Drug interactions
Cholera vaccine + Cladribine
Severity: Major
Cholera vaccine and Cladribine: 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
Cladribine causes prolonged lymphocyte depletion, which can reduce the immune response to vaccines. The oral cholera vaccine is live attenuated, so there is also a theoretical risk of infection from the vaccine strain.
What this interaction means in plain words
Cholera vaccine and Cladribine 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
Cladribine-induced lymphopenia impairs vaccine immune responses and may permit replication of a live attenuated vaccine strain.
What to do
Avoid live vaccines during and after cladribine until lymphocyte counts have recovered. Where possible, complete vaccination at least 4 to 6 weeks before starting cladribine.
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 Cladribine
- Adenovirus types 4 and 7 live + Cladribine Contraindicated
- Cladribine + Siponimod Contraindicated
- Cladribine + Tofacitinib Contraindicated
- Axicabtagene ciloleucel + Cladribine Major
- Belatacept + Cladribine Major
- Brexucabtagene autoleucel + Cladribine Major
Frequently asked questions
Can I take Cholera vaccine with Cladribine?
MediHelp rates the interaction as major. Cholera vaccine and Cladribine 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. Cladribine causes prolonged lymphocyte depletion, which can reduce the immune response to vaccines. The oral cholera vaccine is live attenuated, so there is also a theoretical risk of infection from the vaccine strain.
How serious is the interaction between Cholera vaccine and Cladribine?
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 vaccines during and after cladribine until lymphocyte counts have recovered. Where possible, complete vaccination at least 4 to 6 weeks before starting cladribine.
What other medicines interact with Cladribine?
MediHelp also lists interactions of Cladribine with, for example, Adenovirus types 4 and 7 live, Siponimod, Tofacitinib. The full list is on the Cladribine page.
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