Interactions between Acyclovir and Zoster vaccine live
1 drug interaction and 19 additional warnings found for the following 2 drugs:
- acyclovir
- zoster vaccine live
Drug interactions
Major drug interactions
Major:
acyclovir zoster vaccine live
Applies to: acyclovir and zoster vaccine live
Generally avoid
Concomitant use of live, attenuated varicella virus vaccine or zoster vaccine with acyclovir, famciclovir, or valacyclovir may result in diminished immunologic response to the vaccine. Although clinical data are lacking, theoretical concern exists that antiviral activity against the vaccine strain may prevent a sufficient degree of replication to occur in order to induce a protective immune response. Acyclovir, specifically, has demonstrated activity against the Oka strain of live, attenuated varicella-zoster virus used in the vaccines.
Management
Acyclovir, famciclovir, and valacyclovir should not be used for at least 24 hours before administration of live, attenuated varicella virus vaccine or zoster vaccine. In addition, these antiviral agents should generally be avoided for 14 days after vaccination.
References (2)
- (2017) "Product Information. Zovirax (acyclovir)." Mylan Pharmaceuticals Inc
- US Centers for Disease Control and Prevention (CDC) (2017) Recommended immunization schedule for adults aged 19 years or older, United States, 2017 https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule-bw.pdf
Food/lifestyle interactions
No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Disease interactions
19 potential interactions Applies to: 18 conditions, including Fever, Hypocalcemia, Hemodialysis, Liver Disease, and Hyponatremia.
Acidosis
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Acidosis.
Acyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Therapy with acyclovir should be administered cautiously in the elderly and in patients with underlying neurologic abnormalities, severe renal or liver disease, or significant electrolyte abnormalities or hypoxia.
Alkalosis
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Alkalosis.
Acyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Therapy with acyclovir should be administered cautiously in the elderly and in patients with underlying neurologic abnormalities, severe renal or liver disease, or significant electrolyte abnormalities or hypoxia.
Asphyxia
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Asphyxia.
Acyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Therapy with acyclovir should be administered cautiously in the elderly and in patients with underlying neurologic abnormalities, severe renal or liver disease, or significant electrolyte abnormalities or hypoxia.
Central Nervous System Disorders
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Central Nervous System Disorders.
Acyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Therapy with acyclovir should be administered cautiously in the elderly and in patients with underlying neurologic abnormalities, severe renal or liver disease, or significant electrolyte abnormalities or hypoxia.
Dehydration
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Dehydration.
Acyclovir crystals may precipitate in the renal tubules, particularly when the drug is injected intravenously as a bolus. Abnormal renal function may occur, which is usually reversible but may infrequently progress to tubular damage and acute renal failure. Patients who are dehydrated may be at increased risk for nephrotoxicity from acyclovir administration. Intravenous acyclovir should be administered over a one-hour period accompanied by adequate hydration. The urine flow should be monitored, especially within the first two hours following infusion when maximum urine concentration occurs. The recommended urine output is a minimum of 500 mL per gram of drug infused.
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Dehydration.
Acyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Therapy with acyclovir should be administered cautiously in the elderly and in patients with underlying neurologic abnormalities, severe renal or liver disease, or significant electrolyte abnormalities or hypoxia.
Electrolyte Abnormalities
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Electrolyte Abnormalities.
Acyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Therapy with acyclovir should be administered cautiously in the elderly and in patients with underlying neurologic abnormalities, severe renal or liver disease, or significant electrolyte abnormalities or hypoxia.
Fever
Major:
zoster vaccine live
Zoster vaccine live has a major potential interaction with Fever.
Ideally, vaccination should occur when an individual is healthy, thus minimizing the risk of an adverse host reaction and/or vaccine failure. However, a current or recent infection does not necessarily preclude the use of vaccines, depending on the severity of the patient's symptoms and their etiology. Superficial infections and minor acute illnesses such as a mild upper respiratory infection with or without low-grade fever do not contraindicate immunization, particularly if prompt administration of a vaccine is deemed necessary or beneficial. In fact, when vaccines are administered during the course of a minor illness, the risk of adverse events is not increased, and serum antibody response is not often diminished. On the other hand, if fever or symptoms suggest a moderate or severe illness, it is usually appropriate to withhold vaccination until the patient has recovered. In addition to the potential risks already mentioned, evolving signs and symptoms of the illness can sometimes confound the diagnosis of a vaccine reaction if it develops. In the presence of any infection, the decision to administer or withhold/defer immunization should take into consideration the benefits versus the risks to an individual patient.
Hemodialysis
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Hemodialysis.
Acyclovir is substantially removed by hemodialysis. Plasma levels of acyclovir have been shown to reduce by 60% following 6 hours of dialysis. Acyclovir should be administered after hemodialysis. Otherwise, an additional dose may be given after each hemodialysis session.
