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Pneumovax 23
pneumococcal 23-valent polysaccharide vaccine (PPSV23)
Adult Dosing .
Dosage forms: INJ
invasive pneumococcal dz prevention
- [no or unknown pneumococcal vaccine history]
- Dose: 0.5 mL SC/IM x1; Info: for patients 65 yo and older and high-risk patients <65 yo; give at least 8wk after last PCV15 dose in patients w/ cochlear implant, CSF leak, or immunocompromised patients, otherwise give at least 1y after last PCV13 or PCV15 dose; search 'immunization' for epocrates Adult Immunization decision tool incl. links to CDC/ACIP schedules
- [previously received PCV7 only]
- Dose: 0.5 mL SC/IM x1; Info: for patients 65 yo and older and high-risk patients <65 yo; give at least 8wk after last PCV15 dose in patients w/ cochlear implant, CSF leak, or immunocompromised patients, otherwise give at least 1y after last PCV13 or PCV15 dose; search 'immunization' for epocrates Adult Immunization decision tool incl. links to CDC/ACIP schedules
- [previously received PCV13 only, <65 yo, patients w/ chronic conditions]
- Dose: 0.5 mL SC/IM x1; Start: >1y after last PCV13 dose; Info: search 'immunization' for epocrates Adult Immunization decision tool incl. links to CDC/ACIP schedules
- [previously received PCV13 only, <65 yo, patients w/ cochlear implant or CSF leak]
- Dose: 0.5 mL SC/IM x1; Start: >8wk after last PCV13 dose; Info: search 'immunization' for epocrates Adult Immunization decision tool incl. links to CDC/ACIP schedules
- [previously received PCV13 only, <65 yo, immunocompromised patients]
- Dose: 0.5 mL SC/IM x2 doses >5y apart; Start: >8wk after last PCV13 dose; Info: search 'immunization' for epocrates Adult Immunization decision tool incl. links to CDC/ACIP schedules
- [previously received PCV13 only, 65 yo and older]
- Dose: 0.5 mL SC/IM x1; Start: >1y after last PCV13 dose; Info: give >8wk after last PCV13 dose in patients w/ cochlear implant, CSF leak, or immunocompromised patients; search 'immunization' for epocrates Adult Immunization decision tool incl. links to CDC/ACIP schedules
- [previously received PCV13 and PPSV23, <65 yo, immunocompromised patients]
- Dose: 0.5 mL SC/IM x1; Start: >5y after last PPSV23 dose and >8wk after last PCV13 dose; Info: search 'immunization' for epocrates Adult Immunization decision tool incl. links to CDC/ACIP schedules
- [previously received PCV13 and PPSV23, 65 yo and older]
- Dose: 0.5 mL SC/IM x1; Info: for patients who received PPSV23 at <65 yo; give at least 5y after last PPSV23 dose; give at least 8wk after last PCV13 dose in patients w/ cochlear implant, CSF leak, or immunocompromised patients, otherwise give at least 1y after last PCV13 dose; search 'immunization' for epocrates Adult Immunization decision tool incl. 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
invasive pneumococcal dz prevention
- [2 yo and older at series start, patients w/ chronic conditions]
- Dose: 0.5 mL SC/IM x1; Start: >8wk after last PCV13 or PCV15 dose; Info: search 'immunization' for epocrates Child/Adolescent Immunization decision tool incl. links to CDC/ACIP schedules
- [2 yo and older at series start, patients w/ CSF leak or cochlear implant]
- Dose: 0.5 mL SC/IM x1; Start: >8wk after last PCV13 or PCV15 dose; Info: search 'immunization' for epocrates Child/Adolescent Immunization decision tool incl. links to CDC/ACIP schedules
- [2 yo and older at series start, immunocompromised patients]
- Dose: 0.5 mL SC/IM x2 doses at least 5y apart; Start: >8wk after last PCV13 or PCV15 dose; may give PCV20 instead of 2nd PPSV23 dose; Info: search 'immunization' for epocrates Child/Adolescent Immunization decision tool incl. 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
- caution: immunocompromised patients
- caution: illness, acute moderate-severe
- caution: CSF leakage, chronic
Drug Interactions .
