Vaccine, cholera: Indication, Dosage, Side Effect, Precaution

Generic Medicine Info Patient Medicine Information

This information is not country-specific. Please refer to the Indonesia prescribing information.

Generic Medicine Info

Indications and Dosage

Oral
Active immunisation against cholera

Adult: As inactivated/killed vaccine: Primary immunisation: 2 doses at weekly interval. Complete course at least 14 days prior to exposure. Booster dose: As single dose within 2 years, if still at risk. As live attenuated vaccine: As single dose at least 10 days prior to potential exposure.
Child: As inactivated/killed vaccine: Primary immunisation: 2-6 years 3 doses at weekly interval. Complete course at least 14 days prior to exposure. Booster dose: As single dose within 6 months if still at risk. >6 years Same as adult dose.

Reconstitution

Lyophilised/Susp: Dissolve the buffer effervescent granules in at least 100-150 mL of purified water then add active component. Consume immediately after reconstitution.

Contraindications

Hypersensitivity.

Special Precautions

Immunocompromised patients. Postpone immunisation in patients with acute gastrointestinal illness or acute febrile illness. Children. Pregnancy and lactation.

Adverse Reactions

Significant: Shedding and transmission, altered immunocompetence.
Gastrointestinal disorders: Gastrointestinal discomfort, diarrhoea, abdominal pain, nausea, vomiting, abdominal cramps, acute gastroenteritis.
General disorders and administration site conditions: Fatigue, fever, weakness.
Nervous system disorders: Headache, dizziness.
Respiratory, thoracic and mediastinal disorders: Cough, rhinitis.
Skin and subcutaneous tissue disorders: Itching, rash.
Potentially Fatal: Hypersensitivity.

Drug Interactions

May diminish therapeutic effect with antibiotic and chloroquine. Reduced therapeutic effect with immunosuppressants.

Food Interaction

Impaired therapeutic effect with food and drinks.

Action

Description:
Mechanism of Action: Cholera vaccine contains either live attenuated or inactivated/killed strains of Vibrio cholerae bacteria. Live attenuated cholera vaccine replicates in the gastrointestinal tract causing immune response from the recipient thus increasing serum vibriocidal antibody within 10 days of vaccination, however, the exact immune mechanism is still unknown. Inactivated strains contain V. cholerae O1 and recombinant non-toxic B-subunit cholera toxin (CTB). It induces antibodies against both the bacterial component and CTB by preventing the bacteria from attaching to the intestinal wall thereby impeding colonisation of V. cholerae O1 and inhibiting the cholera toxin from binding to the intestinal mucosal surface hence, preventing toxin-mediated diarrhoeal symptoms.
Onset: Within 10 days.
Pharmacokinetics:
Excretion: Via faeces.

Storage

Lyophilised: Store between -25 to -15°C. Protect from light and moisture. Susp: Store between 2-8°C. Do not freeze.
Any unused portions or waste material should be disposed of in accordance with local requirements.

MIMS Class

Vaccines, Antisera & Immunologicals

ATC Classification

J07AE02 - cholera, live attenuated ; Belongs to the class of cholera bacterial vaccines.
J07AE - Cholera vaccines ; Used for active immunizations.
J07AE01 - cholera, inactivated, whole cell ; Belongs to the class of cholera bacterial vaccines.

References

Anon. Cholera Vaccine Live Oral. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 03/08/2017.

Anon. Cholera Vaccine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/08/2017.

Buckingham R (ed). Cholera Vaccines. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/08/2017.

Vaxchora (Paxvax, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/08/2017.

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