Drug interactions
Rituximab + Yellow fever vaccine
Severity: Major
Rituximab and Yellow fever vaccine: 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
Yellow fever vaccine is live attenuated and can cause serious vaccine-associated disease in immunocompromised patients. Rituximab-related B-cell depletion also makes the vaccine less likely to protect.
What this interaction means in plain words
Rituximab and Yellow fever vaccine 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
Rituximab-induced B-cell depletion causes immunosuppression that allows live attenuated virus to replicate in an uncontrolled way.
What to do
Avoid the vaccine during rituximab therapy and until B-cell recovery. If travel to an endemic area cannot be avoided, seek specialist advice and consider a medical exemption letter.
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 Rituximab
Frequently asked questions
Can I take Rituximab with Yellow fever vaccine?
MediHelp rates the interaction as major. Rituximab and Yellow fever vaccine 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. Yellow fever vaccine is live attenuated and can cause serious vaccine-associated disease in immunocompromised patients. Rituximab-related B-cell depletion also makes the vaccine less likely to protect.
How serious is the interaction between Rituximab and Yellow fever vaccine?
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 vaccine during rituximab therapy and until B-cell recovery. If travel to an endemic area cannot be avoided, seek specialist advice and consider a medical exemption letter.
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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