Drug interactions
Ocrelizumab + Smallpox vaccine live
Severity: Major
Ocrelizumab and Smallpox 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
Live vaccinia vaccine replicates in the host, and in immunosuppressed patients this can lead to progressive vaccinia or disseminated infection. Ocrelizumab produces prolonged B-cell depletion, which increases this risk and may reduce the protective response.
What this interaction means in plain words
Ocrelizumab and Smallpox 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
Immunosuppression from B-cell depletion impairs control of replicating live vaccine virus and weakens the immune response.
What to do
Avoid live smallpox vaccine during ocrelizumab therapy and until B-cell repletion. If vaccination is needed, give it at least 4 weeks before starting ocrelizumab, or weigh it against a non-replicating alternative where available.
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 Ocrelizumab
- Adenovirus types 4 and 7 live + Ocrelizumab Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Ocrelizumab Contraindicated
- Measles mumps and rubella vaccine live + Ocrelizumab Contraindicated
- Measles mumps rubella and varicella vaccine live + Ocrelizumab Contraindicated
- Measles vaccine + Ocrelizumab Contraindicated
- Anti-thymocyte + Ocrelizumab Major
Frequently asked questions
Can I take Ocrelizumab with Smallpox vaccine live?
MediHelp rates the interaction as major. Ocrelizumab and Smallpox 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. Live vaccinia vaccine replicates in the host, and in immunosuppressed patients this can lead to progressive vaccinia or disseminated infection. Ocrelizumab produces prolonged B-cell depletion, which increases this risk and may reduce the protective response.
How serious is the interaction between Ocrelizumab and Smallpox 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 smallpox vaccine during ocrelizumab therapy and until B-cell repletion. If vaccination is needed, give it at least 4 weeks before starting ocrelizumab, or weigh it against a non-replicating alternative where available.
What other medicines interact with Ocrelizumab?
MediHelp also lists interactions of Ocrelizumab with, for example, Adenovirus types 4 and 7 live, Influenza virus vaccine quadrivalent intranasal, Measles mumps and rubella vaccine live. The full list is on the Ocrelizumab page.
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