Drug Interaction:
Interacting drugs- summary
+Measles Vaccine
Immunosuppressants
administration of measles vaccine to patients receiving immunosuppressants
including corticosteroids or radiation therapy, result in insufficient
response to imminzation. They may remain susceptible despite
immnunization.
Immune glubulins
to avoid inactivation of attenuated virus, administer the vacine at least
14 to 30 days before or 6 to 8 weeks after the immune globulin,
altertnately, check antibody response titers or repeat the vaccine dose
3 months after 1gG.
Interferon
concurent use inhibit antibody response to the vaccine.
RIG
RIG diminish the antibody response through antigen-antibody
antagonism. As a rule administer live virus vaccines 14 to 30 days
before or 6 to 12 weeks after immune globulin administration.
Alternately, administer live virus vaccines during this interval if
corresponding antibody titers are measured 3 months after RIG
administration
Measles+
Meningococcal vaccine
reduced seroconversion rate to meningococcioccur with
concurrent immunization.
Tuberculin skin test
measles vaccine temporarily depress tuberculin skin senstivity.
Administer the test before or simultaneously with the vaccine.
Virus vaccine, other
to avoid the hypothetical concern over the antigenic competition,
give measles vaccine after or > 1 month before other virus vacines.
However,several vaccines may be given simultaneously at separate injection sites
( eg. DTP, OPV, MMR, Hib, hepatitis B)
Adverse Reaction:
Anaphylaxis and anaphylactoid reacrtions have occured
Occasssional- moderate fever of 39.4 C to 39.4C (101 F to 103F) may occur during the month of vaccination.
Generally fever, rash, or both appear between the 5th and the 12th days. Rash is usually minimal but rarely may be generalised. Cough and rhinitis have also occured.
Less common- high fever .> 39.4C, 103F, mild lymphadenopathy
Rare- diarrhea, vasculitis, erythema multiforme
Killed measles- marked swelling, redness and ventriculation at the injection site and systemic reactions including atypical measles have occured in persons previously vaccinated with killed measles.
CNS- children exhibiting fever rarely exhibit febrile convulsions. Syncope particularly at the time of mass vaccination has occured.
Significant CNS reactions (eg. encephalitis, encephalopathy) occuring within 30 days after vaccination have been temporally associated with measles vaccine very rarely.
Local- buring or stinging of short duration at injection site. Rare allergic reactions such as wheal and flare at the injection site or urticaria have occured.
Hematologic- thrombocytopenia, purpura (extremely rare)
Contra-Indications:
Do not vaccinate persons who are immunosuppressed in association with AIDS or other clinical manifestations of infection with HIV, cellular immune deficiencies and hypogammaglobulinemic and dysgammaglobulinemic states.
Special precautions-
Tuberculosis- children under treatment for tuberculosis have not experienced exacerabation of the disease when immunized with measles vaccine.
Warnings-
Hypersensitivity- have epinephrine 1:1000 available to control immediate allergic reactions.
Hypersensitivity to egg- live measles vaccine is produced in chick embryo cell culture. Persons with a history of anaphylactic, anphylactoid or other immediate reactions (eg. hives, swelling of mouth and throat, difficlut breathing, hypotension, shock) subsequent to egg ingestion should not be vaccinated.
Evidence indicates that persons are not at increased risk if they have egg allergies that are not anaphylactic or anaphylactoid in nature.
Elderly- most persons born in 1956 or earlier are likely to have been infected naturally and are considered susceptible.
Pregnancy- Not known whether the drug can cause fetal harm or can affect production capacity. Do not give to pregnant women
Lactation- excercise caution when administering to a nursing woman.
Children- attenuated measle vaccine is safe and effective in persons > 12 months of age.
Dosages/ Overdosage Etc:
Dosage-
Inject the total volume of the single-dose vial or 0.5ml of the multiple -dose vial of the reconstituted vaccine SC preferably at 15 months of age and in the outer aspect of the upper arm.
Missed dose-
1. If you miss a dose of this medicine, and remember it on the day it should be taken, take it as directed.
2. However, if you do not remember the mised dose until the next day,take the missed dose at that time and reschedule your every-other-day doses from then.
3. It is important that this vaccine be taken exactly as directed so that it can give you protection against Measles.
Patient Information:
Ref - USP PDI Vol II 17th Edition (1997)
1.Allergies-
Tell your doctor if you have ever had any unusual or allergic reaction to
Measles Vaccine or any other form of antibiotic neomycin or streptomycin.
Also tell your healthcare care professional if you are allergic to any other
substances such as foods. preservatives or dyes.
2.Pregnancy-
Although studies on the effect in pregnancy have not been done in humans , problems
have not shown to occur. However, use of measle vaccine during pregnancy
or becoming pregnant within 3 months after receiving measles vaccine is
not recommended.You must be in regular consultation with your doctor.
3. Breast-feeding-
Mothers who are taking this medicine and who wish to breast feed should discuss this
with their doctor.
4.Children-
In the U.S. measles vaccine is usually not recommended for infants up to 15 months
of age. In Canada use is not recommeded for infants up to 12 months of age.
5. Other medicines-
Tell your doctor if you are using any of the following -
Treatment of X-rays or cancer medicines - treatment may increase the action
of the vaccine causing increased side effects.
7. Other medical problems-
Make sure you tell your doctor if you have any other medical problems
especially-
Brain or head injury- or
Convulsions - fever a side efect of the vaccine may make the condition worse.
Immune deficiency condition- condition may increase the chance and severity
of side effects of the vaccine
Severe illness with fever- the symptoms of the condition may be confused
with the possible side effects of the vaccine
Tuberculosis- use of measles vacine may make the condition worse or
interfere with the tuberculin skin test.
Pharmacology/ Pharmacokinetics:
Pharmacology-
A more attentuated line of measles virus derived from Endes atentuated Edmonston strain growth cell cultures of chick embryo.
Pregnancy and lactation:
Pregnancy-
Not known whether the drug can cause fetal harm or can affect production capacity. Do not give to pregnant women
Lactation-
Excercise caution when administering to a nursing woman. Children- Attenuated measle vaccine is safe abd efective in persons > 12 months of age.
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