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Varicella virus vaccine (Subcutaneous route)

Pronunciation:

var-i-SEL-a VYE-rus VAX-een

Brand Names:

  • Varivax
  • Zostavax
  • Varilrix

Dosage Forms:

  • Powder for Solution

Classifications:

Therapeutic—

Vaccine

Uses of This Medicine:

Varicella virus vaccine is an active immunizing agent that is given to protect against infection caused by the varicella-zoster virus (VZV). The vaccine works by causing the body to produce its own protection (antibodies) against the virus.

Varicella (commonly known as chickenpox) is an infection that is easily spread from one person to another. Chickenpox is usually a mild infection but sometimes it can cause serious problems, such as pneumonia, inflammation of the brain, and a rare disease called Reye's syndrome.

Immunization against chickenpox is recommended for anyone 12 months of age and older who has not had chickenpox. Immunization against chickenpox is not recommended for infants younger than 12 months of age.

You can be considered to be immune to chickenpox only if you have received the right number of varicella vaccine doses (1 dose if you are between 12 months and 12 years of age; or 2 doses if you are 13 years of age or older). You also are considered to be immune if you have a doctor's diagnosis of a previous chickenpox infection or if you have had a blood test showing that you are immune to varicella.

Varicella virus vaccine (Zostavax®) is also used for the prevention of herpes zoster (commonly known as shingles) in people 50 years of age and older.

This vaccine is to be administered only by or under the supervision of your doctor or other authorized health care professional.

Before Using This Medicine:

In deciding to use a vaccine, the risks of taking the vaccine must be weighed against the good it will do. This is a decision you and your doctor will make. For this vaccine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Varivax® (for preventing chickenpox)—Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of varicella virus vaccine in children 1 year of age and older. However, varicella virus vaccine is not recommended for infants younger than 12 months of age.

Zostavax® (for preventing shingles)—This vaccine should not be used in children.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of varicella virus vaccine in the elderly.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this vaccine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Receiving this vaccine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Aclarubicin
  • Adalimumab
  • Aldesleukin
  • Alemtuzumab
  • Altretamine
  • Amonafide
  • Amsacrine
  • Asparaginase
  • Aspirin
  • Azacitidine
  • Azathioprine
  • Benorilate
  • Bleomycin
  • Broxuridine
  • Busulfan
  • Capecitabine
  • Carboplatin
  • Carmustine
  • Certolizumab Pegol
  • Chlorambucil
  • Choline Magnesium Trisalicylate
  • Cisplatin
  • Cladribine
  • Cyclophosphamide
  • Cytarabine
  • Cytarabine Liposome
  • Dacarbazine
  • Dactinomycin
  • Daunorubicin
  • Daunorubicin Citrate Liposome
  • Decitabine
  • Docetaxel
  • Doxifluridine
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Edatrexate
  • Eflornithine
  • Epirubicin
  • Estramustine
  • Etanercept
  • Etoposide
  • Everolimus
  • Fingolimod
  • Floxuridine
  • Fludarabine
  • Fluorouracil
  • Fotemustine
  • Gallium Nitrate
  • Gemcitabine
  • Golimumab
  • Hydroxyurea
  • Idarubicin
  • Ifosfamide
  • Immune Globulin
  • Infliximab
  • Irinotecan
  • Lomustine
  • Mechlorethamine
  • Melphalan
  • Mercaptopurine
  • Mesalamine
  • Methotrexate
  • Mitolactol
  • Mitomycin
  • Mitotane
  • Mitoxantrone
  • Mycophenolic Acid
  • Olsalazine
  • Oxaliplatin
  • Paclitaxel
  • Pegaspargase
  • Pentostatin
  • Pipobroman
  • Pirarubicin
  • Plicamycin
  • Pneumococcal Vaccine Polyvalent
  • Procarbazine
  • Raltitrexed
  • Rilonacept
  • Rituximab
  • Salicylamide
  • Salicylic Acid
  • Salsalate
  • Siltuximab
  • Sirolimus
  • Sodium Salicylate
  • Sodium Thiosalicylate
  • Streptozocin
  • Tacrolimus
  • Teceleukin
  • Tegafur
  • Temsirolimus
  • Teniposide
  • Thioguanine
  • Thiotepa
  • Topotecan
  • Trabectedin
  • Treosulfan
  • Trimetrexate
  • Trofosfamide
  • Trolamine Salicylate
  • Uracil Mustard
  • Ustekinumab
  • Vinblastine
  • Vincristine
  • Vincristine Sulfate Liposome
  • Vindesine
  • Vinorelbine

Receiving this vaccine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abatacept
  • Leflunomide

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this vaccine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Blood disorder (weak immune system) or
  • Bone marrow cancer or
  • Gelatin allergy, history of or
  • Illness with fever or
  • Immune deficiency condition, or family history of or
  • Leukemia (cancer of the blood) or
  • Lymphoma (cancer of the immune system) or
  • Neomycin allergy, history of or
  • Neutropenia (low white blood cell count) or
  • Receiving immunosuppressive treatment (e.g., steroid medicine such as dexamethasone or prednisone) or
  • Tuberculosis, active and untreated—Should not be used in patients with these conditions.

Proper Use of This Medicine:

A nurse or other trained health professional will give you or your child this vaccine. This vaccine is given as a shot under your skin (usually in the upper arms).

