typhoid vaccine live (Rx)

Brand and Other Names:Vivotif
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

enteric-coated capsule

  • 2-6 x 10^9 colony-forming units of viable Salmonella typhi Ty21a and 5-50 x 10^9 bacterial cells of nonviable S typhi Ty21a
  • Available as pack of 4 capsules
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Typhoid Fever Prophylaxis

Indicated for selective immunization against typhoid fever for people traveling to endemic areas

1 capsule PO every other day x 4 doses (days 0, 2, 4, and 6); swallow with cool water on an empty stomach (see Administration)

Booster: Repeat same regimen every 5 yr

Dosing Considerations

Current vaccination schedules available at http://www.cdc.gov/vaccines/default.htm

Dosage Forms & Strengths

enteric-coated capsule

  • 2-6 x 10^9 colony-forming units of viable Salmonella typhi Ty21a and 5-50 x 10^9 bacterial cells of nonviable S typhi Ty21a
  • Available as pack of 4 capsules
more...

Typhoid Fever Prophylaxis

Indicated for selective immunization against typhoid fever for people traveling to endemic areas

<6 years: Safety and efficacy not established

≥6 years: 1 capsule PO every other day x 4 doses (days 0, 2, 4, and 6); swallow with cool water on an empty stomach (see Administration)

Booster: Repeat same regimen every 5 yr

Dosing Considerations

Current vaccination schedules available at http://www.cdc.gov/vaccines/default.htm

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Interactions

Interaction Checker

and typhoid vaccine live

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    Contraindicated

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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

            1-10%

            Abdominal pain (6.4%)

            Nausea (5.8%)

            Headache (4.8%)

            Fever (3.3%)

            Diarrhea (2.9%)

            Vomiting (1.5%)

            Skin rash (1%)

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            Warnings

            Contraindications

            Hypersensitivity; acute febrile illness; immunosuppression (inability to mount humoral/cell-mediated immune response)

            Cautions

            Complete vaccination 1 week before exposure to endemic area (eg, Africa, Southeast Asia, Central and South America, Near East, Middle East, and Indian subcontinent)

            Postpone vaccine with GI illness

            Coadministration of sulfonamides or antibiotics (eg, mefloquine, chloroquine, proguanil) may inactivate vaccine

            Efficacy: oral 60-70%; parenteral 70-96%

            May administer with Hib, DTP, OPV, IPV, MMR, influenza, and hepatitis B vaccines at same time

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Unknown whether distributed in breast milk, caution advised

            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

            Live attenuated oral vaccine; conveys active immunity via stimulation of production of endogenously produced antibodies

            Pharmacokinetics

            Duration: Not established; onset of protection from disease is relatively slow, but duration is long lasting (years)

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            Administration

            Instructions

            Swallow capsule at least 1 hr before a meal

            Each enteric-coated capsule should be taken with cool water no warmer than 98.6°F (37.0°C)

            Storage

            Not stable when exposed to ambient temperatures; therefore, should be shipped and stored between 2-8°C (35.6-46.4°F)

            Expiration date is valid only if the product has been maintained at 2-8°C (35.6-46.4°F)

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            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.
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