Drug interactions
Influenza virus vaccine quadrivalent intranasal + Melphalan
Severity: Contraindicated
Influenza virus vaccine quadrivalent intranasal and Melphalan: contraindicated 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 intranasal influenza vaccine contains live attenuated virus, which can replicate excessively in a patient immunosuppressed by melphalan. The vaccine response is also reduced.
What this interaction means in plain words
Influenza virus vaccine quadrivalent intranasal and Melphalan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Chemotherapy-induced immunosuppression allows unchecked replication of live attenuated virus and impairs the vaccine response.
What to do
Use an inactivated injectable influenza vaccine instead during melphalan therapy. Avoid the live intranasal product until at least 3 months after treatment ends.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Melphalan
- Adenovirus types 4 and 7 live + Melphalan Contraindicated
- Bcg vaccine live + 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
- Measles vaccine + Melphalan Contraindicated
Frequently asked questions
Can I take Influenza virus vaccine quadrivalent intranasal with Melphalan?
MediHelp rates the interaction as contraindicated. Influenza virus vaccine quadrivalent intranasal and Melphalan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. The intranasal influenza vaccine contains live attenuated virus, which can replicate excessively in a patient immunosuppressed by melphalan. The vaccine response is also reduced.
How serious is the interaction between Influenza virus vaccine quadrivalent intranasal and Melphalan?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use an inactivated injectable influenza vaccine instead during melphalan therapy. Avoid the live intranasal product until at least 3 months after treatment ends.
What other medicines interact with Melphalan?
MediHelp also lists interactions of Melphalan with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Measles mumps and rubella vaccine live. The full list is on the Melphalan page.
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