Children 12 months to 12 years of age may need a second shot within 3 months after receiving the first dose of Varivax®. Teenagers and adults should have a "booster" shot 4 to 8 weeks after the first dose of this vaccine.

Adults receiving Zostavax® should receive only one dose of the vaccine unless your doctor tells you otherwise.

This vaccine comes with a patient information insert. Make sure you understand all of the information in the insert. Ask your doctor if you have any questions.

Tell your doctor before receiving this vaccine if you are severely ill or if you have a fever greater than 101.3 °F.

This vaccine needs to be given on a fixed schedule. If you or your child missed the scheduled dose, call your doctor or your child’s doctor for another appointment as soon as possible.

Precautions While Using This Medicine:

It is very important that you or your child return to your doctor’s office at the right time if you or your child needs a second dose of the vaccine. Be sure to notify your doctor of any side effects that occur after your child receive this vaccine.

Do not become pregnant for 3 months after receiving varicella virus vaccine without first checking with your doctor. There is a chance that this vaccine may cause problems during pregnancy. If you think you have become pregnant, tell your doctor right away. Your doctor may want you to join a pregnancy registry for patients receiving this vaccine.

Zostavax® should not be used in place of Varivax®.

Zostavax® should not be used in children.

Tell your doctor that you or your child have received this vaccine:

  • If you are to receive blood transfusions or other blood products within 5 months of receiving this vaccine.
  • If you are to receive varicella-zoster immune globulin (VZIG) or other immune globulins within 2 months after receiving this vaccine.
  • If you are to receive any other live virus vaccines within 1 month of receiving this vaccine.

This vaccine may cause serious types of allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth after you receive the vaccine.

Do not take aspirin or medicines that contain aspirin (such as certain cold medicines) for 6 weeks after receiving this vaccine. Carefully check the label of any pain, headache, or cold medicine you or your child use to be sure it does not contain aspirin or salicylic acid.

You or your child may be able to pass the virus to other people after getting this vaccine. You or your child should avoid close contact with people at high risk for getting chickenpox for 6 weeks after receiving this vaccine. People who are most at risk of catching the virus from you are pregnant women, newborn babies, and people whose bodies cannot fight infection (such as with bone marrow disease, cancer drug treatment, or AIDS). Talk to your doctor about this risk.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
Fever over 39 °C (102 °F)
Less common
Blue lips and fingernails
chest pain
chickenpox-like skin rash
coughing that sometimes produces a pink frothy sputum
decreased urine output
difficult, fast, or noisy breathing, sometimes with wheezing
dilated neck veins
extreme fatigue
general feeling of discomfort or illness
increased sweating
irregular breathing
irregular heartbeat
irritability
pale skin
shortness of breath
swelling of the ankles, face, fingers, feet, or lower legs
tightness in the chest
troubled breathing
weight gain
wheezing
Rare
Black, tarry stools
blood in the urine or stools
chills
confusion
convulsions (seizures) with high fever
cough
difficulty with breathing or swallowing
fever
hives
itching, especially of the feet or hands
muscle or joint pain
pinpoint red spots on the skin
reddening of the skin, especially around the ears
severe or continuing headache
stiff neck
swelling of the glands in the neck
thickening of bronchial secretions
unusual bleeding or bruising
unusual tiredness or weakness, sudden and severe
vomiting
Incidence not known
Back pain, sudden and severe
bleeding gums
blistering, peeling, or loosening of the skin
bloating or swelling of the face, arms, hands, lower legs, or feet
bloody nose
blurred vision
bruising more easily
convulsions (seizures)
dizziness
fast heartbeat
headache
heavier menstrual periods
inability to move the arms and legs
inability to speak
itching
large, flat, blue, or purplish patches in the skin
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
loss of bladder control
muscle spasm or jerking of all extremities
painful blisters on the trunk of the body
painful knees and ankles
pale skin
pinpoint red spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
raised red swellings on the skin, buttocks, legs, or ankles
rapid weight gain
red irritated eyes
red skin lesions, often with a purple center
shakiness and unsteady walk
skin rash
slurred speech
sores, ulcers, or white spots in the mouth or on the lips
stomach pain
sudden loss of consciousness
sudden numbness and weakness in the arms and legs
swelling or puffiness of the face
swollen or painful glands
temporary blindness
tingling of the hands or feet
unsteadiness, trembling, or other problems with muscle control or coordination
unusual weight gain or loss
weakness in the arm or leg on one side of the body, sudden and severe
weakness of the muscles in your face

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Fever of 37.7 °C (100 °F) or higher, but not above 39 °C (102 °F)
hives, itching, pain, redness, soreness, tenderness, or warmth at the injection site
Less common
Common cold
congestion
constipation
cracked, dry, or scaly skin
diaper rash
diarrhea
disturbed sleep
dry skin
earache
heat rash or prickly heat
lack or loss of strength
loss of appetite
muscle aching or cramping
muscle stiffness
nausea
nervousness
runny nose
skin rash, encrusted, scaly, and oozing
sneezing
sore throat
stuffy nose
swelling
swollen joints
teething
Incidence not known
Bacterial skin infections
body aches or pain
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
difficulty with moving
dryness or soreness of the throat
hoarseness
pain, redness, swelling, tenderness, or warmth on the skin
red rash with watery, yellow-colored, or pus filled blisters
tender, swollen glands in the neck
thick yellow to honey-colored crusts
voice changes

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 11/4/2014

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