Drug interactions
Influenza virus vaccine quadrivalent intranasal + Ustekinumab
Severity: Major
Influenza virus vaccine quadrivalent intranasal and Ustekinumab: 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
The intranasal influenza vaccine contains live attenuated virus, which could replicate and cause disease in patients immunosuppressed by ustekinumab. Vaccine efficacy may also be reduced.
What this interaction means in plain words
Influenza virus vaccine quadrivalent intranasal and Ustekinumab 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
Immunosuppression through IL-12/23 blockade may permit replication of live attenuated virus and impairs vaccine response.
What to do
Use an inactivated injectable influenza vaccine instead of the live intranasal product during ustekinumab therapy.
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 Ustekinumab
- Bcg vaccine live + Ustekinumab Contraindicated
- Typhoid vaccine live + Ustekinumab Contraindicated
- Adalimumab + Ustekinumab Major
- Adenovirus types 4 and 7 live + Ustekinumab Major
- Alefacept + Ustekinumab Major
- Anakinra + Ustekinumab Major
Frequently asked questions
Can I take Influenza virus vaccine quadrivalent intranasal with Ustekinumab?
MediHelp rates the interaction as major. Influenza virus vaccine quadrivalent intranasal and Ustekinumab 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. The intranasal influenza vaccine contains live attenuated virus, which could replicate and cause disease in patients immunosuppressed by ustekinumab. Vaccine efficacy may also be reduced.
How serious is the interaction between Influenza virus vaccine quadrivalent intranasal and Ustekinumab?
MediHelp rates it major, 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 of the live intranasal product during ustekinumab therapy.
What other medicines interact with Ustekinumab?
MediHelp also lists interactions of Ustekinumab with, for example, Bcg vaccine live, Typhoid vaccine live, Adalimumab. The full list is on the Ustekinumab page.
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