zoster vaccine recombinant (Rx)

Brand and Other Names:Shingrix
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Dosing & Uses

AdultPediatric

Dosage Forms and Strengths

injection, single-dose IM suspension

  • 0.5mL

Shingles Prophylaxis

Adults aged ≥50 years

Indicated for prevention of herpes zoster (HZ) (shingles) in adults ≥50 years

≥50 years: 0.5 mL IM x2 doses administered 2-6 months apart

Immunocompromised adults

  • Indicated for prevention of HZ in adults aged ≥18 years who are or who will be at increased risk of shingles owing to immunodeficiency or immunosuppression caused by known disease or therapy
  • For individuals who are or will be immunodeficient or immunosuppressed and who would benefit from a shorter vaccination schedule
  • 0.5 mL IM x2 doses administered 1-2 months apart

ACIP recommendation

  • Administer 2 doses of recombinant zoster vaccine (RZV) (Shingrix) 2-6 months apart to adults aged ≥50 years regardless of past episode of herpes zoster or receipt of zoster vaccine live (ZVL) (Zostavax); as of November 2020, Zostavax is no longer marketed in the United States
  • Administer 2 doses of RZV 2-6 months apart to adults who previously received ZVL at least 2 months after ZVL
  • Current immunization schedules available at http://www.cdc.gov/vaccines/schedules/hcp/index.html

Dosing Considerations

Limitation of use

  • Shingrix is not indicated for prevention of primary varicella infection (chickenpox)

Safety and effectiveness have not been established

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Interactions

Interaction Checker

and zoster vaccine recombinant

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (2)

              • ofatumumab SC

                ofatumumab SC decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Administer all immunizations according to immunization guidelines at least 2 weeks before initiating ofatumumab SC for inactivated vaccines, and whenever possible.

              • siponimod

                siponimod decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Pause vaccinations beginning 1 week before initiating siponimod and for 4 weeks after stopping treatment. Coadministration with live attenuated vaccines may increase infection risk.

              Monitor Closely (64)

              • adalimumab

                adalimumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • alefacept

                alefacept decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • anakinra

                anakinra decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • anthrax immune globulin

                anthrax immune globulin decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • antithymocyte globulin equine

                antithymocyte globulin equine decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • antithymocyte globulin rabbit

                antithymocyte globulin rabbit decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • azathioprine

                azathioprine decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • basiliximab

                basiliximab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • belatacept

                belatacept decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • belimumab

                belimumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • budesonide

                budesonide decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • cabazitaxel

                cabazitaxel decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • canakinumab

                canakinumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • certolizumab pegol

                certolizumab pegol decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • chloroquine

                chloroquine decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • cortisone

                cortisone decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • cyclosporine

                cyclosporine decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. If possible, complete all age-appropriate vaccinations at least 2 weeks before initiating immunosuppressant therapy. Patients vaccinated <14 days before starting immunosuppressive therapy or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued if immune competence has been restored. Longer waiting periods may be required for drugs that maintain their immunosuppressive effects for more than 3 months after discontinuation (eg, ocrelizumab). .

              • deflazacort

                deflazacort decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • dexamethasone

                dexamethasone decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • etanercept

                etanercept decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • everolimus

                everolimus decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • famciclovir

                famciclovir decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • fingolimod

                fingolimod decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • fludrocortisone

                fludrocortisone decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • glatiramer

                glatiramer decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • golimumab

                golimumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • guselkumab

                guselkumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • hydrocortisone

                hydrocortisone decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • hydroxychloroquine sulfate

                hydroxychloroquine sulfate decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • ibrutinib

                ibrutinib decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .

              • ifosfamide

                ifosfamide decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .

              • infliximab

                infliximab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • ixekizumab

                ixekizumab decreases effects of zoster vaccine recombinant by pharmacodynamic synergism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • leflunomide

                leflunomide decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • lomustine

                lomustine decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .

              • mechlorethamine

                mechlorethamine decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .

              • melphalan

                melphalan decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .

              • mercaptopurine

                mercaptopurine decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • methotrexate

                methotrexate decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • methylprednisolone

                methylprednisolone decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • muromonab CD3

                muromonab CD3 decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • mycophenolate

                mycophenolate decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • obinutuzumab

                obinutuzumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • ocrelizumab

                ocrelizumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • onasemnogene abeparvovec

                onasemnogene abeparvovec decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Adjust vaccinations to accommodate concomitant corticosteroid administration prior to and following onasemnogene abeparvovec infusion. When initiating systemic corticosteriod therapy, wait 2 weeks after an inactivated vaccine.

