Drug interactions
Prednisone + Zoster vaccine live
Severity: Major
Prednisone and Zoster vaccine live: major interaction.
Last updated Sources: US FDA label
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 can cause disseminated varicella-zoster vaccine-strain infection in patients on immunosuppressive prednisone doses, and the response may be blunted. This is a risk of serious infection.
What this interaction means in plain words
Prednisone 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
Corticosteroid-induced suppression of cell-mediated immunity permits uncontrolled replication of the live attenuated virus.
What to do
Avoid the live vaccine during high-dose or prolonged prednisone therapy and wait at least 1 month after stopping. Use the recombinant non-live zoster vaccine where available, as it can be given during immunosuppression.
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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References
Other interactions of Prednisone
- Bcg vaccine live + Prednisone Contraindicated
- Measles vaccine + Prednisone Contraindicated
- Mifepristone + Prednisone Contraindicated
- Prednisone + Radium-223 dichloride Contraindicated
- Prednisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Prednisone Major
Frequently asked questions
Can I take Prednisone with Zoster vaccine live?
MediHelp rates the interaction as major. Prednisone 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 can cause disseminated varicella-zoster vaccine-strain infection in patients on immunosuppressive prednisone doses, and the response may be blunted. This is a risk of serious infection.
How serious is the interaction between Prednisone 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 the live vaccine during high-dose or prolonged prednisone therapy and wait at least 1 month after stopping. Use the recombinant non-live zoster vaccine where available, as it can be given during immunosuppression.
What other medicines interact with Prednisone?
MediHelp also lists interactions of Prednisone with, for example, Bcg vaccine live, Measles vaccine, Mifepristone. The full list is on the Prednisone page.
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