Drug Interaction Report

ADJUST DOSING INTERVAL: The use of live, attenuated cholera vaccine with systemic antibiotics may result in a diminished immunologic response to the vaccine. Some antibiotics may be active against the vaccine strain of Vibrio cholerae, thereby preventing a sufficient degree of multiplication to occur in order to induce a protective immune response.

MANAGEMENT: It is recommended to avoid treatment with systemic antibiotics for 10 days after vaccination with live, attenuated cholera vaccine. In addition, vaccination with live, attenuated cholera vaccine should be avoided within 14 days of treatment with systemic antibiotics.

ADJUST DOSING INTERVAL: Certain penicillins may exhibit reduced gastrointestinal absorption in the presence of food. The therapeutic effect of the antimicrobial may be reduced.

MANAGEMENT: The interacting penicillin should be administered one hour before or two hours after meals. Penicillin V and amoxicillin are not affected by food and may be given without regard to meals.

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.