sterapred and Dryvax Interactions

Interactions between sterapred(predniSONE) and Dryvax (smallpox vaccine)

predniSONE and smallpox vaccine (Major Drug-Drug)

CONTRAINDICATED: The administration of live virus smallpox vaccine during systemic corticosteroid therapy may be associated with a risk of disseminated infection due to enhanced replication of vaccine virus in the presence of diminished immune competence. Patients receiving high doses of corticosteroids (e.g., greater than 20 mg/day or greater than 2 mg/kg/day of prednisone or equivalent for more than 2 weeks) or who are systemically immunosuppressed due to long-term topical or aerosol use of corticosteroids may also have an increased risk of neurologic reactions to vaccines and decreased or suboptimal immunologic response due to antibody inhibition.

MANAGEMENT: Routine non-emergency smallpox vaccination is considered contraindicated in patients receiving immunosuppressive therapy including corticosteroids and should be deferred until after such therapy is discontinued for at least 3 months. In patients who have recently been vaccinated, high dose corticosteroid therapy should not be initiated for at least 2 weeks. Household contacts of immunosuppressed patients should also not be vaccinated. However, there are no absolute contraindications to vaccination if a high-risk exposure has occurred. In an outbreak emergency, smallpox vaccine is recommended for all persons, regardless of medical conditions. The risk for experiencing serious complications from the vaccine should be weighed against the risk of acquiring a potentially fatal smallpox infection. Vaccines may generally be administered to patients receiving corticosteroids as replacement therapy (e.g., for Addison's disease).