Drug Interaction Report

GENERALLY AVOID: The administration of live, attenuated viral or bacterial vaccines during nemolizumab therapy may be associated with a risk of disseminated infection due to enhanced replication of vaccine virus or bacteria in the presence of diminished immune competence. However, data evaluating the impact of nemolizumab treatment on the safety and effectiveness of these vaccines is not available.

MANAGEMENT: The manufacturer of nemolizumab recommends that the use of live, attenuated virus or bacterial vaccines be avoided during treatment with nemolizumab. Administration of all age-appropriate vaccines is recommended to be completed prior to initiation of nemolizumab, and in accordance with current immunization guidelines.

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.