Drug General Information (ID: DDIDA9G4B8)
Drug Name			Cobimetinib		Drug Info		Typhoid vaccine (inactivated)		Drug Info
Drug Type		Small molecule				Vaccine
Therapeutic Class		Multikinase Inhibitors				Vaccines

Mechanism of Cobimetinib-Typhoid vaccine (inactivated) Interaction (Severity Level: Moderate)
Antagonize the effect of vaccine/toxoid Click to Show/Hide Mechanism Graph
Drug Name		Cobimetinib				Typhoid vaccine (inactivated)
Mechanism		Immunosuppressive effects				Vaccine or toxoid
Key Mechanism Factor 1
		Factor Name		Vaccine/toxoid
		Factor Description		The beneficial effects of the vaccine/toxinoid may be reduced, leading to a diminished or suboptimal immune response.
Mechanism Description		Antagonize the effect of Typhoid vaccine (inactivated) when combined with Cobimetinib

Recommended Action
Management		In general, the US Department of Public Health Advisory Committee on Immunization Practices (ACIP) recommends that inactivated or killed vaccines be administered to non-HIV immunosuppressed patients according to the same guidelines as for healthy patients. For Haemophilus influenzae b vaccine, some experts recommend that it be administered at least 2 weeks before starting or 3 months after discontinuing chemotherapy when used in patients with Hodgkin's disease. For rabies vaccine, some authorities suggest that immunosuppressive agents should generally be avoided during postexposure therapy except when absolutely necessary for the treatment of other conditions.

References
1	CDC. Centers for Disease Control and Prevention/ "Recommendations of the advisory committtee on immunization practices (ACIP): use of vaccines and immune globulins in persons with altered immunocompetence." MMWR Morb Mortal Wkly Rep 42(RR-04) (1993): 1-18. [PMID: 20300058]
2	Product Information. Imovax Rabies (rabies vaccine). sanofi pasteur, Swiftwater, PA.
3	Department of Health. National Health Service "Immunisation Against Infectious Disease - "The Green Book". Chapter 6: Contraindications and special considerations.".