Can vaccines interact with drug metabolism?

Paolo Pellegrino, Emilio Clementi, Annalisa Capuano, Sonia Radice

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Vaccines are safe and efficacious in reducing the burden of several serious infections affecting children and adults. Due to their efficacy, vaccines are often administered in patients with chronic diseases, likely to be under poly-therapy. Because of several case reports indicating changes in drug metabolism after vaccination, the hypothesis of an interaction between vaccines and specific drugs has been put forward. These interactions are conceivably of great concern, especially in patients treated with molecules characterised by a narrow therapeutic index. Herein, we review and systematise the available evidence on vaccine-drug interactions. The picture that emerges indicates that reduction in the activity of specific CYPs following vaccination may occur, most likely via interferon γ overproduction, and for specific drugs such as anticonvulsivant and theophylline may have significant clinical relevance. Clinical interaction between vaccines and drugs that are metabolised by cytochromes uninfluenced by INFγ levels, such as warfarin, are instead unlikely to happen. Further studies are however needed to gain a complete picture of vaccine-drug interactions and define their relevance in terms of possible negative clinical impact.

Original languageEnglish
Pages (from-to)13-17
Number of pages5
JournalPharmacological Research
Volume92
DOIs
Publication statusPublished - 2015

Fingerprint

Vaccines
Pharmaceutical Preparations
Drug Interactions
Vaccination
Warfarin
Cytochromes
Theophylline
Interferons
Chronic Disease
Therapeutics
Infection

Keywords

  • Anticonvulsants
  • Drug interaction
  • Theophylline
  • Vaccine
  • Vaccine interaction
  • Warfarin

ASJC Scopus subject areas

  • Pharmacology
  • Medicine(all)

Cite this

Pellegrino, P., Clementi, E., Capuano, A., & Radice, S. (2015). Can vaccines interact with drug metabolism? Pharmacological Research, 92, 13-17. https://doi.org/10.1016/j.phrs.2014.09.003

Can vaccines interact with drug metabolism? / Pellegrino, Paolo; Clementi, Emilio; Capuano, Annalisa; Radice, Sonia.

In: Pharmacological Research, Vol. 92, 2015, p. 13-17.

Research output: Contribution to journalArticle

Pellegrino, P, Clementi, E, Capuano, A & Radice, S 2015, 'Can vaccines interact with drug metabolism?', Pharmacological Research, vol. 92, pp. 13-17. https://doi.org/10.1016/j.phrs.2014.09.003
Pellegrino, Paolo ; Clementi, Emilio ; Capuano, Annalisa ; Radice, Sonia. / Can vaccines interact with drug metabolism?. In: Pharmacological Research. 2015 ; Vol. 92. pp. 13-17.
@article{53fdf59e167f4abd8543f13e87e94d64,
title = "Can vaccines interact with drug metabolism?",
abstract = "Vaccines are safe and efficacious in reducing the burden of several serious infections affecting children and adults. Due to their efficacy, vaccines are often administered in patients with chronic diseases, likely to be under poly-therapy. Because of several case reports indicating changes in drug metabolism after vaccination, the hypothesis of an interaction between vaccines and specific drugs has been put forward. These interactions are conceivably of great concern, especially in patients treated with molecules characterised by a narrow therapeutic index. Herein, we review and systematise the available evidence on vaccine-drug interactions. The picture that emerges indicates that reduction in the activity of specific CYPs following vaccination may occur, most likely via interferon γ overproduction, and for specific drugs such as anticonvulsivant and theophylline may have significant clinical relevance. Clinical interaction between vaccines and drugs that are metabolised by cytochromes uninfluenced by INFγ levels, such as warfarin, are instead unlikely to happen. Further studies are however needed to gain a complete picture of vaccine-drug interactions and define their relevance in terms of possible negative clinical impact.",
keywords = "Anticonvulsants, Drug interaction, Theophylline, Vaccine, Vaccine interaction, Warfarin",
author = "Paolo Pellegrino and Emilio Clementi and Annalisa Capuano and Sonia Radice",
year = "2015",
doi = "10.1016/j.phrs.2014.09.003",
language = "English",
volume = "92",
pages = "13--17",
journal = "Pharmacological Research",
issn = "1043-6618",
publisher = "Academic Press",

}

TY - JOUR

T1 - Can vaccines interact with drug metabolism?

AU - Pellegrino, Paolo

AU - Clementi, Emilio

AU - Capuano, Annalisa

AU - Radice, Sonia

PY - 2015

Y1 - 2015

N2 - Vaccines are safe and efficacious in reducing the burden of several serious infections affecting children and adults. Due to their efficacy, vaccines are often administered in patients with chronic diseases, likely to be under poly-therapy. Because of several case reports indicating changes in drug metabolism after vaccination, the hypothesis of an interaction between vaccines and specific drugs has been put forward. These interactions are conceivably of great concern, especially in patients treated with molecules characterised by a narrow therapeutic index. Herein, we review and systematise the available evidence on vaccine-drug interactions. The picture that emerges indicates that reduction in the activity of specific CYPs following vaccination may occur, most likely via interferon γ overproduction, and for specific drugs such as anticonvulsivant and theophylline may have significant clinical relevance. Clinical interaction between vaccines and drugs that are metabolised by cytochromes uninfluenced by INFγ levels, such as warfarin, are instead unlikely to happen. Further studies are however needed to gain a complete picture of vaccine-drug interactions and define their relevance in terms of possible negative clinical impact.

AB - Vaccines are safe and efficacious in reducing the burden of several serious infections affecting children and adults. Due to their efficacy, vaccines are often administered in patients with chronic diseases, likely to be under poly-therapy. Because of several case reports indicating changes in drug metabolism after vaccination, the hypothesis of an interaction between vaccines and specific drugs has been put forward. These interactions are conceivably of great concern, especially in patients treated with molecules characterised by a narrow therapeutic index. Herein, we review and systematise the available evidence on vaccine-drug interactions. The picture that emerges indicates that reduction in the activity of specific CYPs following vaccination may occur, most likely via interferon γ overproduction, and for specific drugs such as anticonvulsivant and theophylline may have significant clinical relevance. Clinical interaction between vaccines and drugs that are metabolised by cytochromes uninfluenced by INFγ levels, such as warfarin, are instead unlikely to happen. Further studies are however needed to gain a complete picture of vaccine-drug interactions and define their relevance in terms of possible negative clinical impact.

KW - Anticonvulsants

KW - Drug interaction

KW - Theophylline

KW - Vaccine

KW - Vaccine interaction

KW - Warfarin

UR - http://www.scopus.com/inward/record.url?scp=84923308621&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84923308621&partnerID=8YFLogxK

U2 - 10.1016/j.phrs.2014.09.003

DO - 10.1016/j.phrs.2014.09.003

M3 - Article

VL - 92

SP - 13

EP - 17

JO - Pharmacological Research

JF - Pharmacological Research

SN - 1043-6618

ER -