Skip to main content

Drug Interactions between avapritinib and measles virus vaccine / rubella virus vaccine

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

Edit list (add/remove drugs)

Interactions between your drugs

Major

measles virus vaccine avapritinib

Applies to: measles virus vaccine / rubella virus vaccine and avapritinib

CONTRAINDICATED: The administration of live, attenuated viral or bacterial vaccines during immunosuppressant or intense antineoplastic therapy may be associated with a risk of disseminated infection due to enhanced replication of vaccine virus or bacteria in the presence of diminished immune competence. Patients may be immunosuppressed if they have recently received or are receiving alkylating agents, antimetabolites, radiation, some antirheumatic agents, high dosages of corticosteroids or adrenocorticotropic agents (e.g., greater than or equal to 2 mg/kg/day or 20 mg/day of prednisone or equivalent for 14 consecutive days or more), or long-term topical or inhaled corticosteroids. These patients may also have increased adverse reactions and decreased or suboptimal immunologic response to vaccines.

MANAGEMENT: In general, live attenuated vaccines should not be used in patients receiving immunosuppressive therapy or cancer chemotherapy. Vaccination should be deferred until after such therapy is discontinued and immune function has been restored, usually 4 to 12 weeks after stopping immunosuppressive therapy. A longer waiting period may be necessary following treatment with agents that have a prolonged elimination half-life (e.g., leflunomide, teriflunomide). In most situations, patients who have recently been vaccinated with a live vaccine should not initiate treatment with immunosuppressive therapy for at least 2 weeks (possibly longer in some cases). Current local immunization guidelines and prescribing information for individual vaccines and immunosuppressive agents should be consulted for more specific recommendations. Vaccines may generally be administered to patients receiving corticosteroids as replacement therapy (e.g., for Addison's disease).

References

  1. (2022) "Product Information. Meruvax II (rubella virus vaccine)." Merck & Co., Inc
  2. (2022) "Product Information. Attenuvax (measles virus vaccine)." Merck & Co., Inc
  3. (2001) "Product Information. YF-Vax (yellow fever vaccine)." sanofi pasteur
  4. Braunwald E, Hauser SL, Kasper DL, Fauci AS, Isselbacher KJ, Longo DL, Martin JB, eds., Wilson JD (1998) "Harrison's Principles of Internal Medicine." New York, NY: McGraw-Hill Health Professionals Division
  5. CDC. Centers for Disease Control and Prevention/ (1993) "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), p. 1-18
  6. (2002) "Product Information. M-M-R II (measles/mumps/rubella virus vaccine)." Merck & Co., Inc
  7. Charkoudian LD, Kaiser GM, Steinmetz RL, Srivastava SK (2011) "Acute retinal necrosis after herpes zoster vaccination." Arch Ophthalmol, 129, p. 1495-7
  8. Kriner P, Lopez K, Leung J, Harpaz R, Bialek SR (2014) "Notes from the field: varicella-associated death of a vaccinated child with leukemia - California, 2012." MMWR Morb Mortal Wkly Rep, 63, p. 161
  9. CDC Centers for Disease Control and Prevention (2019) General Best Practice Guidelines for Immunization: Altered Immunocompetence. https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/immunocompetence.pdf
  10. (2022) "Product Information. DENGVAXIA (dengue vaccine)." sanofi pasteur
  11. Advisory Committee on Immunization Practices: Centers for Disease Control and Prevention General Best Practice Guidelines for Immunization: Contraindications and Precautions: https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html
View all 11 references

Switch to consumer interaction data

Major

rubella virus vaccine avapritinib

Applies to: measles virus vaccine / rubella virus vaccine and avapritinib

CONTRAINDICATED: The administration of live, attenuated viral or bacterial vaccines during immunosuppressant or intense antineoplastic therapy may be associated with a risk of disseminated infection due to enhanced replication of vaccine virus or bacteria in the presence of diminished immune competence. Patients may be immunosuppressed if they have recently received or are receiving alkylating agents, antimetabolites, radiation, some antirheumatic agents, high dosages of corticosteroids or adrenocorticotropic agents (e.g., greater than or equal to 2 mg/kg/day or 20 mg/day of prednisone or equivalent for 14 consecutive days or more), or long-term topical or inhaled corticosteroids. These patients may also have increased adverse reactions and decreased or suboptimal immunologic response to vaccines.

