How does this medication work? What will it do for me?

Influenza vaccine (intranasal spray) belongs to the class of medications called vaccine. It is used to prevent influenza (the flu) for people 2 to 59 years of age. Influenza is a common viral illness caused by 2 types of virus: influenza A and influenza B.

Each year, different strains (new, slightly different versions of the virus) appear. Scientists predict which strains will be most likely for the coming year, and then these strains are used to make up the year's influenza vaccine. Each year's influenza vaccine contains 3 to 4 virus strains that are likely to circulate in Canada in the coming winter. The vaccine only provides protection against the strains of flu virus used to prepare the vaccine.

The vaccine increases a person's defenses against the influenza virus. It works by introducing very small amounts of viral components (parts) into the body. These components are enough to stimulate the production of antibodies (cells designed to attack that particular virus), which will remain in the body ready to attack that same virus in the future.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor.

What form(s) does this medication come in?

Each 0.2 mL dose contains 10 6.5-7.5 FFU (fluorescent focus units) of live attenuated influenza virus reassortants of each of the four strains for the specific season. Nonmedicinal ingredients: sucrose, dibasic potassium phosphate, monobasic potassium phosphate, gelatin hydrolysate (porcine Type A), arginine hydrochloride, monosodium glutamate, gentamicin (a trace residual), and ovalbumin (a trace residual). Does not contain preservatives (e.g., no thimerosal) or latex.

How should I use this medication?

The influenza vaccine (intranasal spray) is given once a year, usually in October or November, as a spray into the nose. One-half of the dose should be given into each nostril. It is given by a health care professional. Children 2 to 8 years of age who have not previously received an influenza vaccine require 2 doses of the vaccine, given at least 4 weeks apart.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are receiving the medication without consulting your doctor.

It is important this medication be given exactly as recommended by your doctor. If you miss an appointment to receive influenza vaccine (intranasal spray), contact your doctor as soon as possible to reschedule your appointment.

This medication is stored in the refrigerator, protected from light and should not be allowed to freeze.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Influenza vaccine (intranasal spray) should not be used by anyone who:

  • is allergic to the influenza vaccine or to any of the ingredients of the medication
  • is allergic to any of the following:
    • eggs
    • egg proteins
    • gentamicin
    • gelatin
    • arginine

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abdominal pain
  • chills
  • cough
  • decreased activity, tiredness, or weakness
  • decreased appetite
  • feeling unwell
  • fever
  • headache
  • muscle aches
  • runny or stuffy nose
  • sore throat

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • nosebleeds
  • rash

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a severe allergic reaction (e.g., hives; difficulty breathing; wheezing; swelling of the face, mouth, or throat)
  • symptoms of Guillain-Barré syndrome, an extremely rare complication of vaccines (e.g., weakness or tingling in the feet, legs, arms or face; difficulty breathing; severe low back pain; difficulty walking, speaking, chewing, or swallowing)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergic reactions: Rarely, this vaccine may cause severe allergic reactions. This is why your doctor may ask you to stay in the office for about 30 minutes after having the vaccine so that you can get medical care if you experience an allergic reaction. If you notice signs of a severe allergic reaction (hives; trouble breathing or swallowing; or swelling of the lips, face, throat, or tongue), get medical attention immediately.

Asthma: People who have severe asthma or who have experienced wheezing within the past 7 days should not receive this medication.

Guillain-Barré syndrome: Guillain-Barré syndrome is a rare condition that affects the central nervous system and is thought to be triggered by viral infections and in rare cases, vaccination. When treated quickly, the majority of people affected fully recover. People who have had Guillain-Barré syndrome within 6 months of a vaccination should discuss the risks and benefits of receiving this medication with their doctor.

Immune system: As with any vaccine, influenza vaccine may not be as effective for those who have a weakened immune system (e.g., people on chemotherapy, people who have had an organ transplant, or people with HIV). Also, this vaccine contains live, inactivated virus and people who receive this vaccine may pass the virus on to people with a weakened immune system. If you have received this vaccine, avoid contact with people who have a severely weakened immune system (e.g., people who have received a bone marrow transplant and are in isolation) for at least 2 weeks after receiving the vaccine.

Vaccine protection: As with any vaccine, this vaccine may not protect 100% of people who receive it. The vaccine only provides protection against certain strains of the flu virus (i.e., the ones from which it was prepared, or ones that are closely related).

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if influenza vaccine (intranasal spray) passes into breast milk. If you are a breast-feeding mother and are going to receive this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: This medication is not recommended for children under 2 years of age, as they are at an increased risk of experiencing wheezing. Also, children under 18 years of age who are taking acetylsalicylic acid (ASA) or ASA-related medications should not receive this vaccine due to the risk of developing Reye's syndrome (a severe but rare condition that affects the nervous system and liver).

What other drugs could interact with this medication?

There may be an interaction between influenza vaccine (intranasal spray) and any of the following:

  • medications that suppress the immune system:
    • corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
    • medications used to treat conditions such as cancer, inflammatory bowel disease, multiple sclerosis, psoriasis, rheumatoid arthritis, or medications used after a transplant
  • other vaccines

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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