influenza virus vaccine quadrivalent (Rx)Brand and Other Names:Fluarix Quadrivalent, Fluzone Quadrivalent, more...Fluzone Intradermal Quadrivalent, FluLaval Quadrivalent, Flucelvax Quadrivalent, Afluria Quadrivalent

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

IM suspension

  • 0.5mL/syringe
  • 0.5mL/vial
  • Note: Flucelvax uses mammalian culture instead of chicken embyros

intradermal suspension

  • 0.1mL/microinjection system
more...

Influenza Prophylaxis

CDC's ACIP recommends that everyone 6 months of age and older receive an annual influenza vaccination

0.5 mL IM x1 dose/season

For more vaccine information see http://www.cdc.gov/vaccines/

Intradermal

  • 18-64 yr: 0.1 mL ID x1 dose at beginning of flu season

Dosing Considerations

Contains the following 4 viral strains for 2016-2017 northern hemisphere season

A/California/7/2009 (H1N1) pdm09-like virus (same strain as was used for 2009 H1N1 monovalent vaccines)

A/Hong Kong/4801/2014 (H3N2)-like virus (new for 2016-2017)

B/Phuket/3073/2013-like virus (B/Yamagata lineage)

B/Brisbane/60/2008-like virus (B/Victoria lineage vaccine virus)

Dosage Forms & Strengths

IM suspension

  • 0.25mL/syringe (Fluzone Quadrivalent)
  • 0.5mL/syringe
  • 0.5mL/vial
  • Note: Flucelvax uses mammalian culture instead of chicken embyros
more...

Influenza Prophylaxis

CDC's ACIP recommends that everyone 6 months of age and older receive an annual influenza vaccination; http://www.cdc.gov/vaccines/

See Administration section for information regarding if 1 or 2 doses are required for children up to age 8 years

6 months through 35 months (Fluzone Quadrivalent): 0.25 mL IM x 1-2 doses/season

3-8 years: 0.5 mL IM (deltoid) x1-2 doses/season

≥9 years: 0.5 mL IM x1 dose/season

Safety and efficacy not established

  • <6 months: Fluzone Quadrivalent
  • <3 years: Fluarix Quadrivalent, FluLaval Quadrivalent
  • <4 years: Flucelvax Quadrivalent
  • <18 years: Afluria Quadrivalent

Dosing Considerations

Contains the following 4 viral strains for 2016-2017 northern hemisphere season

A/California/7/2009 (H1N1) pdm09-like virus (same strain as was used for 2009 H1N1 monovalent vaccines)

A/Hong Kong/4801/2014 (H3N2)-like virus (new for 2016-2017)

B/Phuket/3073/2013-like virus (B/Yamagata lineage)

B/Brisbane/60/2008-like virus (B/Victoria lineage vaccine virus)

Next

Interactions

Interaction Checker

influenza virus vaccine quadrivalent and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            Sort by :  
             activity indicator 
            Previous
            Next

            Adverse Effects

            >10%

            Injection site pain (36%)

            Muscle aches (16%)

            Headache (16%)

            Fatigue (16%)

            Children 3-17 years

            • Injection site pain (44%)
            • Injection site redness (23%)
            • Injection site swelling (19%)

            Children 3-5 years

            • Drowsiness (17%)
            • Irritability (17%)
            • Loss of appetite (16%)

            Children 6-17 years

            • Fatigue (20%)
            • Muscle aches (18%)
            • Headache (16%)

            1-10%

            Arthralgia (8%)

            Gastrointestinal symptoms (7%)

            Shivering (4%)

            Fever 99.5°F (37.5°C) or greater (2%)

            Injection site redness or swelling (2%)

            Children 3-5 years

            • Fever 99.5°F (37.5°C) or greater (9%)

            Children 6-17 years

            • Arthralgia (10%)
            • Gastrointestinal symptoms (10%)
            • Shivering (6%)
            • Fever 99.5°F (37.5°C) or greater (6%)

            Postmarketing Reports

            Blood and lymphatic disorders: Lymphadenopathy

            Cardiac disorders: Tachycardia

            Ear and labyrinth disorders: Vertigo

            Eye disorders: Conjunctivitis, eye irritation, eye pain, eye redness, eye swelling, eyelid swelling

