Drug interactions
Leflunomide + Rotavirus oral vaccine live
Severity: Major
Leflunomide and Rotavirus oral 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
Leflunomide is immunosuppressive, and a live attenuated rotavirus vaccine could cause prolonged or disseminated vaccine-strain infection. The vaccine response may also be reduced. Relevance is mainly for infants exposed to the drug, for example via a treated mother during pregnancy or breastfeeding.
What this interaction means in plain words
Leflunomide and Rotavirus oral 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
Leflunomide's active metabolite inhibits dihydroorotate dehydrogenase and lymphocyte proliferation, reducing control of replicating live vaccine organisms.
What to do
Avoid live vaccines in patients on leflunomide; the active metabolite persists for a long time unless washout with cholestyramine is performed. Seek specialist advice on timing, particularly for infants with in utero or breast milk exposure.
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 Leflunomide
- Bcg vaccine live + Leflunomide Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Leflunomide Contraindicated
- Leflunomide + Measles mumps and rubella vaccine live Contraindicated
- Leflunomide + Measles mumps rubella and varicella vaccine live Contraindicated
- Leflunomide + Measles vaccine Contraindicated
- Leflunomide + Smallpox vaccine live Contraindicated
Frequently asked questions
Can I take Leflunomide with Rotavirus oral vaccine live?
MediHelp rates the interaction as major. Leflunomide and Rotavirus oral 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. Leflunomide is immunosuppressive, and a live attenuated rotavirus vaccine could cause prolonged or disseminated vaccine-strain infection. The vaccine response may also be reduced. Relevance is mainly for infants exposed to the drug, for example via a treated mother during pregnancy or breastfeeding.
How serious is the interaction between Leflunomide and Rotavirus oral 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 vaccines in patients on leflunomide; the active metabolite persists for a long time unless washout with cholestyramine is performed. Seek specialist advice on timing, particularly for infants with in utero or breast milk exposure.
What other medicines interact with Leflunomide?
MediHelp also lists interactions of Leflunomide with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Measles mumps and rubella vaccine live. The full list is on the Leflunomide page.
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