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Drug Interactions between Gamulin Rh and mumps virus vaccine

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

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Major

RHo (D) immune globulin mumps virus vaccine

Applies to: Gamulin Rh (rho (d) immune globulin) and mumps virus vaccine

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), monovalent 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 immune globulin 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 vaccinations (e.g., dengue vaccine, live attenuated oral cholera vaccine) after the administration of all different immune globulin preparations is 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 can be 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. Immunization guidelines vary by country and have exceptions to this general rule and other specific recommendations. According to the Advisory Committee on Immunization Practices (ACIP), measles- and varicella-containing vaccines may be administered either 2 weeks prior to or anywhere from 3 to 11 months after the receipt of an antibody-containing product, depending on the product and dosage regimen in question. They also recommend against delaying MMR, MMRV, or varicella vaccination in postpartum women who received anti-Rho(D) globulin or any other blood product during the last trimester of pregnancy or at delivery. In addition, administration of the dengue vaccine (including pre-vaccination testing) should be delayed by 12 months in those who have received blood products or other immune globulin preparations. Local guidelines and prescribing information for the products involved should be consulted for further recommendations.

References

  1. "Interference of immune globulin with measles and rubella immunization." Eur J Pediatr 152 (1993): 536
  2. "Product Information. Sandoglobulin (immune globulin intravenous)." Sandoz Pharmaceuticals Corporation PROD
  3. "Product Information. Bayrab (rabies immune globulin, human)." Bayer PROD (2001):
  4. "Product Information. Varivax (varicella virus vaccine)." Merck & Co., Inc (2022):
  5. "Product Information. Attenuvax (measles virus vaccine)." Merck & Co., Inc (2022):
  6. "Product Information. Baygam (immunglobulin, intramuskulärt)." Bayer PROD
  7. CDC. Centers for Disease Control and Prevention/ "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) (1993): 1-18
  8. "Product Information. Thymoglobulin (immune globulin intravenous)." SangStat Medical Corporation, Menlo Park, CA.
  9. "Product Information. H-BIG (hepatitis B immune globulin)." Allscrips Pharmaceutical Company
  10. "Product Information. Cytogam (cytomegalovirus immune globulin)." CSL Behring LLC (2002):
  11. "Product Information. Varicella Zoster Immune Globulin (varicella zoster immune globulin)." American Red Cross Blood Services (2002):
  12. "Product Information. Baytet (tetanus immune globulin)." Bayer (2002):
  13. "Product Information. WinRho SDF (RHo (D) immune globulin)." Apothecon Inc (2022):
  14. "Product Information. BayRHo-D (RHo (D) immune globulin)." Bayer
  15. "Product Information. Bayhep B (hepatitis B immune globulin)." Bayer Pharmaceutical Inc (2022):
  16. "Product Information. Nabi-HB (hepatitis B immune globulin)." Biotest Pharmaceuticals Corporation (2022):
  17. "Product Information. Rhophylac (RHo (D) immune globulin)." Apothecon Inc (2022):
  18. "Product Information. HyperRHO S/D Full Dose (RHo (D) immune globulin)." Talecris Biotherapeutics (2022):
  19. "Product Information. Vivaglobin (immune globulin subcutaneous)." *ZLB Bioplasma Inc (2006):
  20. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  21. Canadian Pharmacists Association "e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink" (2006):
  22. "Product Information. BabyBIG (botulism immune globulin)." FFF Enterprises (2008):
  23. "Product Information. Hyperhep B (hepatitis B immune globulin)." Apothecon Inc (2022):
  24. "Product Information. Imogam Rabies-HT (rabies immune globulin, human)." sanofi pasteur (2010):
  25. Department of Health. National Health Service "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" (2019):
  26. "Product Information. Qdenga (dengue vaccine)." Takeda UK Ltd (2023):
  27. 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"
  28. 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"
  29. 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/"
  30. 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/"
  31. 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"
  32. Australian Government. Department of Health and Aged Care "Australian Immunisation Handbook: Tuberculosis https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/tuberculosis"
  33. 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"
  34. Australian Government. Department of Health and Aged Care "Australian Immunisation Handbook: Measles https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/measles#vaccine-information"
  35. Australian Government. Department of Health and Aged Care "Australian Immunisation Handbook: Rubella https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/rubella"
  36. Australian Government. Department of Health and Aged Care "Australian Immunisation Handbook: Mumps https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/mumps"
  37. Australian Government. Department of Health and Aged Care "Australian Immunisation Handbook: Varicella (chickenpox) https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/varicella-chickenpox"
View all 37 references

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Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

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.

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