              • oxaliplatin

                oxaliplatin decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .

              • pneumococcal vaccine polyvalent

                pneumococcal vaccine polyvalent decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • ponesimod

                ponesimod decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Use Caution/Monitor. If possible, complete all age-appropriate vaccinations at least 4 weeks before initiating ponesimod.

              • prednisolone

                prednisolone decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • prednisone

                prednisone decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • procarbazine

                procarbazine decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .

              • rilonacept

                rilonacept decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • rituximab

                rituximab, zoster vaccine recombinant. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.

              • rituximab-hyaluronidase

                rituximab-hyaluronidase, zoster vaccine recombinant. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.

              • sarilumab

                sarilumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • secukinumab

                secukinumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • sirolimus

                sirolimus decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • tacrolimus

                tacrolimus decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • temsirolimus

                temsirolimus decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • tisagenlecleucel

                tisagenlecleucel decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • tocilizumab

                tocilizumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • triamcinolone acetonide injectable suspension

                triamcinolone acetonide injectable suspension decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • ustekinumab

                ustekinumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              • vedolizumab

                vedolizumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

              Minor (1)

              • ozanimod

                ozanimod decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Minor/Significance Unknown. No clinical data are available on the efficacy and safety of vaccinations in patients taking ozanimod. Vaccinations may be less effective if coadministered with ozanimod.

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              Adverse Effects

              >10%

              50-59 years

              • Pain (88.4%)
              • Fatigue (57%)
              • Myalgia (56.9%)
              • Headache (50.6%)
              • Redness (38.7%)
              • Shivering (35.8%)
              • Swelling (30.5%)
              • Fever (27.8%)
              • Gastrointestinal [GI] symptoms (24.3%)
              • Pain, Grade 3 (10.3%)
              • Redness >100 mm (2.8%)
              • Swelling >100 mm (1.1%)

              60-69 years

              • Pain (82.8%)
              • Myalgia (49%)
              • Fatigue (45.7%)
              • Headache (39.6%)
              • Redness (38.4%)
              • Shivering (30.3%)
              • Swelling (26.5%)
              • Fever (23.9%)
              • GI symptoms (16.7%)

              70-79 years

              • Pain (69.2%)
              • Myalgia (35.1%)
              • Fatigue (36.6%)
              • Redness (37.7%)
              • Swelling (23%)
              • Headache (29%)
              • Shivering (19.5%)
              • Fever (14.3%)
              • GI symptoms (13.5%)

              Immunocompromised adults

              • ≥50 years
                • Pain (74-75%)
                • Fatigue (37-46%)
                • Myalgia (37-43%)
                • Redness (21-28%)
                • Headache (15-25%)
                • Shivering (11-21%)
                • GI symptoms (18%)
                • Swelling (10-15%)
                • Fever (6-15%)
              • 18-49 years
                • Pain (81-82%)
                • Fatigue (49-51%)
                • Myalgia (41-51%)
                • Fever (9-28%)
                • Headache (23-38%)
                • Shivering (20-26%)
                • Redness (20-25%)
                • Swelling (14-17%)
                • GI symptoms (13-14%)
                • Pain, Grade 3 (11%)

              1-10%

              50-59 years

              • Myalgia, Grade 3 (8.9%)
              • Fatigue, Grade 3 (8.5%)
              • Shivering, Grade 3 (6.8%)
              • Headache (6%)
              • Redness >100 mm (2.8%)
              • GI symptoms, Grade 3 (2.1%)
              • Swelling >100 mm (1.1%)

              60-69 years

              • Pain, Grade 3 (6.9%)
              • Shivering, Grade 3 (4.5%)
              • Redness, >100 mm (2.6%)
              • Swelling (1%)

              70-79 years

              • Pain, Grade 3 (4%)
              • Fatigue, Grade 3 (3.5%)
              • Redness >100 mm (3.1%)
              • Myalgia, Grade 3 (2.8%)
              • Shivering, Grade 3 (2.2%)
              • Headache, Grade 3 (1.5%)
              • Swelling >100 mm (1.3%)
              • GI symptoms, Grade 3 (1.2%)

