Prednisone with Varicella Virus Vaccine, Live Interaction Details
Brand Names Associated with Prednisone
- Cortan®
- Deltasone®
- Orasone®
- Prednisone
- Prednisone Intensol
- Rayos®
- Sterapred®
- Sterapred® DS
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 05, 2023
Interaction Effect
An inadequate immunological response to the vaccine
Interaction Summary
Steroid therapy less than 2 mg/kg of body weight or less than 20 mg/day of prednisone or equivalent for persons who weigh more than 10 kg when administered for less than 14 days is not sufficiently immunosuppressive to raise concern about the safety of vaccination with live-virus vaccines. The immune response to vaccines can be reduced in patients who receive greater than physiologic doses of corticosteroids. Live-virus vaccination should be deferred for at least 1 month after discontinuation of high-dose systemically absorbed corticosteroid therapy administered for more than 14 days. When initiating immunosuppressive therapy, providers should wait 4 weeks after a live vaccine and 2 weeks after an inactivated vaccine. If patients require therapy for chronic inflammatory conditions, therapy should not be delayed because of past administration of vaccines. Short term (less than 14 days); a low to moderate dose (less than 20 mg/day of prednisone or equivalent); long-term, alternate-day treatment with short-acting preparations; maintenance physiologic doses; or topical (skin or eyes), inhaled, or by intraarticular, bursal, or tendon injection therapy is not considered sufficiently immunosuppressive to create vaccine safety concerns and is not a contraindication for administration of live-virus vaccine.
Severity
Moderate
Onset
Delayed
Evidence
Theoretical
How To Manage Interaction
The immune response to vaccines can be reduced in patients who receive greater than physiologic doses of corticosteroids. Live-virus vaccination should be deferred for at least 1 month after discontinuation of high-dose systemically absorbed corticosteroid therapy administered for more than 14 days. When initiating immunosuppressive therapy, providers should wait 4 weeks after a live vaccine and 2 weeks after an inactivated vaccine. If patients require therapy for chronic inflammatory conditions, therapy should not be delayed because of past administration of vaccines. Short term (less than 14 days); a low to moderate dose (less than 20 mg/day of prednisone or equivalent); long-term, alternate-day treatment with short-acting preparations; maintenance physiologic doses; or topical (skin or eyes), inhaled, or by intraarticular, bursal, or tendon injection therapy is not considered sufficiently immunosuppressive to create vaccine safety concerns and is not a contraindication for administration of live-virus vaccine. Steroid therapy less than 2 mg/kg of body weight or less than 20 mg/day of prednisone or equivalent for persons who weigh more than 10 kg when administered for less than 14 days is not sufficiently immunosuppressive to raise concern about the safety of vaccination with live-virus vaccines.
Mechanism Of Interaction
Suppression of the immune system
Prednisone Overview
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Prednisone is used alone or with other medications to treat the symptoms of low corticosteroid levels (lack of certain substances that are usually produced by the body and are needed for normal body functioning). Prednisone is also used to treat other conditions in patients with normal corticosteroid levels. These conditions include certain types of arthritis; severe allergic reactions; multiple sclerosis (a disease in which the nerves do not function properly); lupus (a disease in which the body attacks many of its own organs); and certain conditions that affect the lungs, skin, eyes, kidneys blood, thyroid, stomach, and intestines. Prednisone is also sometimes used to treat the symptoms of certain types of cancer. Prednisone is in a class of medications called corticosteroids. It works to treat patients with low levels of corticosteroids by replacing steroids that are normally produced naturally by the body. It works to treat other conditions by reducing swelling and redness and by changing the way the immune system works.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.