Abemaciclib and Rotavirus Vaccine, Live: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 10, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Abemaciclib
Rotavirus Vaccine, Live
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Abemaciclib (Verzenio) is a cancer medicine that can weaken your immune system. The rotavirus vaccine is a live vaccine, meaning it contains a weakened but living form of the virus. In a healthy person, the immune system easily keeps that weakened virus in check. But if your defenses are lowered by chemotherapy, the vaccine virus could actually cause an infection instead of just training your body to fight it.
The good news is this is very manageable. Your care team knows about this concern and will decide the safest timing for any live vaccine. Always let your doctor or pharmacist know about every vaccine before you get it.
Interaction: Abemaciclib, a CDK4/6 inhibitor used in breast cancer, can cause myelosuppression and immunosuppression. Co-administration with the live rotavirus vaccine raises the risk of vaccine-strain infection.
- Mechanism: reduced host immune response permits uncontrolled replication of the attenuated vaccine virus (PD interaction, not PK; neither agent is enzymatically activated).
- Direction/severity: increased infection risk; rated major, evidence established.
- Management: generally avoid live vaccines in severely immunocompromised patients. Live vaccination may be considered when disease is in remission, immunocompetence is restored, and chemotherapy has been discontinued for at least 3 months. Individualize timing with oncology/ID.
What happens
An increased risk of infection by the live vaccine
Interaction Deep Dive
As a rule, live vaccines should be withheld from patients who are severely immunocompromised2. In infants who have recognized primary or secondary immunodeficiencies, such as those undergoing immunosuppressive therapy or those with malignant neoplasms involving the bone marrow or lymphatic system, the effectiveness and safety of rotavirus vaccine remain unestablished3. A live vaccine may be administered to individuals with leukemia, lymphoma, or other malignancies provided their disease is in remission, their immunocompetence has been restored, and at least 3 months have passed since chemotherapy was stopped1.
Why it happens (mechanism)
Decreased immune response allows live vaccine to produce infection
How to manage this interaction
What your care team may do:
- Generally avoid giving live vaccines, including the rotavirus vaccine, while the immune system is significantly weakened by abemaciclib.
- Consider timing any live vaccine for when the cancer is in remission, immune function has recovered, and chemotherapy has been stopped for at least 3 months.
- Choose non-live (inactivated) vaccine options where possible.
What you should do: Keep taking abemaciclib as prescribed, and never start or skip a vaccine on your own. Before any vaccination, tell your pharmacist or oncologist that you are on abemaciclib so they can pick the safest option and timing.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Abemaciclib and Rotavirus Vaccine, Live together?
Abemaciclib weakens the immune system, so the live rotavirus vaccine could cause an infection instead of protection. Do not get any live vaccine without clearing the timing with your oncology team first. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abemaciclib and Rotavirus Vaccine, Live interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Abemaciclib and Rotavirus Vaccine, Live interaction managed?
What your care team may do: Generally avoid giving live vaccines, including the rotavirus vaccine, while the immune system is significantly weakened by abemaciclib. Consider timing any live vaccine for when the cancer is in remission, immune function has recovered, and chemotherapy has been stopped for at least 3 months. Choose non-live (inactivated) vaccine options where possible. What you should… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
Questions for your pharmacist
- Does my dose of Abemaciclib or Rotavirus Vaccine, Live need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Centers for Disease Control and Prevention (CDC): Vaccines & Immunizations: altered immunocompetence. Centers for Disease Control and Prevention (CDC). Atlanta, GA. 2024.
- National Center for Immunization and Respiratory Diseases (NCIRD): Vaccines & immunizations: contraindications and precautions. Centers for Disease Control and Prevention (CDC). Atlanta, GA. 2024.
- Product Information: ROTARIX(R) oral suspension, rotavirus vaccine live oral suspension. GlaxoSmithKline (per manufacturer), Research Triangle Park, NC, 2022. DailyMed
Keep reading about Abemaciclib
Keep reading about Rotavirus Vaccine, Live
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