diphtheria & tetanus toxoids/ acellular pertussis vaccine (Rx)

Brand and Other Names:Infanrix, Daptacel
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Dosing & Uses

AdultPediatric

Immunization

Not indicated for adults

Dosage Forms & Strengths

Lf = limits of flocculation

pertussis/diphtheria/tetanus

DTaP suspension

  • (10mcg/15Lf/5Lf)/0.5mL (Daptacel)
  • (58mcg/25Lf/10Lf)/0.5mL (Infanrix)
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Primary Immunization

DTaP

6 weeks-7 years

  • 0.5 mL IM x 3 at 2, 4, 6 months of age; may administer as early as six weeks of age and repeated every 4-8 weeks; THEN 4th dose at 15-20 months of age but at least 6 months after the third dose & 5th dose at 4-6 years of age, prior to starting school or kindergarten; if fourth dose given at >4 years of age, may omit fifth dose;
  • For children <7 years who didn't receive DTaP at early infancy, give first 3 doses q1Month, THEN 4th dose at least 6 months later

>7 years

  • Not approved for use; use tetanus and diphtheria toxoids vaccine instead
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Interactions

Interaction Checker

and diphtheria & tetanus toxoids/ acellular pertussis vaccine

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    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), 1-800-822-7967

            Frequency Not Defined

            Swelling

            Erythema

            Fever

            Drowsiness

            Fussiness

            Irritability

            Anorexia

            Lethargi

            Swelling

            Tenderness

            Angioedema

            Apnea

            Cellulitis

            Cough

            Cyanosis

            Ear pain

            Headache

            Hypotonia

            Limb swelling

            Pruritus

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            Warnings

            Contraindications

            Documented hypersensitivity

            History of Arthus reaction to prior tetanus vaccination (unless 10 yr have elapsed)

            History of encephalopathy (within 7 days of administration not attributable to other causes), progressive neurologic disorder including uncontrolled or progressive epilepsy, infantile spasms, with pertussis-containing vaccine

            Cautions

            DTaP (Tripedia) now contains <0.5 mcg thimerosal; Daptacel, Infanrix are thimerosal-free

            Do not use DTaP with HIB (TriHIBit) for primary immunization of infants; only use for booster shots

            Caution in patients with neurological disorders

            Apnea reported in premature infants following IM vaccine administration; weigh risk/benefit

            Syncope accompanied by transient disturbances , tonic-clonic movements, or weakness reported

            Consider postponing administration iin patients with moderate or severe acute illness (with or without fever)

            Use caution in patients with a history of bleeding disorders (including thrombocytopenia) and or patients on anticoagulants

            History of Guillain-Barre syndrome with prior tetanus vaccine; weigh risk/benefit

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Excretion in milk unknown; use with caution

            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.

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            Pharmacology

            Mechanism of Action

            Production of specific antibodies to tetanus, diphtheria, and pertusis (active immunity)

            Conveys active immunity via stimulation of production of endogenously produced antibodies

            Pharmacokinetics

            The onset of protection from disease is relatively slow, but duration is long lasting (years)

            Duration: Variable, possibly >10 yr; Tdap maternal pertussis antibodies appear to wane greatly between subsequent pregnancies

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            Formulary

            FormularyPatient Discounts

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            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.
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