Hypercalcemia
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Hypercalcemia.
Acyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Therapy with acyclovir should be administered cautiously in the elderly and in patients with underlying neurologic abnormalities, severe renal or liver disease, or significant electrolyte abnormalities or hypoxia.
Hypernatremia
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Hypernatremia.
Acyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Therapy with acyclovir should be administered cautiously in the elderly and in patients with underlying neurologic abnormalities, severe renal or liver disease, or significant electrolyte abnormalities or hypoxia.
Hypocalcemia
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Hypocalcemia.
Acyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Therapy with acyclovir should be administered cautiously in the elderly and in patients with underlying neurologic abnormalities, severe renal or liver disease, or significant electrolyte abnormalities or hypoxia.
Hyponatremia
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Hyponatremia.
Acyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Therapy with acyclovir should be administered cautiously in the elderly and in patients with underlying neurologic abnormalities, severe renal or liver disease, or significant electrolyte abnormalities or hypoxia.
Immunodeficiency
Major:
zoster vaccine live
Zoster vaccine live has a major potential interaction with Immunodeficiency.
In general, the use of varicella virus vaccine is contraindicated in patients with primary or acquired immunodeficiency or infection with HIV. Since varicella virus vaccine contains live attenuated virus, the absence of immune competence may potentiate the replication of vaccine virus, increase adverse host reactions, and compromise serum antibody response. The vaccine should not be administered to immunosuppressed or immunodeficient individuals and those receiving immunosuppressive therapy, including individuals receiving immunosuppressive doses of corticosteroids as it may cause an extensive vaccine-associated rash or disseminated disease in these individuals.
Infection
Major:
zoster vaccine live
Zoster vaccine live has a major potential interaction with Infection.
Ideally, vaccination should occur when an individual is healthy, thus minimizing the risk of an adverse host reaction and/or vaccine failure. However, a current or recent infection does not necessarily preclude the use of vaccines, depending on the severity of the patient's symptoms and their etiology. Superficial infections and minor acute illnesses such as a mild upper respiratory infection with or without low-grade fever do not contraindicate immunization, particularly if prompt administration of a vaccine is deemed necessary or beneficial. In fact, when vaccines are administered during the course of a minor illness, the risk of adverse events is not increased, and serum antibody response is not often diminished. On the other hand, if fever or symptoms suggest a moderate or severe illness, it is usually appropriate to withhold vaccination until the patient has recovered. In addition to the potential risks already mentioned, evolving signs and symptoms of the illness can sometimes confound the diagnosis of a vaccine reaction if it develops. In the presence of any infection, the decision to administer or withhold/defer immunization should take into consideration the benefits versus the risks to an individual patient.
Liver Disease
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Liver Disease.
Acyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Therapy with acyclovir should be administered cautiously in the elderly and in patients with underlying neurologic abnormalities, severe renal or liver disease, or significant electrolyte abnormalities or hypoxia.
Magnesium Imbalance
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Magnesium Imbalance.
Acyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Therapy with acyclovir should be administered cautiously in the elderly and in patients with underlying neurologic abnormalities, severe renal or liver disease, or significant electrolyte abnormalities or hypoxia.
Phosphate Imbalance
Moderate:
acyclovir
Acyclovir has a moderate potential interaction with Phosphate Imbalance.
Acyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Therapy with acyclovir should be administered cautiously in the elderly and in patients with underlying neurologic abnormalities, severe renal or liver disease, or significant electrolyte abnormalities or hypoxia.
Renal Dysfunction
Major:
acyclovir
Acyclovir has a major potential interaction with Renal Dysfunction.
Acyclovir is primarily eliminated by the kidney. Patients with renal impairment may be at greater risk for neuro- and nephrotoxicity (including further deterioration in renal function, tubular damage and acute renal failure) from acyclovir due to decreased drug clearance. Therapy with acyclovir should be administered cautiously in patients with renal impairment. Dosage adjustments are recommended in patients with moderate to severe renal dysfunction.
More resources
acyclovir
A total of 71 drugs are known to interact with acyclovir.
- Acyclovir is in the drug class purine nucleosides.
-
Acyclovir is used to treat the following conditions:
- Cold Sores
- Herpes Simplex - Congenital
- Herpes Simplex (HSV)
- Herpes Simplex Encephalitis
- Herpes Simplex, Mucocutaneous/Immunocompetent Host
- Herpes Simplex, Mucocutaneous/Immunocompromised Host
- Herpes Simplex, Suppression
- Herpes Zoster
- Infectious Mononucleosis (off-label)
- Mononucleosis (off-label)
- Ramsay Hunt Syndrome
- Varicella-Zoster
zoster vaccine live
A total of 385 drugs are known to interact with zoster vaccine live.
- Zoster vaccine live is in the drug class viral vaccines.
- Zoster vaccine live is used to treat Herpes Zoster, Prophylaxis.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.