Drug interactions
Ocrelizumab + Zoster vaccine live
Severity: Major
Ocrelizumab and Zoster 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 zoster vaccine contains replicating varicella-zoster virus, which can cause disseminated disease in immunosuppressed patients. Ocrelizumab causes sustained B-cell depletion that raises this risk and may reduce the immune response.
What this interaction means in plain words
Ocrelizumab and Zoster 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 zoster vaccine during ocrelizumab therapy. Use the recombinant non-live zoster vaccine instead where it is indicated.
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 Zoster vaccine live?
MediHelp rates the interaction as major. Ocrelizumab and Zoster 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 zoster vaccine contains replicating varicella-zoster virus, which can cause disseminated disease in immunosuppressed patients. Ocrelizumab causes sustained B-cell depletion that raises this risk and may reduce the immune response.
How serious is the interaction between Ocrelizumab and Zoster 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 zoster vaccine during ocrelizumab therapy. Use the recombinant non-live zoster vaccine instead where it is indicated.
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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