Drug interactions
Cilastatin-imipenem + Typhoid vaccine live
Severity: Moderate
Cilastatin-imipenem and Typhoid vaccine live: moderate 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
Oral live typhoid vaccine (Ty21a) depends on replication of live bacteria in the gut, and antibacterials active against Salmonella can inactivate it. This may lead to inadequate protection.
What this interaction means in plain words
Cilastatin-imipenem and Typhoid vaccine live can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Antibacterial activity against the live attenuated Salmonella strain reduces vaccine viability and immune response.
What to do
Give the live oral typhoid vaccine at least 3 days after the last antibiotic dose, or use the injectable inactivated vaccine if immunization cannot wait.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Cilastatin-imipenem
Frequently asked questions
Can I take Cilastatin-imipenem with Typhoid vaccine live?
MediHelp rates the interaction as moderate. Cilastatin-imipenem and Typhoid vaccine live can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Oral live typhoid vaccine (Ty21a) depends on replication of live bacteria in the gut, and antibacterials active against Salmonella can inactivate it. This may lead to inadequate protection.
How serious is the interaction between Cilastatin-imipenem and Typhoid vaccine live?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Give the live oral typhoid vaccine at least 3 days after the last antibiotic dose, or use the injectable inactivated vaccine if immunization cannot wait.
What other medicines interact with Cilastatin-imipenem?
MediHelp also lists interactions of Cilastatin-imipenem with, for example, Divalproex, Ganciclovir, Valproic acid. The full list is on the Cilastatin-imipenem page.
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