Drug interactions
Smallpox vaccine live + Tacrolimus
Severity: Contraindicated
Smallpox vaccine live and Tacrolimus: contraindicated 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 can cause progressive vaccinia and serious disseminated infection in immunosuppressed patients. Tacrolimus markedly raises that risk.
What this interaction means in plain words
Smallpox vaccine live and Tacrolimus are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Impaired T-cell immunity from calcineurin inhibition allows uncontrolled replication of vaccinia virus.
What to do
Avoid live vaccinia vaccine in patients on tacrolimus, and in their household contacts where possible. Seek specialist advice on non-replicating alternatives if protection is needed.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus Contraindicated
Frequently asked questions
Can I take Smallpox vaccine live with Tacrolimus?
MediHelp rates the interaction as contraindicated. Smallpox vaccine live and Tacrolimus are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Live vaccinia vaccine can cause progressive vaccinia and serious disseminated infection in immunosuppressed patients. Tacrolimus markedly raises that risk.
How serious is the interaction between Smallpox vaccine live and Tacrolimus?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid live vaccinia vaccine in patients on tacrolimus, and in their household contacts where possible. Seek specialist advice on non-replicating alternatives if protection is needed.
What other medicines interact with Tacrolimus?
MediHelp also lists interactions of Tacrolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Cidofovir. The full list is on the Tacrolimus page.
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