Drug interactions
Rabies vaccine + Rituximab
Severity: Moderate
Rabies vaccine and Rituximab: moderate 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
Rituximab-treated patients may not develop adequate neutralizing antibody after rabies vaccination. This is important for pre-exposure prophylaxis, and post-exposure care may need strengthening.
What this interaction means in plain words
Rabies vaccine and Rituximab can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Rituximab-mediated CD20-positive B-cell depletion impairs humoral vaccine responses.
What to do
Give pre-exposure vaccination at least 4 weeks before rituximab when possible. In immunosuppressed patients, check rabies neutralizing antibody titres after vaccination, and for exposure use full post-exposure prophylaxis including immune globulin.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Rituximab
Frequently asked questions
Can I take Rabies vaccine with Rituximab?
MediHelp rates the interaction as moderate. Rabies vaccine and Rituximab can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Rituximab-treated patients may not develop adequate neutralizing antibody after rabies vaccination. This is important for pre-exposure prophylaxis, and post-exposure care may need strengthening.
How serious is the interaction between Rabies vaccine and Rituximab?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Give pre-exposure vaccination at least 4 weeks before rituximab when possible. In immunosuppressed patients, check rabies neutralizing antibody titres after vaccination, and for exposure use full post-exposure prophylaxis including immune globulin.
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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