer Pharmaceutical Inc (2022):
  11. "Product Information. Nabi-HB (hepatitis B immune globulin)." Biotest Pharmaceuticals Corporation (2022):
  12. "Product Information. Rhophylac (RHo (D) immune globulin)." Apothecon Inc (2022):
  13. "Product Information. HyperRHO S/D Full Dose (RHo (D) immune globulin)." Talecris Biotherapeutics (2022):
  14. "Product Information. Vivaglobin (immune globulin subcutaneous)." *ZLB Bioplasma Inc (2006):
  15. "Product Information. BabyBIG (botulism immune globulin)." FFF Enterprises (2008):
  16. "Product Information. Imogam Rabies-HT (rabies immune globulin, human)." sanofi pasteur (2010):
  17. Department of Health. National Health Service "Immunisation Against Infectious Disease - "The Green Book". Chapter 6: Contraindications and special considerations. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/655225/Greenbook_chapter_6.pdf" (2019):
  18. "Product Information. Qdenga (dengue vaccine)." Takeda UK Ltd (2023):
  19. Advisory Committee on Immunization Practices: Centers for Disease Control and Prevention "General Best Practice Guidelines for Immunization: Timing and Spacing of Immunobiologics https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/timing.html"
  20. Public Health Agency of Canada "Blood products, human immunoglobulin and timing of immunization: Canadian Immunization Guide https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-1-key-immunization-information/page-11-blood-product"
  21. Clucas L, Crawford N, Danchin M, Greenway A "Live-attenuated vaccines in patients receiving regular red blood cell transfusions https://mvec.mcri.edu.au/references/live-attenuated-vaccines-in-patients-receiving-regular-red-blood-cell-transfusions/"
  22. Melbourne Vaccine Education Centre "Live-attenuated vaccines and immunoglobulins or blood products https://mvec.mcri.edu.au/references/live-attenuated-vaccines-and-immunoglobulins-or-blood-products/"
  23. Australian Government. Department of Health and Aged Care "Australian Immunisation Handbook: Vaccination for people who have recently received normal human immunoglobulin and other blood products https://immunisationhandbook.health.gov.au/contents/vaccination-for-special-risk-groups/vaccination-for-people-who-ha"
  24. Australian Government. Department of Health and Aged Care "Australian Immunisation Handbook: Tuberculosis https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/tuberculosis"
  25. Australian Government. Department of Health and Aged Care "Australian Immunisation Handbook: Zoster (herpes zoster) https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/zoster-herpes-zoster"
  26. Australian Government. Department of Health and Aged Care "Australian Immunisation Handbook: Measles https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/measles#vaccine-information"
  27. Australian Government. Department of Health and Aged Care "Australian Immunisation Handbook: Rubella https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/rubella"
  28. Australian Government. Department of Health and Aged Care "Australian Immunisation Handbook: Mumps https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/mumps"
  29. Australian Government. Department of Health and Aged Care "Australian Immunisation Handbook: Varicella (chickenpox) https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/varicella-chickenpox"
View all 29 references

Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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