Relugolix and Typhoid Vaccine: 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
Typhoid 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.
This warning is about the live version of the typhoid vaccine (the oral capsules or certain injections that contain a weakened but live germ). A live vaccine works by giving your body a tiny, safe dose of the actual bug so your immune system learns to fight it.
If your immune system is weakened, that weakened germ can sometimes grow enough to cause a real infection instead of just training your defenses. Relugolix (Orgovyx) is a hormone therapy used in prostate cancer, and being treated for cancer can lower your body's defenses. Because of that, a live typhoid vaccine may not be safe while you are in this situation. The good news is your care team can plan safe timing or pick a non-live option, so talk with your doctor or pharmacist before getting any vaccine.
Effect: Increased risk of vaccine-derived infection from the live typhoid vaccine (e.g., Ty21a/Vivotif) in immunocompromised patients.
Mechanism: A blunted humoral/cell-mediated immune response permits the attenuated organism to cause clinical infection. This is a pharmacodynamic (immune) interaction, not a metabolic one; neither agent is a prodrug and no CYP pathway is involved.
- Direction: Reduced immune competence, increased infection risk.
- Severity: Contraindicated. Evidence: Established.
- Management: Avoid live typhoid vaccine during immunosuppressive/antineoplastic therapy. Live vaccination may be considered once immunocompetence is restored (commonly cited as at least 3 months after stopping chemotherapy). Consider timing around therapy and defer to specialist guidance.
What happens
An increased risk of infection by the live vaccine
Interaction Deep Dive
In patients whose capacity to generate a humoral or cell-mediated immune response is impaired, whether from a congenital or acquired immunodeficient state, including the use of immunosuppressive or antimitotic agents, typhoid vaccine should not be administered 2. A live vaccine may be given to individuals with leukemia, lymphoma, or other malignancies who are in remission, whose immunocompetence has returned, and for whom 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
The main point: the live typhoid vaccine is not recommended while you are being treated with a cancer therapy like relugolix, because your defenses may be too low to safely handle even a weakened germ.
- Keep taking your relugolix as prescribed. Do not skip doses to get a vaccine.
- Before any travel or vaccine, tell your pharmacist or doctor that you are on relugolix so they can plan safe timing or choose a suitable option.
- Live vaccines are generally considered again only after immune function has recovered (often at least 3 months after stopping certain cancer treatments), and your care team will decide when that applies to you.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Relugolix and Typhoid Vaccine together?
Do not get the live typhoid vaccine while on relugolix without your care team's approval; ask your doctor or pharmacist about safe timing or a non-live alternative. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Relugolix and Typhoid Vaccine interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Relugolix and Typhoid Vaccine interaction managed?
The main point: the live typhoid vaccine is not recommended while you are being treated with a cancer therapy like relugolix, because your defenses may be too low to safely handle even a weakened germ. Keep taking your relugolix as prescribed. Do not skip doses to get a vaccine. Before any travel or vaccine, tell your pharmacist or doctor that you are on relugolix so they can plan safe timing or c… 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 Relugolix or Typhoid Vaccine 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 (2)
- Centers for Disease Control and Prevention (CDC): Vaccines & Immunizations: altered immunocompetence. Centers for Disease Control and Prevention (CDC). Atlanta, GA. 2024.
- Product Information: VIVOTIF(R) oral coated capsules, live typhoid vaccine ty21a oral coated capsules. Bavarian Nordic Inc (per Dailymed), Morrisville, NC, 2024. DailyMed
Keep reading about Typhoid Vaccine
Keep reading about Relugolix
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