Drug interactions
Cholera vaccine + Levofloxacin
Severity: Major
Cholera vaccine and Levofloxacin: 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
The oral cholera vaccine contains live attenuated bacteria that must multiply in the gut to induce immunity. Levofloxacin is active against the vaccine strain and may reduce its viability, leading to a weaker immune response and incomplete protection.
What this interaction means in plain words
Cholera vaccine and Levofloxacin 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
Antibacterial activity of levofloxacin against the live attenuated vaccine strain reduces vaccine colonization and immunogenicity.
What to do
Delay live oral cholera vaccination until at least 14 days after the last antibiotic dose, per product labeling. If the vaccine was given during antibiotic therapy, consider revaccinating after the antibiotic course.
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 Levofloxacin
- Dronedarone + Levofloxacin Contraindicated
- Ibutilide + Levofloxacin Contraindicated
- Levofloxacin + Thioridazine Contraindicated
- Levofloxacin + Vandetanib Contraindicated
- Levofloxacin + Ziprasidone Contraindicated
- Adagrasib + Levofloxacin Major
Frequently asked questions
Can I take Cholera vaccine with Levofloxacin?
MediHelp rates the interaction as major. Cholera vaccine and Levofloxacin 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. The oral cholera vaccine contains live attenuated bacteria that must multiply in the gut to induce immunity. Levofloxacin is active against the vaccine strain and may reduce its viability, leading to a weaker immune response and incomplete protection.
How serious is the interaction between Cholera vaccine and Levofloxacin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Delay live oral cholera vaccination until at least 14 days after the last antibiotic dose, per product labeling. If the vaccine was given during antibiotic therapy, consider revaccinating after the antibiotic course.
What other medicines interact with Levofloxacin?
MediHelp also lists interactions of Levofloxacin with, for example, Dronedarone, Ibutilide, Thioridazine. The full list is on the Levofloxacin page.
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