Drug interactions
Dengue vaccine + Melphalan
Severity: Major
Dengue vaccine and Melphalan: major interaction.
Last updated Sources: UK SmPC
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
Dengue vaccine is a live attenuated vaccine. In patients immunosuppressed by melphalan, the vaccine response may be weaker and there is a theoretical risk of vaccine-related infection.
What this interaction means in plain words
Dengue vaccine and Melphalan 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
Cytotoxic immunosuppression impairs the immune response to the vaccine and may allow replication of the live virus.
What to do
Avoid giving the live vaccine during melphalan therapy and until immune recovery. Use non-live alternatives where available, and vaccinate before starting chemotherapy when possible.
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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References
Other interactions of Melphalan
- Adenovirus types 4 and 7 live + Melphalan Contraindicated
- Bcg vaccine live + Melphalan Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Melphalan Contraindicated
- Measles mumps and rubella vaccine live + Melphalan Contraindicated
- Measles mumps and rubella vaccine + Melphalan Contraindicated
- Measles mumps rubella and varicella vaccine live + Melphalan Contraindicated
Frequently asked questions
Can I take Dengue vaccine with Melphalan?
MediHelp rates the interaction as major. Dengue vaccine and Melphalan 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. Dengue vaccine is a live attenuated vaccine. In patients immunosuppressed by melphalan, the vaccine response may be weaker and there is a theoretical risk of vaccine-related infection.
How serious is the interaction between Dengue vaccine and Melphalan?
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 giving the live vaccine during melphalan therapy and until immune recovery. Use non-live alternatives where available, and vaccinate before starting chemotherapy when possible.
What other medicines interact with Melphalan?
MediHelp also lists interactions of Melphalan with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Melphalan page.
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