MANAGEMENT: In general, live attenuated vaccines should not be used in patients receiving immunosuppressive therapy or cancer chemotherapy. Vaccination should be deferred until after such therapy is discontinued and immune function has been restored, usually 4 to 12 weeks after stopping immunosuppressive therapy. A longer waiting period may be necessary following treatment with agents that have a prolonged elimination half-life (e.g., leflunomide, teriflunomide). In most situations, patients who have recently been vaccinated with a live vaccine should not initiate treatment with immunosuppressive therapy for at least 2 weeks (possibly longer in some cases). Current local immunization guidelines and prescribing information for individual vaccines and immunosuppressive agents should be consulted for more specific recommendations. Vaccines may generally be administered to patients receiving corticosteroids as replacement therapy (e.g., for Addison's disease).

References

  1. (2022) "Product Information. Meruvax II (rubella virus vaccine)." Merck & Co., Inc
  2. (2022) "Product Information. Attenuvax (measles virus vaccine)." Merck & Co., Inc
  3. (2001) "Product Information. YF-Vax (yellow fever vaccine)." sanofi pasteur
  4. Braunwald E, Hauser SL, Kasper DL, Fauci AS, Isselbacher KJ, Longo DL, Martin JB, eds., Wilson JD (1998) "Harrison's Principles of Internal Medicine." New York, NY: McGraw-Hill Health Professionals Division
  5. CDC. Centers for Disease Control and Prevention/ (1993) "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), p. 1-18
  6. (2002) "Product Information. M-M-R II (measles/mumps/rubella virus vaccine)." Merck & Co., Inc
  7. Charkoudian LD, Kaiser GM, Steinmetz RL, Srivastava SK (2011) "Acute retinal necrosis after herpes zoster vaccination." Arch Ophthalmol, 129, p. 1495-7
  8. Kriner P, Lopez K, Leung J, Harpaz R, Bialek SR (2014) "Notes from the field: varicella-associated death of a vaccinated child with leukemia - California, 2012." MMWR Morb Mortal Wkly Rep, 63, p. 161
  9. CDC Centers for Disease Control and Prevention (2019) General Best Practice Guidelines for Immunization: Altered Immunocompetence. https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/immunocompetence.pdf
  10. (2022) "Product Information. DENGVAXIA (dengue vaccine)." sanofi pasteur
  11. Advisory Committee on Immunization Practices: Centers for Disease Control and Prevention General Best Practice Guidelines for Immunization: Contraindications and Precautions: https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html
View all 11 references

Switch to consumer interaction data

Drug and food interactions

Major

avapritinib food

Applies to: avapritinib

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of avapritinib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Inhibition of hepatic CYP450 3A4 may also contribute. The interaction has not been studied with grapefruit juice, but has been reported for other CYP450 3A4 inhibitors. Based on pharmacokinetic modeling, administration of avapritinib (300 mg once daily) in combination with the potent CYP450 3A4 inhibitor itraconazole (200 mg once daily) is predicted to increase avapritinib systemic exposure (AUC) by 600% at steady state, while administration with the moderate CYP450 3A4 inhibitor fluconazole (200 mg once daily) is predicted to increase avapritinib systemic exposure (AUC) by 210% at steady state. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Increased exposure to avapritinib may increase the risk and/or severity of serious adverse effects such as intracranial hemorrhage, cognitive impairment, mood disorders, hallucinations, edema, and decreases in hemoglobin, leukocytes, neutrophils, and platelets.

ADJUST DOSING INTERVAL: Food may increase the oral absorption of avapritinib. When avapritinib was administered with a high-calorie, high-fat meal (approximately 909 calories; 58 g carbohydrate, 56 g fat, 43 g protein), avapritinib Cmax and AUC increased by 59% and 29%, respectively, compared to administration in the fasted state.

MANAGEMENT: Avapritinib should be administered on an empty stomach at least 1 hour before or 2 hours after a meal. Patients should avoid consumption of grapefruit and grapefruit juice during treatment with avapritinib.

References

  1. (2020) "Product Information. Ayvakit (avapritinib)." Blueprint Medicines Corporation

Switch to consumer interaction data

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

Report options

Loading...
QR code containing a link to this page

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.

Medical Disclaimer