            Gastrointestinal disorders: Abdominal pain or discomfort, swelling of the mouth, throat, and/or tongue

            General disorders and administration site conditions: Asthenia, chest pain, feeling hot, injection site mass, injection site reaction, injection site warmth, body aches

            Immune system disorders: Anaphylactic reaction including shock, anaphylactoid reaction, hypersensitivity, serum sickness

            Infections and infestations: Injection site abscess, injection site cellulitis, pharyngitis, rhinitis, tonsillitis

            Nervous system disorders: Convulsion, encephalomyelitis, facial palsy, facial paresis, Guillain-Barré syndrome, hypoesthesia, myelitis, neuritis, neuropathy, paresthesia, syncope

            Respiratory, thoracic, and mediastinal disorders: Asthma, bronchospasm, dyspnea, respiratory distress, stridor

            Skin and subcutaneous tissue disorders: Angioedema, erythema, erythema multiforme, facial swelling, pruritus, Stevens-Johnson syndrome, sweating, urticaria

            Vascular disorders: Henoch-Schönlein purpura, vasculitis

            Previous
            Next

            Warnings

            Contraindications

            Severe hypersensitivity (eg, anaphylaxis) to any component of the vaccine, including egg protein, or following a previous administration of any influenza vaccine

            Persons with hives-only allergy to eggs, can receive the inactivated influenza vaccine

            Cautions

            Use split or purified surface antigen in children

            Defer vaccine with febrile illnesses until illness is resolved; may administer vaccine with minor illnesses without fever (eg, URIs)

            Expected immune response may not be obtained in immunocompromised individuals, including those receiving immunosuppressive therapy

            Influenza vaccine may not protect all susceptible individuals Guillain-Barre syndrome has been reported within 6 weeks of receipt of influenza vaccines

            Tip of syringe may contain natural rubber latex

            Syncope reported with injectable vaccines

            IM injections may cause hematoma in individuals with bleeding disorders (eg, hemophilia, anticoagulant therapy)

            Previous
            Next

            Pregnancy & Lactation

            Pregnancy Category: B

            CDC recommends Influenza vaccine be administered during pregnancy (all trimesters); vaccination during pregnancy shown to decrease risk of illness in the mother, as well as the risk of influenza and influenza hospitalization in their infants during the first 6 months of life (MMWR August 26, 2011;60[33]:1128-32)

            Lactation: Unknown whether distributed in breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next

            Pharmacology

            Mechanism of Action

            Inactivated influenza virus types A & B subunits

            Conveys active immunity via stimulation of production of endogenously produced antibodies

            Pharmacokinetics

            Onset: Within days to several weeks

            Duration: few months

            Effectiveness: 70-90%; lower elderly or immunosuppressed individuals

            Previous
            Next

            Administration

            Instructions

            Administer at beginning of influenza season

            Should not be mixed with any other vaccine in the same syringe or vial

            Shake well before administration

            Adults and children >8 years

            • IM: Administer IM in deltoid muscle of upper arm
            • ID (18-64 yr): Administer ID in deltoid region of upper arm

            Children aged 6 months through 8 years

            • IM (aged 6-35 months): Administer IM in anterolateral thigh; do not inject in the gluteal area or areas where there may be a major nerve trunk
            • IM (aged 3-8 years): Administer IM in deltoid muscle of upper arm
            • If child requires 2 doses, administer at least 4 weeks apart (see dosing algorithm)
            • Dosing algorithm for children aged 6 months through 8 years
              • Did the child receive at least 1 dose of the previous year’s seasonal influenza vaccine?
              • If yes, give 1 dose
              • If no or don’t know, did the child receive a total of at least 2 doses of seasonal influenza vaccine since July 1, 2010?
              • If yes, give 1 dose and if no or don’t know, give 2 doses
              • From ACIP recommendations: MMWR 2014 Aug 15 / 63(32);691-697

            Storage

            Store refrigerated between 2-8ºC (36-46ºF)

            Do not freeze and protect from light

            Previous
            Next

            Images

            Previous
            Next

            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Add or Remove Plans
            Plans for
            Select State:
            Non-Medicare PlansMedicare Plans

            Select a box to add or remove a plan.

            Select a class to view formulary status for similar drugs

            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
             
             
             
            All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.