Drug interactions
Bcg vaccine live + Fludrocortisone
Severity: Major
Bcg vaccine live and Fludrocortisone: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
BCG is a live attenuated vaccine. Corticosteroid-induced immunosuppression could permit uncontrolled vaccine strain replication and disseminated BCG infection, and could also impair the vaccine response. Fludrocortisone at replacement doses has limited immunosuppressive effect, but the risk is higher with higher or prolonged dosing.
What this interaction means in plain words
Bcg vaccine live and Fludrocortisone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Corticosteroid-mediated immunosuppression reduces control of live attenuated organisms and blunts immune response.
What to do
Avoid live BCG in patients on immunosuppressive corticosteroid doses; at replacement-only doses for adrenal insufficiency, vaccination may be considered after specialist review. Otherwise defer vaccination until steroid exposure has fallen to a non-immunosuppressive level.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Fludrocortisone
- Fludrocortisone + Mifepristone Contraindicated
- Aldesleukin + Fludrocortisone Major
- Amphotericin b + Fludrocortisone Major
- Fludrocortisone + Influenza virus vaccine quadrivalent intranasal Major
- Fludrocortisone + Measles mumps and rubella vaccine live Major
- Fludrocortisone + Measles mumps rubella and varicella vaccine live Major
Frequently asked questions
Can I take Bcg vaccine live with Fludrocortisone?
MediHelp rates the interaction as major. Bcg vaccine live and Fludrocortisone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. BCG is a live attenuated vaccine. Corticosteroid-induced immunosuppression could permit uncontrolled vaccine strain replication and disseminated BCG infection, and could also impair the vaccine response. Fludrocortisone at replacement doses has limited immunosuppressive effect, but the risk is higher with higher or prolonged dosing.
How serious is the interaction between Bcg vaccine live and Fludrocortisone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid live BCG in patients on immunosuppressive corticosteroid doses; at replacement-only doses for adrenal insufficiency, vaccination may be considered after specialist review. Otherwise defer vaccination until steroid exposure has fallen to a non-immunosuppressive level.
What other medicines interact with Fludrocortisone?
MediHelp also lists interactions of Fludrocortisone with, for example, Mifepristone, Aldesleukin, Amphotericin b. The full list is on the Fludrocortisone page.
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