Cholera Vaccine and Relugolix: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Cholera Vaccine
Relugolix
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.
The cholera vaccine (Vaxchora) is a live vaccine, which means it contains a weakened form of the germ to help train your body's defenses. Relugolix (Orgovyx) is used to lower certain hormones, often as part of cancer treatment, and some people on this kind of treatment can have a weaker immune system.
If your defenses are lowered, a live vaccine could, in rare cases, cause the very infection it is meant to prevent. The good news is your care team knows how to handle this. Before getting any live vaccine, talk with your doctor or pharmacist so they can check whether it is the right time for you.
Interaction: Live attenuated cholera vaccine (Vaxchora) in a patient who may be immunocompromised secondary to relugolix-based therapy carries an increased risk of vaccine-derived infection.
- Mechanism: Blunted immune response permits replication of the live organism, causing disseminated or symptomatic infection (a PD interaction, not PK; neither agent is metabolically involved).
- Direction: Reduced vaccine safety / active infection risk.
- Evidence: Established; onset unspecified.
- Management: Severely immunocompromised patients generally should not receive live vaccines. Safety in immunocompromised patients is not established. Defer live vaccination and individualize timing based on immune status and treatment history.
What happens
An increased risk of infection by the live vaccine
Interaction Deep Dive
As a rule, live vaccines should not be given to patients who are severely immunocompromised 2. In immunocompromised individuals, neither the safety nor the efficacy of cholera vaccine has been established 3. A live vaccine may be administered to patients with leukemia, lymphoma, or other malignancies provided their disease is in remission, their immunocompetence has been restored, and chemotherapy has been stopped for a minimum of 3 months 1.
Why it happens (mechanism)
Decreased immune response allows live vaccine to produce infection
How to manage this interaction
What your care team may do:
- Assess whether your immune system is significantly suppressed before giving any live vaccine such as cholera vaccine.
- Generally avoid live vaccines in severely immunocompromised patients, since safety has not been established.
- Consider timing: for those whose cancer is in remission with restored immune function and whose chemotherapy has been stopped for at least 3 months, a live vaccine may be appropriate.
What you should do: Keep taking relugolix as prescribed, and do not get the cholera vaccine without first checking with your prescriber or pharmacist so they can confirm the right timing for you.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Cholera Vaccine and Relugolix together?
The live cholera vaccine may not be safe if relugolix therapy has weakened your immune system, so check with your doctor or pharmacist before getting it. Your care team will time the vaccine around your immune status. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Cholera Vaccine and Relugolix 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 Relugolix interaction managed?
What your care team may do: Assess whether your immune system is significantly suppressed before giving any live vaccine such as cholera vaccine. Generally avoid live vaccines in severely immunocompromised patients, since safety has not been established. Consider timing: for those whose cancer is in remission with restored immune function and whose chemotherapy has been stopped for at least 3 mont… 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 Relugolix 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 Cholera Vaccine
Keep reading about Relugolix
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