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Drug Interactions between cholera vaccine, live and dimethyl fumarate

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

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Interactions between your drugs

Major

dimethyl fumarate cholera vaccine, live

Applies to: dimethyl fumarate and cholera vaccine, live

GENERALLY AVOID: The safety and efficacy of live, attenuated cholera vaccine have not been established in patients receiving immunosuppressive therapies, including alkylating agents, antimetabolites, radiation, some antirheumatic agents, high dosages of corticosteroids or adrenocorticotropic agents, and long-term topical or inhaled corticosteroids. It is not known whether immunosuppressed patients may have an increased risk of adverse reactions or a decreased or suboptimal immunologic response to the vaccine.

MANAGEMENT: The safety and efficacy of live, attenuated cholera vaccine have not been established in patients receiving immunosuppressive therapies. Some authorities consider coadministration of live, attenuated oral cholera vaccine with immunosuppressant therapies contraindicated. Administration of live attenuated vaccines in severely immunocompromised persons is generally considered a contraindication. The risks of adverse reactions or a decreased or suboptimal immunologic response should be weighed against the benefits of vaccination. Current local immunization guidelines and individual product labeling for the prescribed immunosuppressive therapy should be consulted for further information.

References (5)
  1. 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
  2. (2016) "Product Information. Vaxchora (cholera vaccine, live)." PaxVax
  3. 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
  4. (2023) "Product Information. Vaxchora (cholera vaccine, live)." Patientric Ltd
  5. (2024) "Product Information. Vaxchora (cholera vaccine, live)." Emergent Travel Health, Inc

Drug and food interactions

Moderate

cholera vaccine, live food

Applies to: cholera vaccine, live

ADJUST DOSING INTERVAL: Coadministration of oral cholera vaccine with food or an oral beverage may impair its efficacy. The formulations of both the inactivated and live, attenuated oral cholera vaccines (Dukoral and Vaxchora, respectively) are acid-labile, and must be administered with a buffer. According to the manufacturer, eating and drinking may interfere with the protective effect of the buffer. However, clinical data are not available.

MANAGEMENT: It is recommended that patients avoid eating or drinking for 60 minutes before and after administration of either Dukoral or Vaxchora oral cholera vaccines.

References (4)
  1. (2023) "Product Information. Vaxchora (cholera vaccine, live)." Patientric Ltd
  2. (2022) "Product Information. Dukoral (cholera vaccine, inactivated)." Valneva Sweden AB
  3. (2023) "Product Information. Dukoral (cholera vaccine)." Valneva UK Ltd
  4. (2024) "Product Information. Vaxchora (cholera vaccine, live)." Emergent Travel Health, Inc
Minor

dimethyl fumarate food

Applies to: dimethyl fumarate

Food does not significantly affect the oral bioavailability of dimethyl fumarate. Administration of dimethyl fumarate with a high-fat, high-calorie meal did not affect the systemic exposure (AUC) to its active metabolite, monomethyl fumarate (MMF), but decreased its peak plasma concentration (Cmax) by 40% and prolonged the time to reach peak concentration (Tmax) from 2.0 hours to 5.5 hours. In the study, the incidence of flushing was reduced by approximately 25% in the fed state. Dimethyl fumarate may be taken with or without food; however, taking it with food may help reduce flushing.

References (1)
  1. (2013) "Product Information. Tecfidera (dimethyl fumarate)." Biogen

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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