Drug Interaction Report

The safety and immunogenicity of live influenza virus vaccines when administered concurrently with other vaccines have not been determined. Clinical studies for FluMist (live influenza virus vaccine intranasal spray) have excluded subjects who received any inactivated or subunit vaccine within two weeks of enrollment. Data concerning use with live vaccines are limited to the measles, mumps and rubella vaccine and the varicella vaccine. In a study consisting of 1,245 children 12 to 15 months of age, adverse events observed during concurrent administration of FluMist with these vaccines were similar to the adverse effects reported in other clinical trials for FluMist. No evidence of interference with immune responses to any of the study vaccines was observed. Concurrent administration in children greater than 15 months of age has not been studied.

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.