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Drug Interactions between bcg vaccine and pretomanid

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

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Interactions between your drugs

Major

BCG vaccine pretomanid

Applies to: bcg vaccine and pretomanid

GENERALLY AVOID: Coadministration of antituberculosis drugs with the BCG vaccine may result in an inadequate immune response to the vaccine. The exact mechanism has not been described but it is likely that BCG vaccine, which contains a live, attenuated culture of Bacillus of Calmette and Guerin strain of Mycobacterium bovis, is sensitive to the antituberculosis effects of these drugs. Available data suggests that BCG vaccine is sensitive to commonly used antituberculosis agents such as isoniazid, ethambutol, and rifampin; it is reportedly not sensitive to pyrazinamide. However, clinical and/or sensitivity data are not available for BCG vaccine and all antituberculosis agents.

MANAGEMENT: Due to the potential loss of vaccine efficacy, the manufacturer recommends that concomitant use of antituberculosis drugs with the BCG vaccine should generally be avoided. However, in cases of accidental BCG overdosage, immediate treatment with antituberculosis drugs is recommended. In addition, if a systemic BCG infection is suspected after administration of the vaccine, antituberculosis therapy should be initiated and an infectious disease expert consulted for further guidance.

References (3)
  1. (2019) "Product Information. BCG Vaccine AJV (BCG vaccine)." AJ Vaccines
  2. (2023) "Product Information. BCG Vaccine (BCG vaccine)." Merck Sharp & Dohme LLC
  3. Durek C, Rusch-Gerdes S, Jocham D, Bohle A (2024) Sensitivity of BCG to modern antibiotics https://pubmed.ncbi.nlm.nih.gov/10575268/

Drug and food interactions

Moderate

pretomanid food

Applies to: pretomanid

GENERALLY AVOID: Coadministration with alcohol may increase the risk of hepatotoxicity associated with the use of combination drug regimens that include pretomanid.

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of pretomanid. The mechanism has not been reported. Compared with the fasted state, oral administration of pretomanid with a high-fat, high-calorie meal (approximately 150, 250, and 500 to 600 calories from protein, carbohydrate, and fat, respectively) increased mean systemic exposure (AUC) and peak plasma concentration (Cmax) of pretomanid by 88% and 76%, respectively.

MANAGEMENT: Patients should avoid alcohol use during treatment with pretomanid. In addition, to ensure maximal oral absorption, pretomanid should be administered with food. Tablets should be swallowed whole.

References (1)
  1. (2019) "Product Information. Pretomanid (pretomanid)." The Global Alliance for TB Drug Development

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.

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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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