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

This medication belongs to a family of medications known as vaccines. It is used to prevent shingles for people over 50 years of age. It may also be used to prevent shingles for people aged 18 years or older who have weakened immune systems due to disease or medications. Shingles is caused by the same virus that causes chickenpox. After you have had chickenpox, the virus retreats to the nerves, where it lies dormant for years.

Shingles occurs when the virus becomes active again, causing a blistering rash and severe burning pain. The medication works by boosting the immune system to help prevent shingles. It does not treat shingles.

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 taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

After reconstitution with the supplied diluent, each 0.5 mL single dose of opalescent, colourless-to-pale-brownish liquid, contains 50 µg of Varicella Zoster Virus (VZV) glycoprotein E (gE). Nonmedicinal ingredients: dipotassium phosphate, polysorbate 80, sodium dihydrogen phosphate dihydrate, and sucrose; adjuvant diluent: Quillaja saponaria Molina, fraction 21 (QS-21), 3–O–desacyl–4'-monophosphoryl lipid A (MPL), cholesterol, dioleoyl phosphatidylcholine, disodium phosphate anhydrous, potassium dihydrogen phosphate, sodium chloride, and water for injection.  

How should I use this medication?

This medication is given as an injection of 0.5 mL into the muscle of the upper arm. Vaccination consists of 2 doses. After the first injection, a second dose is given 2 to 6 months later. For people who have weakened immune systems, the second dose may be given 1 to 2 months after the first dose.

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 this vaccine, contact your doctor as soon as possible to reschedule your appointment.

This medication should be protected from light and stored in the refrigerator at a temperature of 2°C to 8°C, until it is mixed to be used for injection. Do not freeze this medication. After mixing, the vaccine must be given immediately or stored in the refrigerator for up to 6 hours.

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?

Do not take this medication if you are allergic to zoster vaccine or any ingredients of the medication.

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.

  • chills
  • diarrhea
  • fever
  • general feeling of being unwell
  • headache
  • joint or muscle pain
  • nausea
  • pain, redness, itching, and swelling at the injection site
  • stomach pain
  • tiredness
  • vomiting

Contact your doctor immediately if any of the following occur:

  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

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.

Bleeding problems: If you have a medical condition that causes you to bruise or bleed easily, or you are taking medications to prevent blood clots, let your doctor know. Some people who have bleeding problems may bruise or bleed after an intramuscular injection.

Illness with fever: If you have an illness with a fever, talk to your doctor about whether you should receive the vaccine.

Pregnancy: No studies have been done to determine the effect of this medication on the developing baby or mother if it is given during pregnancy. This vaccine should not be used during pregnancy.

Breast-feeding: It is not known if zoster vaccine passes into breast milk. If you are breast-feeding and are taking 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.

What other drugs could interact with this medication?

There may be an interaction between herpes zoster vaccine and any of the following:

  • acetaminophen
  • anakinra
  • azathioprine
  • baricitinib
  • cancer medications (e.g., carboplatin, cyclophosphamide, doxorubicin, ifosfamide, venetoclax, vincristine)
  • corticosteroids (e.g., budesonide, dexamethasone, hydrocortisone, fluticasone, prednisone)
  • cyclosporine
  • etanercept
  • hydroxyurea
  • leflunomide
  • methotrexate
  • monoclonal antibodies (e.g., adalimumab, belimumab, daclizumab, golimumab, infliximab, rituximab)
  • multiple sclerosis (MS) medications (e.g., fingolimod, ozanimod, ponesimod, siponimod)
  • mycophenolate
  • nonsteroidal anti-inflammatory medications (NSAIDs; e.g., diclofenac, ibuprofen, naproxen)
  • sirolimus
  • tacrolimus
  • teriflunomide
  • tofacitinib
  • upadacitinib

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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