Typhoid vaccine, live (oral route)


    Brand Name

    US Brand Name

    Vivotif


    Description

    Typhoid fever is a serious disease that can cause death. It is caused by a germ called Salmonella typhi, and is spread most often through infected food or water. Typhoid may also be spread by close person-to-person contact with infected persons (such as occurs with persons living in the same household). Some infected persons do not appear to be sick, but they can still spread the germ to others.

    Typhoid fever is very rare in the United States (U.S.) and other areas of the world that have good water and sewage (waste) systems. However, it is a problem in parts of the world that do not have such systems. If you are traveling to certain countries or remote areas, typhoid vaccine will help protect you from typhoid fever. The U.S. CDC recommends caution in the following areas of the world:

    • Africa
    • Asia
    • Latin America

    Typhoid vaccine taken by mouth helps prevent typhoid fever, but does not provide 100% protection. Therefore, it is very important to avoid infected persons and food and water that may be infected, even if you have taken the vaccine.

    To get the best possible protection against typhoid, you should complete the vaccine dosing schedule (all 4 doses of the vaccine) at least 1 week before travel to areas where you may be exposed to typhoid.

    If you will be traveling regularly to parts of the world where typhoid is a problem, you should get a booster (repeat) dose of the vaccine every 5 years.

    Typhoid vaccine is available only from a health care professional.

    This product is available in the following dosage forms:

    • Capsule

    Before Using

    In deciding to use a vaccine, the risks of taking the vaccine must be weighed against the good it will do. This is a decision you and your doctor will make. For this vaccine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Typhoid vaccine is not recommended for infants and children up to 6 years of age. Although there is no specific information comparing use of typhoid vaccine in children 6 years of age and over with use in other age groups, this vaccine is not expected to cause different side effects or problems in these children than it does in adults.

    Geriatric

    Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of typhoid vaccine in the elderly with use in other age groups, this vaccine is not expected to cause different side effects or problems in older people than it does in younger adults.

    Breastfeeding

    Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this vaccine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Receiving this vaccine with any of the following medicines is not recommended. Your doctor may decide not to use this vaccine or change some of the other medicines you take.

    • Deflazacort
    • Thiotepa

    Receiving this vaccine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Adalimumab
    • Alemtuzumab
    • Anifrolumab-fnia
    • Ansuvimab-zykl
    • Antithymocyte Globulin Rabbit
    • Atidarsagene Autotemcel
    • Axicabtagene Ciloleucel
    • Azathioprine
    • Baricitinib
    • Belatacept
    • Bendamustine
    • Betibeglogene Autotemcel
    • Bimekizumab-bkzx
    • Bortezomib
    • Bosutinib
    • Brexucabtagene Autoleucel
    • Brodalumab
    • Cabazitaxel
    • Canakinumab
    • Capecitabine
    • Carboplatin
    • Carfilzomib
    • Carmustine
    • Certolizumab Pegol
    • Chlorambucil
    • Cisplatin
    • Cladribine
    • Clofarabine
    • Cyclophosphamide
    • Cyclosporine
    • Cytarabine
    • Cytarabine Liposome
    • Dacarbazine
    • Dasatinib
    • Daunorubicin
    • Daunorubicin Citrate Liposome
    • Daunorubicin Liposome
    • Deucravacitinib
    • Deuruxolitinib
    • Docetaxel

    Receiving this vaccine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Abatacept

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

    Other Medical Problems

    The presence of other medical problems may affect the use of this vaccine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Diarrhea or
    • Fever or
    • Other illness (severe) or
    • Stomach or intestinal illness (severe) or
    • Vomiting—These conditions may reduce the useful effect of the vaccine.
    • Immune deficiency condition, including HIV or AIDS—May increase the chance of side effects from the vaccine.

    Proper Use

    It is important that all 4 doses of the vaccine be taken exactly as directed. If all the doses are not taken or if doses are not taken at the correct times, the vaccine may not work properly.

    The vaccine capsules are meant to dissolve in the intestines. Therefore, they should be inspected to make sure that they are not broken or cracked when you take them. If any are broken or cracked, you will need to replace them.

    Typhoid vaccine must be stored in the refrigerator at a temperature between 2 and 8 degrees C (35.6 and 46.4 degrees F) at all times. If the vaccine is left at room temperature, it will lose its effectiveness. Therefore, remember to replace unused vaccine in the refrigerator between doses.

    Each dose of the vaccine should be taken approximately 1 hour before a meal. Take with a cold or lukewarm drink that has a temperature that does not exceed body temperature (eg, 37 degrees C or 98.6 degrees F).

    Swallow the capsule whole. Do not chew it before swallowing. Also swallow the capsule as soon as possible after you place it in your mouth.

    Dosing

    The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

    The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

    • Take 1 capsule by mouth every other day for a total of 4 doses.

    Missed Dose

    Call your doctor or pharmacist for instructions.

    If you do not remember the missed dose until the next day, take the missed dose at that time and reschedule your every-other-day doses from then. It is important that this vaccine be taken exactly as directed so it can give you the most protection against typhoid fever.

    Storage

    Store in the refrigerator. Do not freeze.

    Keep out of the reach of children.

    Do not keep outdated medicine or medicine no longer needed.


    Precautions

    Tell all of your doctors that you have taken this vaccine if you plan to receive any other live vaccines within 1 month after the last dose.

    If you are receiving this vaccine, do not take proguanil (Paludrine(R)) as a single medicine (not available in the United States) for at least 10 days after your last dose.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur:

    • Difficulty with breathing or swallowing
    • hives
    • itching, especially of the feet or hands
    • reddening of the skin, especially around the ears
    • swelling of the eyes, face, or inside of the nose
    • unusual tiredness or weakness that is sudden and severe

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Less common or rare

    • Diarrhea
    • fever
    • nausea
    • skin rash
    • stomach cramps or pain
    • vomiting

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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