Drug interactions
Smallpox vaccine live + Ustekinumab
Severity: Major
Smallpox vaccine live and Ustekinumab: 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
Live vaccinia vaccine can cause progressive vaccinia and serious complications in immunosuppressed patients. Ustekinumab may increase this risk and reduce vaccine effect.
What this interaction means in plain words
Smallpox vaccine live and Ustekinumab 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
Immunosuppression via IL-12/23 blockade may permit uncontrolled replication of live vaccinia virus.
What to do
Avoid replicating smallpox vaccine during ustekinumab therapy; use a non-replicating vaccine if protection is needed and seek specialist advice.
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 Ustekinumab
- Bcg vaccine live + Ustekinumab Contraindicated
- Typhoid vaccine live + Ustekinumab Contraindicated
- Adalimumab + Ustekinumab Major
- Adenovirus types 4 and 7 live + Ustekinumab Major
- Alefacept + Ustekinumab Major
- Anakinra + Ustekinumab Major
Frequently asked questions
Can I take Smallpox vaccine live with Ustekinumab?
MediHelp rates the interaction as major. Smallpox vaccine live and Ustekinumab 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. Live vaccinia vaccine can cause progressive vaccinia and serious complications in immunosuppressed patients. Ustekinumab may increase this risk and reduce vaccine effect.
How serious is the interaction between Smallpox vaccine live and Ustekinumab?
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 replicating smallpox vaccine during ustekinumab therapy; use a non-replicating vaccine if protection is needed and seek specialist advice.
What other medicines interact with Ustekinumab?
MediHelp also lists interactions of Ustekinumab with, for example, Bcg vaccine live, Typhoid vaccine live, Adalimumab. The full list is on the Ustekinumab page.
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