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Drug Interactions between cholera vaccine, live and immune globulin intravenous

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

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Interactions between your drugs

Moderate

immune globulin intravenous cholera vaccine, live

Applies to: immune globulin intravenous and cholera vaccine, live

ADJUST DOSING INTERVAL: Administration of immune globulin preparations with, shortly before, or after live vaccines may impair the immune response to the vaccination(s). Injected live, attenuated virus vaccines (e.g., measles/mumps/rubella (MMR), measles/mumps/rubella/varicella (MMRV), varicella) may be affected by circulating antibodies present in immune globulin therapy or other blood products. The passive transfer of these antibodies may prevent replication of the vaccine virus, potentially reducing the vaccine's efficacy. In general, there appears to be minimal to no interaction between immune globulin preparations or blood products and the yellow fever vaccine, some live oral vaccines (e.g., rotavirus vaccine, oral typhoid vaccine), the live attenuated influenza vaccine (LAIV), and the Bacille Calmette-Guerin (BCG) vaccine. As this interaction is dependent upon the antibodies present in the immunoglobulin or blood product, it may be affected by the source used to create the product. Additionally, the vaccinations impacted may vary from country to country. Data on the immunogenicity and safety of all different vaccinations after the administration of all different immune globulin preparations are not available.

MANAGEMENT: In general, administration of a live vaccine should be delayed until the passive antibody received from the immune globulin product has degraded, which is product- and dose-dependent. If rapid protection is required, vaccination should proceed, but additional dose(s) of the vaccine and/or laboratory testing to ensure vaccine efficacy may be advised. According to the Advisory Committee on Immunization Practices (ACIP), the Ty21a typhoid, yellow fever, LAIV, and rotavirus vaccines may be administered at any time before, concurrently with, or after the administration of any immune globulin preparation or blood product. Local guidelines and prescribing information for the products involved should be consulted for further recommendations.

References (29)
  1. "Product Information. Sandoglobulin (immune globulin intravenous)." Sandoz Pharmaceuticals Corporation
  2. (2001) "Product Information. Bayrab (rabies immune globulin, human)." Bayer
  3. (2022) "Product Information. Varivax (varicella virus vaccine)." Merck & Co., Inc
  4. (2022) "Product Information. Attenuvax (measles virus vaccine)." Merck & Co., Inc
  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. "Product Information. H-BIG (hepatitis B immune globulin)." Allscrips Pharmaceutical Company
  7. (2002) "Product Information. Cytogam (cytomegalovirus immune globulin)." CSL Behring LLC
  8. (2002) "Product Information. Varicella Zoster Immune Globulin (varicella zoster immune globulin)." American Red Cross Blood Services
  9. (2022) "Product Information. WinRho SDF (RHo (D) immune globulin)." Apothecon Inc
  10. (2022) "Product Information. Bayhep B (hepatitis B immune globulin)." Bayer Pharmaceutical Inc
  11. (2022) "Product Information. Nabi-HB (hepatitis B immune globulin)." Biotest Pharmaceuticals Corporation
  12. (2022) "Product Information. Rhophylac (RHo (D) immune globulin)." Apothecon Inc
  13. (2022) "Product Information. HyperRHO S/D Full Dose (RHo (D) immune globulin)." Talecris Biotherapeutics
  14. (2006) "Product Information. Vivaglobin (immune globulin subcutaneous)." *ZLB Bioplasma Inc
  15. (2008) "Product Information. BabyBIG (botulism immune globulin)." FFF Enterprises
  16. (2010) "Product Information. Imogam Rabies-HT (rabies immune globulin, human)." sanofi pasteur
  17. Department of Health. National Health Service (2019) Immunisation Against Infectious Disease - "The Green Book". Chapter 6: Contraindications and special considerations. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/655225/Greenbook_chapter_6.pdf
  18. (2023) "Product Information. Qdenga (dengue vaccine)." Takeda UK Ltd
  19. Advisory Committee on Immunization Practices: Centers for Disease Control and Prevention General Best Practice Guidelines for Immunization: Timing and Spacing of Immunobiologics https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/timing.html
  20. Public Health Agency of Canada Blood products, human immunoglobulin and timing of immunization: Canadian Immunization Guide https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-1-key-immunization-information/page-11-blood-product
  21. Clucas L, Crawford N, Danchin M, Greenway A Live-attenuated vaccines in patients receiving regular red blood cell transfusions https://mvec.mcri.edu.au/references/live-attenuated-vaccines-in-patients-receiving-regular-red-blood-cell-transfusions/
  22. Melbourne Vaccine Education Centre Live-attenuated vaccines and immunoglobulins or blood products https://mvec.mcri.edu.au/references/live-attenuated-vaccines-and-immunoglobulins-or-blood-products/
  23. Australian Government. Department of Health and Aged Care Australian Immunisation Handbook: Vaccination for people who have recently received normal human immunoglobulin and other blood products https://immunisationhandbook.health.gov.au/contents/vaccination-for-special-risk-groups/vaccination-for-people-who-ha
  24. Australian Government. Department of Health and Aged Care Australian Immunisation Handbook: Tuberculosis https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/tuberculosis
  25. Australian Government. Department of Health and Aged Care Australian Immunisation Handbook: Zoster (herpes zoster) https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/zoster-herpes-zoster
  26. Australian Government. Department of Health and Aged Care Australian Immunisation Handbook: Measles https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/measles#vaccine-information
  27. Australian Government. Department of Health and Aged Care Australian Immunisation Handbook: Rubella https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/rubella
  28. Australian Government. Department of Health and Aged Care Australian Immunisation Handbook: Mumps https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/mumps
  29. Australian Government. Department of Health and Aged Care Australian Immunisation Handbook: Varicella (chickenpox) https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/varicella-chickenpox

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

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

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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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