Drug interactions
Measles mumps rubella and varicella vaccine live + Rituximab
Severity: Major
Measles mumps rubella and varicella vaccine live and Rituximab: 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 MMRV vaccine contains four live attenuated viruses, which can cause disseminated vaccine-strain infection, particularly varicella, in patients with B-cell depletion. The immune response may also be inadequate.
What this interaction means in plain words
Measles mumps rubella and varicella vaccine live and Rituximab 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
Rituximab-induced B-cell depletion causes immunosuppression that allows live attenuated virus to replicate in an uncontrolled way.
What to do
Avoid live vaccines during rituximab therapy and until B-cell recovery. Give any needed live vaccines at least 4 weeks before starting rituximab.
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 Rituximab
Frequently asked questions
Can I take Measles mumps rubella and varicella vaccine live with Rituximab?
MediHelp rates the interaction as major. Measles mumps rubella and varicella vaccine live and Rituximab 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 MMRV vaccine contains four live attenuated viruses, which can cause disseminated vaccine-strain infection, particularly varicella, in patients with B-cell depletion. The immune response may also be inadequate.
How serious is the interaction between Measles mumps rubella and varicella vaccine live and Rituximab?
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 during rituximab therapy and until B-cell recovery. Give any needed live vaccines at least 4 weeks before starting rituximab.
What other medicines interact with Rituximab?
MediHelp also lists interactions of Rituximab with, for example, Adenovirus types 4 and 7 live, Baricitinib, Certolizumab pegol. The full list is on the Rituximab page.
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