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Flumist (Influenza Virus Vaccine Live Intranasal) - Drug Interactions, Contraindications, Overdosage, etc

 
 



DRUG INTERACTIONS

Children or adolescents who are receiving aspirin therapy or aspirin-containing therapy should not receive FluMist (see CONTRAINDICATIONS). FluMist should not be administered to persons on immunosuppressive therapy.

The concurrent use of FluMist with antiviral compounds that are active against influenza A and/or B viruses has not been evaluated. However, based upon the potential for interference between such compounds and FluMist, it is advisable not to administer FluMist until 48 hours after the cessation of antiviral therapy and that antiviral agents not be administered until two weeks after administration of FluMist unless medically indicated.

There are no data regarding co-administration of FluMist with other intranasal preparations, including steroids.

CONTRAINDICATIONS

Under no circumstances should FluMist™ be administered parenterally.

Individuals with a history of hypersensitivity, especially anaphylactic reactions, to any component of FluMist, including eggs or egg products, should not receive FluMist (see DESCRIPTION).

FluMist is contraindicated in children and adolescents (5-17 years of age) receiving aspirin therapy or aspirin-containing therapy, because of the association of Reye syndrome with aspirin and wild-type influenza infection.

FluMist should not be administered to individuals who have a history of Guillain-Barré syndrome.

As with other live virus vaccines, FluMist should not be administered to individuals with known or suspected immune deficiency diseases such as combined immunodeficiency, agammaglobulinemia, and thymic abnormalities and conditions such as human immunodeficiency virus infection, malignancy, leukemia, or lymphoma. FluMist is also contraindicated in patients who may be immunosuppressed or have altered or compromised immune status as a consequence of treatment with systemic corticosteroids, alkylating drugs, antimetabolites, radiation, or other immunosuppressive therapies.

REFERENCES

  1. Centers for Disease Control and Prevention. Prevention and control of Influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2004;53 (Early release) (No. RR-6):1-40.
  2. Murphy BR, Coelingh KC. Principles underlying the development and use of live attenuated cold-adapted influenza A and influenza B virus vaccines. Viral Immunol. 2002;15:295-323.
  3. Jin H, et al. Multiple amino acid residues confer temperature sensitivity to human influenza virus vaccine strains (FluMist) derived from cold-adapted A/Ann Arbor/6/60. Virology. 2003;306:18-24.
  4. Hoffmann, et al. Molecular basis for temperature sensitivity and attenuation of the human vaccine strain B/Ann Arbor/1/66. Presented at the International Conference on Options for the Control of Influenza V, (Okinawa, Japan). 2003.
  5. Monto AS, Sullivan KM. Acute respiratory illness in the community. Frequency of illness and the agents involved. Epidemiol Infect. 1993;110:145-160.
  6. Sullivan KM. Health impact of influenza in the United States. Pharmacoeconomics. 1996;9 Suppl. 3:26-33.
  7. Barker WH, Mullooly JP. Impact of epidemic Type A influenza in a defined adult population. Am J Epi. 1980;112:798-811.
  8. Thompson WW, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA. 2003;289:179-186.
  9. Murphy BR, Clements ML. The systemic and mucosal immune response of humans to influenza A virus. Curr Topics in Micro Immun. 1989;146:107-116.
  10. McMichael AJ, et al. Cytotoxic T-cell immunity to influenza. N Engl J Med. 1983;309:13-17.
  11. Belshe RB, et al. Correlates of immune protection induced by live, attenuated, cold-adapted, trivalent, intranasal influenza virus vaccine. J Infect Dis. 2000a;181:1133-1137.
  12. Treanor JJ, et al. Evaluation of trivalent, live, cold-adapted (CAIV-T) and inactivated (TIV) influenza vaccines in prevention of virus infection and illness following challenge of adults with wild-type influenza A (H1N1), A (H3N2), and B viruses. Vaccine. 2000;18:899-906.
  13. Belshe RB, et al. The efficacy of live attenuated, cold-adapted, trivalent, intranasal influenza virus vaccine in children. N Engl J Med. 1998;338:1405-1412.
  14. Belshe RB, et al. Efficacy of vaccination with live attenuated, cold-adapted, trivalent, intranasal influenza virus vaccine against a variant (A/Sydney) not contained in the vaccine. J Peds. 2000b;136:168-175.
  15. MedImmune data on file.
  16. Nichol KL, et al. Effectiveness of live, attenuated intranasal influenza virus vaccine in healthy, working adults. JAMA. 1999;282:137-144.
  17. Vesikari T, et al. A randomized, double-blind, placebo-controlled trial of the safety, transmissibility and phenotypic stability of a live, attenuated, cold-adapted influenza virus vaccine (CAIV-T) in children attending day care. Presented at the 41st Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (Chicago, IL). 2001.
  18. Longini IM, et al. Estimating household and community transmission parameters for influenza. Am J Epidemiol. 1982;115:736-751.

Manufactured and Marketed by:

MedImmune Vaccines, Inc.

Gaithersburg, MD 20878

MedImmune

Vaccines, Inc.

Component No. FLU04-072

Issue Date: September 2004

U.S. Govt. License No. 1652

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