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Adult Dosing .
Dosage forms: INJ
measles, mumps and rubella prevention
- [patients without immunity and with low infection risk]
- Dose: 0.5 mL SC/IM x1; Info: for patients with no evidence of immunity or born after 1956; search 'immunization' for epocrates Adult Immunization decision tool including links to CDC/ACIP schedules
- [patients without immunity and with high infection risk]
- Dose: 0.5 mL SC/IM x2 doses at least 4wk apart; Info: for college students, healthcare workers, international travelers, household or close contacts of immunocompromised patients, and patients with HIV infection and CD4 >200 and >15% for at least 6mo; search 'immunization' for epocrates Adult Immunization decision tool including links to CDC/ACIP schedules
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [no adjustment]
Peds Dosing .
- Dosage forms: INJ
measles, mumps and rubella prevention
- [6-11 mo (off-label)]
- Dose: 0.5 mL SC/IM x1; Info: for international travel-related prophylaxis; give 1 dose before departure; revaccinate at 12-15 mo with 2-dose series at least 4wk apart; search 'immunization' for epocrates Child/Adolescent Immunization decision tool including links to CDC/ACIP schedules
- [12 mo and older]
- Dose: 0.5 mL SC/IM x1 at 12-15 mo, then 0.5 mL SC/IM x1 at 4-6 yo; Info: may give 2nd dose as early as 4wk after 1st dose; if unvaccinated and traveling internationally, give 2-dose series at least 4wk apart before departure; search 'immunization' for epocrates Child/Adolescent Immunization decision tool including links to CDC/ACIP schedules
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [no adjustment]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- hypersensitivity to gelatin
- pregnancy
- immunocompromised patients
- HIV infection with CD4 <15%
- HIV infection with CD4 <200
- TB infection, active untreated
- febrile illness, acute
- caution: antibody-containing blood product use, recent
- caution: hypersensitivity to egg
- caution: hypersensitivity to neomycin
- caution: patients of childbearing potential
- caution: seizure history
- caution: seizures family history
- caution: thrombocytopenia
- caution: TB infection risk
- caution: illness, acute moderate-severe
Drug Interactions .
Overview
measles/mumps/rubella vaccine, live
live vaccine
- live vaccine
Contraindicated
Avoid/Use Alternative
Monitor/Modify Tx
Caution Advised
Adverse Reactions .
Serious Reactions
- anaphylaxis
- hypersensitivity reaction
- Henoch-Schonlein purpura
- acute hemorrhagic edema of infancy
- erythema multiforme
- Stevens-Johnson syndrome
- atypical measles
- thrombocytopenia
- seizures
- febrile seizures
- encephalopathy
- encephalitis
- Guillain-Barre syndrome
- neurotoxicity
- pneumonitis
- pancreatitis
Common Reactions
- arthralgia
- arthritis
- fever
- urticaria
- rash
- rash, measles-like
- pruritus
- injection site reaction
- headache
- dizziness
- malaise
- irritability
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Look/Sound-Alike Drug Names
M-M-R II confused with: Meruvax II
Pregnancy/Lactation .
Pregnancy
Clinical Summary
contraindicated during pregnancy; delay vaccination until pregnancy completed; possible risk of congenital rubella syndrome based on limited human data with other measles/mumps/rubella vaccine
Individuals of Reproductive Potential
avoid pregnancy by using effective contraception x4wk after vaccination in patients of childbearing potential
Lactation
Clinical Summary
benefits outweigh risks while breastfeeding; inadequate human data available, though possible risk of mild infant rubella infection; no human data available to assess effects on milk production
Pharmacology .
Metabolism: for measles/mumps/rubella vaccine: other; CYP450: unknown
Excretion: for measles/mumps/rubella vaccine: other; Half-life: unknown
Subclass: Measles/Mumps/Rubella Vaccines ; Routine Adult Vaccines ; Routine Pediatric Vaccines ; Travel Vaccines
Mechanism of Action
for measles/mumps/rubella vaccine: exact mechanism of action unknown; induces antibody formation
Formulary .
No Formulary Selected
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