Drug interactions
Smallpox vaccine live + Upadacitinib
Severity: Contraindicated
Smallpox vaccine live and Upadacitinib: 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 in an immunosuppressed patient risks progressive vaccinia and serious disseminated infection. Upadacitinib also reduces the vaccine response.
What this interaction means in plain words
Smallpox vaccine live and Upadacitinib 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
JAK inhibition impairs immune control of live vaccinia virus replication.
What to do
Avoid live smallpox vaccine during upadacitinib therapy unless exposure risk clearly outweighs harm and specialist advice is obtained. Consider a non-replicating vaccine where available.
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 Upadacitinib
- Abrocitinib + Upadacitinib Contraindicated
- Adenovirus types 4 and 7 live + Upadacitinib Contraindicated
- Baricitinib + Upadacitinib Contraindicated
- Bcg vaccine live + Upadacitinib Contraindicated
- Cyclosporine + Upadacitinib Contraindicated
- Dengue vaccine + Upadacitinib Contraindicated
Frequently asked questions
Can I take Smallpox vaccine live with Upadacitinib?
MediHelp rates the interaction as contraindicated. Smallpox vaccine live and Upadacitinib 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 in an immunosuppressed patient risks progressive vaccinia and serious disseminated infection. Upadacitinib also reduces the vaccine response.
How serious is the interaction between Smallpox vaccine live and Upadacitinib?
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 during upadacitinib therapy unless exposure risk clearly outweighs harm and specialist advice is obtained. Consider a non-replicating vaccine where available.
What other medicines interact with Upadacitinib?
MediHelp also lists interactions of Upadacitinib with, for example, Abrocitinib, Adenovirus types 4 and 7 live, Baricitinib. The full list is on the Upadacitinib page.
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