Cholera Vaccine and Abemaciclib: 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
Cholera Vaccine
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 cholera vaccine (Vaxchora) is a live vaccine, which means it contains a weakened but living form of the germ. Normally your immune system easily handles it, but when your defenses are lowered by chemotherapy, that live germ could actually cause an infection instead of just training your body to fight it.
The good news is that your care team knows how to handle this. Please don't stop either medicine on your own. Just talk with your oncologist or pharmacist before getting any vaccine so they can decide the safest timing for you.
Mechanism: Abemaciclib-associated myelosuppression and immunosuppression can blunt the immune response, allowing the attenuated organism in the live oral cholera vaccine (Vaxchora) to cause active infection. This is a pharmacodynamic interaction; neither agent is a prodrug and no CYP pathway is involved.
Direction: Increased risk of vaccine-derived infection. Evidence: established. Onset: unspecified.
- Severely immunocompromised patients generally should not receive live vaccines.
- Safety/efficacy of cholera vaccine not established in immunocompromised patients.
- Patients with malignancy in remission, restored immunocompetence, and chemotherapy discontinued for at least 3 months may be candidates for live vaccination.
What happens
An increased risk of infection by the live vaccine
Interaction Deep Dive
As a rule, live vaccines should not be administered to patients who are severely immunocompromised2. In patients with compromised immune systems, neither the safety nor the efficacy of cholera vaccine has been established3. A live vaccine may be given to individuals with leukemia, lymphoma, or other malignancies when 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
The main concern is that a live vaccine may be unsafe while your immune system is suppressed by cancer treatment.
- Keep taking your abemaciclib as prescribed unless your oncologist tells you otherwise.
- Do not get the live cholera vaccine without clearing it with your cancer team first.
- Timing matters: live vaccines are generally considered only when the cancer is in remission, immune function has recovered, and chemotherapy has been stopped for at least 3 months.
- Ask your pharmacist or prescriber whether a non-live alternative or a delay is right for you, especially if you are planning travel.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Cholera Vaccine and Abemaciclib together?
Avoid the live cholera vaccine while on abemaciclib because your weakened immune system could let the vaccine cause an actual infection. Let your oncologist decide on safe timing, generally only after remission and at least 3 months off chemotherapy. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Cholera Vaccine and Abemaciclib 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 Cholera Vaccine and Abemaciclib interaction managed?
The main concern is that a live vaccine may be unsafe while your immune system is suppressed by cancer treatment. Keep taking your abemaciclib as prescribed unless your oncologist tells you otherwise. Do not get the live cholera vaccine without clearing it with your cancer team first. Timing matters: live vaccines are generally considered only when the cancer is in remission, immune function has r… 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 Cholera Vaccine or Abemaciclib 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: VAXCHORA(R) oral suspension, cholera vaccine live oral suspension. Emergent Travel Health Inc (per FDA), Redwood City, CA, 2020. DailyMed
Keep reading about Abemaciclib
Keep reading about Cholera Vaccine
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