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Vaccine-drug interactions.

P F D'Arcy

    Drug Intelligence & Clinical Pharmacy
    |September 1, 1984
    PubMed
    Summary

    Vaccine-drug interactions, like with influenza vaccines, may affect drug metabolism. However, adverse reactions are rare, and vaccination is recommended for at-risk elderly patients.

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    Area of Science:

    • Pharmacology
    • Immunology
    • Vaccinology

    Background:

    • Vaccine-drug interactions are documented with influenza and BCG vaccines and specific drugs.
    • Some reported interactions remain unconfirmed.
    • A potential mechanism involves vaccines inducing interferon, inhibiting hepatic cytochrome P-450 and reducing drug metabolism.

    Purpose of the Study:

    • To review known vaccine-drug interactions.
    • To explore the potential mechanism and broader implications of these interactions.
    • To assess the clinical significance of vaccine-drug interactions, particularly for influenza vaccination in the elderly.

    Main Methods:

    • Literature review of reported vaccine-drug interactions.
    • Discussion of the proposed mechanism involving interferon induction and cytochrome P-450 inhibition.
    • Analysis of clinical evidence regarding adverse events following vaccination.

    Main Results:

    • Interactions reported primarily involve influenza vaccine with aminopyrine, phenytoin sodium, theophylline, and warfarin sodium.
    • The proposed mechanism suggests a nonspecific interaction affecting drug metabolism.
    • Evidence indicates adverse reactions to warfarin or theophylline post-influenza vaccination are rare.

    Conclusions:

    • The nonspecific mechanism of vaccine-drug interaction could lead to unrecognized interactions with other vaccines.
    • The clinical significance of these interactions is not fully established.
    • Physicians should not withhold influenza vaccination from at-risk elderly patients due to rare potential adverse drug reactions, but should monitor patients post-vaccination.

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