Live Vaccines; Live BCG/Selected Immunosuppressive Agents Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Very Serious. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Medication which suppresses the immune system may prevent your body from responding correctly to the vaccine or to your BCG medicine for bladder cancer.

What might happen:

If you are receiving immunosuppressant medicine, you may not develop disease immunity from the vaccination and/or the live vaccine may cause you to develop the illness it was supposed to prevent. However, an inactive vaccine cannot cause you to develop the illness it was supposed to prevent, even if you receive immunosuppressant medicine.If you are receiving an immunosuppressant medicine when you receive your BCG bladder treatment it may not work as well, and/or you could get a severe infection if the BCG medicine gets into your blood stream.

What you should do about this interaction:

Before receiving a vaccination with a live vaccine, or BCG medicine for bladder cancer, let your doctor know all of the other medicines you are taking, especially if your medications work by suppressing the immune system (e.g. transplant medicines)or if you have recently received radiation or chemotherapy for cancer. Your doctor may decide to give you an inactive vaccine, may want to change the timing of your vaccination or may want to change when you receive your BCG cancer medicine.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Centers for Disease Control and Prevention. General Recommendations on Immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Available at: February 17, 2022;60(RR No.
  • 2):1-68.
  • 3.Orencia (abatacept) US prescribing information. Bristol-Myers Squibb Company December, 2021.
  • 4.TICE BCG (BCG live, for intravesical use) prescribing information. Organon USA Inc. October, 2010.
  • 5.Zinbryta (daclizumab) US prescribing information. Biogen Inc. August, 2017.
  • 6.Tremfya (guselkumab) US prescribing information. Janssen Biotech, Inc. July, 2020.
  • 7.Uplizna (inebilizumab-cdon) US prescribing information. Viela Bio June, 2020.
  • 8.Ocrevus (ocrelizumab) US prescribing information. Genentech November, 2020.
  • 9.Zeposia (ozanimod) US prescribing information. Celgene Corporation May, 2021.
  • 10.Mayzent (siponimod) US prescribing information. Novartis Pharmaceuticals Corporation June, 2022.
  • 11.Stelara (ustekinumab) US prescribing information. Janssen Biotech, Inc. March, 2024.
  • 12.Enspryng (satralizumab-mwge) US Prescribing Information. Genentech, Inc. August 2020.
  • 13.Briumvi (ublituximab-xiiy) US prescribing information. TG Therapeutics December, 2022.
  • 14.Velsipity (etrasimod) US prescribing information. Pfizer Inc. October 2023.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.