Zoster Vaccine Live/Methotrexate (lower dosage or strength) Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Methotrexate, depending upon your dose, may suppresses the immune system preventing your body from responding correctly to the vaccine.

What might happen:

If you are receiving methotrexate, you may not develop disease immunity from the vaccination.If you are taking a high dose of methotrexate, a live vaccine may cause you to develop the illness it was supposed to prevent.Note that the inactive type of vaccines cannot cause you to develop the illness it was supposed to prevent, even if you receive a high dose of methotrexate.

What you should do about this interaction:

Before receiving a vaccination with a live vaccine, let your doctor know all of the other medicines you are taking, especially if you take methotrexate or other medications that work by suppressing the immune system (e.g. some medicines for rheumatoid arthritis or inflammatory bowel disease) or if you have recently received radiation or chemotherapy for cancer. Your doctor may decide to give you an inactive vaccine, or may want to change the timing of your vaccination.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Centers for Disease Control and Prevention. General Recommendations on Immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6002a1.htm January 28, 2011; 60(RR No.
  • 2):1-64.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.