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Drug Interactions between Vaxchora and Venclexta

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

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Interactions between your drugs

Major

venetoclax cholera vaccine, live

Applies to: Venclexta (venetoclax) and Vaxchora (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

  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
View all 5 references

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Drug and food interactions

Major

venetoclax food

Applies to: Venclexta (venetoclax)

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of venetoclax. Relative to fasting conditions, venetoclax systemic exposure (AUC) increased by approximately 3.4-fold when administered with a low-fat meal and by 5.1- to 5.3-fold when administered with a high-fat meal.

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of venetoclax. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Increased venetoclax exposure may potentiate the risk of tumor lysis syndrome, particularly at initiation of therapy and during the dosage ramp-up phase, as well as other adverse effects such as diarrhea, nausea, vomiting, neutropenia, anemia, and thrombocytopenia.

MANAGEMENT: Venetoclax should be administered with a meal and water at approximately the same time each day. Patients should avoid consumption of grapefruit products, Seville oranges, and starfruit during treatment with venetoclax.

References

  1. (2016) "Product Information. Venclexta (venetoclax)." AbbVie US LLC

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Moderate

cholera vaccine, live food

Applies to: Vaxchora (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

  1. (2023) "Product Information. Vaxchora (cholera vaccine, live)." Patientric Ltd
  2. (2022) "Product Information. Dukoral (vibrio cholerae vaccine)." 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
View all 4 references

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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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