Drug Interactions between cholera vaccine, live and dexamethasone / ketorolac / moxifloxacin

Moxifloxacin and other medications in its class can cause tendinitis and tendon rupture, and the risk may be increased when combined with a steroid such as dexAMETHasone. Older adults over 60 years of age and those who have received a kidney, heart, and/or lung transplant may be particularly susceptible. Tendon rupture can occur during or up to several months after finishing moxifloxacin treatment and may require surgery or result in prolonged disability. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Stop taking moxifloxacin and call your doctor immediately if you experience pain, swelling, or inflammation of a tendon area such as the back of the ankle, shoulder, biceps, hand, or thumb. You should also avoid exercise or use of the affected area until further instruction from your doctor. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

If you are currently being treated or have recently been treated with dexAMETHasone, you should let your doctor know before receiving cholera vaccine, live. The use of cholera vaccine, live has not been adequately studied in patients receiving medications that affect the immune system, and it is not known whether you may have an increased risk of side effects or a reduced response to the vaccine. In some situations, your doctor may want to delay vaccination to give your body time to recover from the effects of dexAMETHasone therapy. If you have recently been vaccinated with cholera vaccine, live, your doctor may choose to postpone treatment with dexAMETHasone for a couple of weeks. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

If you are currently being treated with moxifloxacin or have been treated within the last 14 days, you should talk to your doctor before receiving cholera vaccine, live. Antibiotics like moxifloxacin may reduce the activity of the vaccine. To ensure adequate vaccine response, vaccination with cholera vaccine, live should be given either at least 14 days after you complete your treatment with moxifloxacin or 10 days prior to starting treatment with moxifloxacin. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Using dexAMETHasone together with ketorolac may increase the risk of side effects in the gastrointestinal tract such as inflammation, bleeding, ulceration, and rarely, perforation. Gastrointestinal perforation is a potentially fatal condition and medical emergency where a hole forms all the way through the stomach or intestine. You should take these medications with food to lessen the risk. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Your doctor may also be able to recommend medications to help protect the stomach and intestine if you are at high risk for developing serious gastrointestinal complications. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moxifloxacin may rarely cause central nervous system side effects such as tremors, involuntary muscle movements, anxiety, confusion, depression, hallucinations or seizures, and combining it with other medications that can also affect the central nervous system such as ketorolac may increase that risk. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.