Drug Interaction Report

ADJUST DOSING INTERVAL: The administration of live, attenuated viral or bacterial vaccines or oncolytic immunotherapy containing live, attenuated virus or bacteria to patients receiving teplizumab is not recommended, and may be associated with a risk of disseminated infection due to enhanced replication of virus or bacteria in the presence of diminished immune competence. In addition, teplizumab may interfere with the immune response to vaccination and decrease vaccine efficacy. However, data are not available. A specific timeframe for immunization of infants exposed to teplizumab in utero is not available due to a lack of sufficient data about infant serum levels or the duration of persistence of teplizumab in infant serum after birth.

MANAGEMENT: The administration of live, attenuated viral or bacterial vaccines or oncolytic immunotherapy containing live, attenuated virus or bacteria is not recommended within the 8 weeks prior to treatment, during, and for up to 52 weeks after treatment with teplizumab. Patients should be advised to receive all age-appropriate vaccinations prior to starting treatment with teplizumab. The risks and benefits should be considered prior to the administration of live, attenuated viral or bacterial vaccines or oncolytic immunotherapy containing live, attenuated virus or bacteria to infants exposed to teplizumab in utero.

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.