Live Vaccines; Live BCG/Selected Immunosuppressive Agents 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:

Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Medication which suppresses the immune system may prevent your body from responding correctly to the vaccine or to your BCG medicine for bladder cancer.

What might happen:

If you are receiving immunosuppressant medicine, you may not develop disease immunity from the vaccination and/or the live vaccine may cause you to develop the illness it was supposed to prevent. However, an inactive vaccine cannot cause you to develop the illness it was supposed to prevent, even if you receive immunosuppressant medicine.If you are receiving an immunosuppressant medicine when you receive your BCG bladder treatment it may not work as well, and/or you could get a severe infection if the BCG medicine gets into your blood stream.

What you should do about this interaction:

Before receiving a vaccination with a live vaccine, or BCG medicine for bladder cancer, let your doctor know all of the other medicines you are taking, especially if your medications work by suppressing the immune system (e.g. transplant medicines)or if you have recently received radiation or chemotherapy for cancer. Your doctor may decide to give you an inactive vaccine, may want to change the timing of your vaccination or may want to change when you receive your BCG cancer medicine.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: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6002a1.htm January 28, 2011; 60(RR No.
  • 2):1-64.
  • 3.TICE BCG (BCG live, for intravesical use) prescribing information. Organon USA Inc. October, 2010.
  • 4.Tremfya (guselkumab) US prescribing information. Janssen Biotech, Inc. July, 2017.
  • 5.Zinbryta (daclizumab) US prescribing information. Biogen Inc. May 27, 2016.
  • 6.Stelara (ustekinumab) US prescribing information. Janssen Biotech, Inc. March 4, 2014.