Drug interactions
Smallpox vaccine live + Tocilizumab
Severity: Contraindicated
Smallpox vaccine live and Tocilizumab: 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. Tocilizumab increases this risk and may reduce the vaccine response.
What this interaction means in plain words
Smallpox vaccine live and Tocilizumab 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
IL-6 receptor blockade impairs control of live vaccinia virus replication.
What to do
Avoid live smallpox vaccine in patients on tocilizumab; use a non-replicating alternative if one is available and vaccination is essential.
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 Tocilizumab
- Bcg vaccine live + Tocilizumab Contraindicated
- Measles mumps and rubella vaccine live + Tocilizumab Contraindicated
- Measles mumps rubella and varicella vaccine live + Tocilizumab Contraindicated
- Measles vaccine + Tocilizumab Contraindicated
- Rubella vaccine + Tocilizumab Contraindicated
- Tocilizumab + Typhoid vaccine live Contraindicated
Frequently asked questions
Can I take Smallpox vaccine live with Tocilizumab?
MediHelp rates the interaction as contraindicated. Smallpox vaccine live and Tocilizumab 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. Tocilizumab increases this risk and may reduce the vaccine response.
How serious is the interaction between Smallpox vaccine live and Tocilizumab?
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 smallpox vaccine in patients on tocilizumab; use a non-replicating alternative if one is available and vaccination is essential.
What other medicines interact with Tocilizumab?
MediHelp also lists interactions of Tocilizumab with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Tocilizumab page.
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