Drug interactions
Melphalan + Varicella virus vaccine live
Severity: Contraindicated
Melphalan and Varicella virus vaccine live: 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
Melphalan causes marked myelosuppression and immunosuppression, so a live attenuated varicella vaccine may replicate unchecked and cause disseminated vaccine-strain disease. The vaccine response is also likely to be blunted.
What this interaction means in plain words
Melphalan and Varicella virus vaccine live 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
Cytotoxic immunosuppression impairs control of live vaccine virus replication and reduces the immune response.
What to do
Do not give live varicella vaccine during melphalan therapy; defer it until immune recovery, generally at least 3 months after chemotherapy ends. Consider inactivated alternatives where available.
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
- Influenza virus vaccine quadrivalent intranasal + 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
Frequently asked questions
Can I take Melphalan with Varicella virus vaccine live?
MediHelp rates the interaction as contraindicated. Melphalan and Varicella virus vaccine live 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. Melphalan causes marked myelosuppression and immunosuppression, so a live attenuated varicella vaccine may replicate unchecked and cause disseminated vaccine-strain disease. The vaccine response is also likely to be blunted.
How serious is the interaction between Melphalan and Varicella virus vaccine live?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not give live varicella vaccine during melphalan therapy; defer it until immune recovery, generally at least 3 months after chemotherapy ends. Consider inactivated alternatives where available.
What other medicines interact with Melphalan?
MediHelp also lists interactions of Melphalan with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Melphalan page.
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