Drug interactions
Influenza virus vaccine quadrivalent intranasal + Tocilizumab
Severity: Major
Influenza virus vaccine quadrivalent intranasal and Tocilizumab: 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
Intranasal influenza vaccine contains live attenuated virus, which may replicate excessively in patients immunosuppressed by tocilizumab. Efficacy may also be reduced.
What this interaction means in plain words
Influenza virus vaccine quadrivalent intranasal and Tocilizumab 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
Pharmacodynamic: IL-6 blockade impairs immune control of live attenuated influenza virus.
What to do
Avoid intranasal live vaccine during tocilizumab therapy and use an inactivated injectable influenza vaccine instead.
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 Tocilizumab
- Bcg vaccine live + Tocilizumab Contraindicated
- Measles mumps and rubella vaccine live + Tocilizumab Contraindicated
- Measles mumps rubella and varicella vaccine live + Tocilizumab Contraindicated
- Measles vaccine + Tocilizumab Contraindicated
- Rubella vaccine + Tocilizumab Contraindicated
- Smallpox vaccine live + Tocilizumab Contraindicated
Frequently asked questions
Can I take Influenza virus vaccine quadrivalent intranasal with Tocilizumab?
MediHelp rates the interaction as major. Influenza virus vaccine quadrivalent intranasal and Tocilizumab 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. Intranasal influenza vaccine contains live attenuated virus, which may replicate excessively in patients immunosuppressed by tocilizumab. Efficacy may also be reduced.
How serious is the interaction between Influenza virus vaccine quadrivalent intranasal and Tocilizumab?
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 intranasal live vaccine during tocilizumab therapy and use an inactivated injectable influenza vaccine instead.
What other medicines interact with Tocilizumab?
MediHelp also lists interactions of Tocilizumab with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Tocilizumab page.
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