Drug Interaction:
Interacting drugs- summary
Typhoid vaccine +
Anticoagulants
as with other drugs administered by IM injection give Vi polysaccharide
vaccine with caution to persons receiving anticoagulant therapy
Typhoid vaccine + Plague vaccine or Plague vaccine +Typhoid vaccine
when practical plague vaccine should not be given on the same
occassion as AKD and H-P typhoid vaccines to avoid the possibility of
accentuated side effects.
+ Typhoid vaccine
-
Imunosuppressants
like all inactivated and live vaccines, administration of typhoid to persons
receiving immunosuppressants drugs, including high dose corticosteroids
or radiation therapy may result in an insifficient response to immunisation.
They may remain susceptible despite immunisation.
Phenytoin
concomittant phenytoin therapy may decrease antibody response to
SC typhoid vaccination. Anticipate the possibility of suboptimal antibody
response and consider risk/benefit ratios of each drug. Councel these
persons especially to observe good food and water discipline.
Sulfonamides
the vaccine should not be administered to individuals receiving
sulfonamides and antibiotics since these agents may be active against
the vaccine strain and prevent a sufficient degree ofmultiplication to occur
in order to induce a protective immune response.
Indication:
Typhoid vaccine
New Drugs Approved by (DCI) Drug Controller GENERAL - India For Marketing
(Ref- IDMA Publication)
Name of Drug Indication Date of Approval
Purified Vicapsular Typhoid Vaccine February 1993
Polysaccharide of
Salmonella Typhi
Adverse Reaction:
Oral- Reported adverse reactions include- malaise, headache, myalgia, elevated temperature, anaphylaxis.
Parenteral - most receipts of typhoid vacine experience some degree of local systemic response, usually beginning within 24 hours of adiministration and persisting for 1 to 2 days. Local reactions are erythemia, induration and tenderness and should be expected in those injected subcutaneously
Systemic manifestations may include- malasise, headache, myalgia, elevated temperature, anaphylaxis.
Contra-Indications:
Oral- hypersensitivity to any component of the vaccine or the capsule. Do not adminisater the capsule during acute febrile illness or during an acute GI illness (eg. persistent diarrhea or vomiting)
Parentral- A previous severe sytemic or allergic reaction. In the presence of acute respiratory or other active infection,or intensive physical activity (particuarly when environmental temperatures are high.)
Special precautions-
Not all recepients of thyphoid vaccine will be fully protected against typhoid fever. Travellers should take all necessary precautions to avoid contact with or ingestion of potentially contaminated food or water resources.
Warnings-
Hypersensitivity- Two hours after the IM injection of typhoid vaccine, a 20 year old man presented with fever, elevated temperature, a blood pressure of 92/60 mmHg and elevated liver function tests.
On the second day of hospitalization he became hypotensive, developed facial and periorbital edema and showed interstial edema with bilateral pleural effusions.
Immunodeiciency- If administered to immunosuppressed persons or persons receiving
immunosuppressive therapy, the expected immune response may not be obtained.
This include patients with symptomatic or symptomatic HIV infection, severe combined
immunodeficiency , hypogammaglobulinemia or agammaglobulinemia, altered immune states due to diseases such as leukemia, lymphoma, or generalized malignancy. or immune sytem compromised by treatment with corticosteroids, alkylating drugs. antimetabolites or radiation.
Oral- Do not give typhoid vaccine capsules to immunocomprosied persons, including persons with with congenital or aquired immune deficiencies.
Pregnancy- Give to a pregnant women only if needed.
Lactation- It is known if the vacine is excreted in breast milk.
Children- Oral- safety and efficacy have not been established for oral vaccines for childen < 6 years
of age, and it therfore not recommended for use in this age group.
Parentral- AKD and H-P- reduce dosage volume to 0.25 ml for children < 10 years old. These vaccines
are known to be effective in children as young as 6 momths.
Dosages/ Overdosage Etc:
Typhoid Vaccine
Dosage-
Oral- Primary immuninsation- one capsule on alternate days (eg, 1,3,5 and 7) swallowed whole 1 hour
before a meal with cold or lukewarm water , not tro exceed body temperature (37C, 98.6F)
Booster dose- the optimum booster schedule has not been determined . Efficacy persists for at least
5 years.
AKD and H-P-
Adults and children > 10 years old- 0.5ml SC or 0.1ml of the H-P product intracutaneously (interdermally)
Children ( 6 momths to 10 years old) - 0.25ml SC or 0.1ml of the H-P product intracutaneously (intradermally)
Overdosage-
Five to eight doses of oral vaccine was administered to 155 healthy adult males. This dosage was 5-fold higher than the currently recommended dose. No significant reactions(eg. vomiting, acute abdominal distress, fever) was observed.
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 typhoid fever.
Other Information:
For Availability/supplies
Contact -
1.Indian Drug Manufacturers Association (IDMA)
Phone- 022- 24944624/ 24974308
Fax- 022- 24950723
Email- idma@vsnl.com
Website: www.idma-assn.org
2.Bulk Drug Manufacturers Association (India)(BDMA)
Phone - 040-23703910/ 23706718
Fax- 040-23704804
Email- info@bdmai.org
Website: www.info@bdmai.org
Patient Information:
1. Advise vaccine receipts to take standared food and water precautions to avoid typhoid fever. Vaccine protection can be overwhelmed by swallowing a large dose of typhoid bacteria.
2. Oral- it is essential,that all 4 doses of vaccine are taken at the prescribed alternate day interval to obtain a maximal protective immunal response.
3. Vaccine potency is dependent upon storage under regrigeration (2 to 8C, 36 to 46F)
4. Store the vaccine under refrigeration at all times.
5. It is essential to replace unused vaccine in the refrigerator between doses.
6. Swallow vaccine capsule approximately 1 hour before a meal with a cold or lukewarm milk. Do not exceed body temperature (37C, 98.6F)
7. Do not chew the vaccine, swallow as soon as possible.
Pharmacology/ Pharmacokinetics:
Pharmacology-
Typhoid vaccine is estimated to be > 70% effective in preventing typhoid fever, depending partly on the degree of exposure.
Interaction with Food:
Swallow vaccine capsule approximately 1 hour before a meal with a cold or lukewarm milk. Do not exceed body temperature (37C, 98.6F)
Pregnancy and lactation:
Pregnancy-
Give to a pregnant women only if needed.
Lactation-
It is known if the vaccine is excreted in breast milk.
Children-
Oral- safety and efficacy have not been established for oral vaccines for childen < 6 years of age, and it therfore not recommended for use in this age group.
Parentral- AKD and H-P- reduce dosage volume to 0.25 ml for children < 10 years old. These vaccines are known to be effective in children as young as 6 momths.
Manufacturer Details