              Immunocompromised adults

              • ≥50 years
                • Pain, Grade 3 (5-7%)
                • Fatigue, Grade 3 (3-4%)
                • Myalgia, Grade 3 (2-4%)
                • Shivering, Grade 3 (1-3%)
                • Headache, Grade 3 (0.1-2%)
                • Swelling, >100 mm (2%)
                • Redness, >100 mm (1-2%)
                • GI symptoms, Grade 3 (1%)
              • 18-49 years
                • Fatigue, Grade 3 (6-10%)
                • Myalgia, Grade 3 (4-8%)
                • Shivering, Grade 3 (1-6%)
                • Headache, Grade 3 (1-5%)
                • Redness, >100 mm (1-2%)
                • Fever, Grade 3 (>39.5°C/103 .1°F) (1%)
                • GI symptoms, Grade 3 (1%)
                • Swelling, >100 mm (0.1-1%)

              <1%

              50-59 years

              • Fever, Grade 3 (0.4%)

              60-69 years

              • GI symptoms, Grade 3 (0.9%)
              • Pain, Grade 3 (0.5%)
              • Fever, Grade 3 (0.5%)

              70-79 years

              • Fever, grade 3 (0.1%)

              Immunocompromised adults

              • ≥50 years
                • Fever, Grade 3 (0.1-02%)

              Postmarketing Reports

              General disorders and administration site conditions: Decreased mobility of injected arm which may persist for >1 week

              Immune system disorders: Hypersensitivity reactions, including angioedema, rash, and urticaria

              Nervous system disorders: Guillain-Barre syndrome

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              Warnings

              Contraindications

              Hypersensitivity (eg, anaphylaxis) to any component of the vaccine

              Cautions

              Review immunization history for possible vaccine sensitivity and previous vaccination-related adverse reactions; appropriate medical treatment and supervision must be available to manage possible anaphylactic reactions following administration (see Contraindications)

              In a postmarketing observational study, an increased risk of Guillain-Barre syndrome was observed during the 42 days following vaccination

              Syncope can be associated with injectable vaccine administration; may be accompanied by transient neurological signs (visual disturbance, paresthesia, tonic-clonic limb movements); procedures should be in place to avoid falling injury and to restore cerebral perfusion following syncope

              Drug interactions overview

              • Use caution with concomitant use of vaccine administration of zoster recombinant with inactivated influenza
              • Immunosuppressive therapies may reduce effectiveness of the zoster vaccine
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              Pregnancy

              Pregnancy

              There is no available human data to establish vaccine-associated risks with the vaccine in pregnant women

              Lactation

              Unknown whether zoster vaccine is excreted in human milk

              Data are not available to assess effects of the zoster vaccine on the breastfed infant or on milk production/excretion

              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

              Conveys active immunity by stimulating production of endogenously produced antibodies

              Vaccine boosts VZV-specific immune response, which is thought to be the mechanism by which it protects against zoster disease

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              Administration

              IM Preparation

              Reconstitute lyophilized varicella zoster virus glycoprotein E (gE) antigen with the AS01B adjuvant suspension

              Reconstituted vaccine should be an opalescent, colorless to pale brownish liquid

              Visually inspect for particulate matter and discoloration prior to administration, whenever solution and container permit

              IM administration

              IM use only

              Withdraw 0.5 mL from reconstituted vial

              Administer IM immediately

              Store in refrigerator at 2-8°C (36-46°F) for up to 6 hr if unable to administer immediately

              Preferred site for IM injection is the deltoid region of the upper arm

              Storage

              Before reconstitution

              • Vials of adjuvant suspension and antigen component
              • Refrigerate at 2-8°C (36-46°F)
              • Protect from light
              • Do not freeze; discard if adjuvant suspension or antigen component have been frozen

              Reconstituted vials

              • If not administered immediately, refrigerate at 2-8°C (36-46°F) for up to 6 hr
              • Discard reconstituted vaccine if not used within 6 hr
              • Do not freeze; discard if the vaccine has been frozen
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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Shingrix (PF) intramuscular
              -
              50 mcg/0.5 mL kit
              Shingrix (PF) intramuscular
              -
              50 mcg/0.5 mL kit

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              A Patient Handout is not currently available for this monograph.
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              Formulary

              FormularyPatient Discounts

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              • 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.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.