Drug interactions
Dupilumab + Smallpox vaccine live
Severity: Major
Dupilumab and Smallpox vaccine live: 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
Live vaccinia vaccine can cause serious complications with impaired immunity, and its use in dupilumab-treated patients has not been studied. Patients with atopic dermatitis are already at risk of eczema vaccinatum.
What this interaction means in plain words
Dupilumab and Smallpox vaccine live 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
Dupilumab blocks IL-4/IL-13 signaling, which may alter immune control of replicating vaccinia virus; the effect is partly theoretical.
What to do
Avoid live smallpox vaccine during dupilumab therapy unless the exposure risk clearly outweighs the risk; vaccinate before starting treatment where 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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Other interactions of Dupilumab
- Adenovirus types 4 and 7 live + Dupilumab Moderate
- Bcg vaccine live + Dupilumab Moderate
- Cyclosporine + Dupilumab Moderate
- Disopyramide + Dupilumab Moderate
- Dupilumab + Fosphenytoin Moderate
- Dupilumab + Influenza virus vaccine quadrivalent intranasal Moderate
Frequently asked questions
Can I take Dupilumab with Smallpox vaccine live?
MediHelp rates the interaction as major. Dupilumab and Smallpox vaccine live 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. Live vaccinia vaccine can cause serious complications with impaired immunity, and its use in dupilumab-treated patients has not been studied. Patients with atopic dermatitis are already at risk of eczema vaccinatum.
How serious is the interaction between Dupilumab and Smallpox vaccine live?
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 smallpox vaccine during dupilumab therapy unless the exposure risk clearly outweighs the risk; vaccinate before starting treatment where possible.
What other medicines interact with Dupilumab?
MediHelp also lists interactions of Dupilumab with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Cyclosporine. The full list is on the Dupilumab page.
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