Overview
pneumococcal vaccine
vaccine
- non-live vaccine
Avoid/Use Alternative
- interferon gamma 1b
Monitor/Modify Tx
- abatacept
- abemaciclib
- abrocitinib
- acalabrutinib
- adalimumab
- ado-trastuzumab emtansine
- afamitresgene autoleucel
- aldesleukin
- alemtuzumab
- anakinra
- anifrolumab
- anti-thymocyte globulin
- atezolizumab
- atidarsagene autotemcel
- avelumab
- avutometinib
- axicabtagene ciloleucel
- azacitidine
- azathioprine
- baricitinib
- basiliximab
- belatacept
- belimumab
- belinostat
- belzutifan
- bendamustine
- betamethasone
- bimekizumab
- blinatumomab
- bortezomib
- brentuximab vedotin
- brexucabtagene autoleucel
- brodalumab
- budesonide
- budesonide rectal
- busulfan
- cabazitaxel
- canakinumab
- capecitabine
- capmatinib
- carboplatin
- carfilzomib
- carmustine
- cemiplimab
- certolizumab pegol
- chlorambucil
- ciltacabtagene autoleucel
- cisplatin
- cladribine injection
- cladribine oral
- clofarabine
- copanlisib
- corticotropin
- cortisone
- cosibelimab
- cyclophosphamide
- cyclosporine
- cytarabine
- dactinomycin
- daratumumab
- dasatinib
- daunorubicin
- decitabine
- defactinib
- deflazacort
- delgocitinib topical
- deucravacitinib
- deuruxolitinib
- dexamethasone
- dimethyl fumarate
- dinutuximab
- diroximel fumarate
- docetaxel
- dordaviprone
- dostarlimab
- doxorubicin
- dupilumab
- durvalumab
- duvelisib
- efgartigimod alfa
- elivaldogene autotemcel
- elotuzumab
- elranatamab
- emapalumab
- epcoritamab
- epirubicin
- eribulin
- etanercept
- etoposide
- etrasimod
- everolimus
- fam-trastuzumab deruxtecan
- fingolimod
- floxuridine
- fludarabine
- fludrocortisone
- fluorouracil
- fruquintinib
- gemcitabine
- gemtuzumab ozogamicin
- glofitamab
- golimumab
- guselkumab
- hydrocortisone
- hydroxyurea
- ibritumomab tiuxetan
- ibrutinib
- idarubicin
- idecabtagene vicleucel
- idelalisib
- ifosfamide
- imatinib
- inebilizumab
- infliximab
- inotuzumab ozogamicin
- ipilimumab
- irinotecan
- isatuximab
- ixabepilone
- ixekizumab
- lebrikizumab
- leflunomide
- lenalidomide
- linvoseltamab
- lisocabtagene maraleucel
- lomustine
- loncastuximab tesirine
- lurbinectedin
- lymphocyte immune globulin, anti-thymocyte globulin
- margetuximab
- melphalan
- meningococcal vaccine
- mercaptopurine
- methotrexate
- methylprednisolone
- mirikizumab
- mitomycin
- mitoxantrone
- mogamulizumab
- momelotinib
- monomethyl fumarate
- mosunetuzumab
- mycophenolate mofetil
- mycophenolic acid
- natalizumab
- nelarabine
- nemolizumab
- nilotinib
- nipocalimab
- nivolumab
- obecabtagene autoleucel
- obinutuzumab
- ocrelizumab
- ofatumumab
- oxaliplatin
- ozanimod
- paclitaxel
- palbociclib
- panobinostat
- peginterferon alfa 2a
- pembrolizumab
- pentostatin
- pertuzumab
- pirtobrutinib
- polatuzumab vedotin
- pomalidomide
- ponatinib
- ponesimod
- prednisolone
- prednisone
- procarbazine
- regorafenib
- retifanlimab
- rilonacept
- ripretinib
- risankizumab
- ritlecitinib
- rituximab
- romidepsin
- ropeginterferon alfa-2b
- rozanolixizumab
- ruxolitinib
- sarilumab
- satralizumab
- secukinumab
- selinexor
- siltuximab
- siponimod
- sirolimus
- sirolimus albumin-bound
- sirolimus topical
- spesolimab
- sunitinib
- sunvozertinib
- tacrolimus
- tafasitamab
- talquetamab
- tarlatamab
- teclistamab
- temozolomide
- temsirolimus
- teplizumab
- teriflunomide
- thioguanine
- thiotepa
- tildrakizumab
- tisagenlecleucel
- tislelizumab
- tocilizumab
- tofacitinib
- topotecan
- toripalimab
- tralokinumab
- tremelimumab
- triamcinolone
- ublituximab
- upadacitinib
- ustekinumab
- vamorolone
- vandetanib
- vedolizumab
- venetoclax
- vinblastine
- vincristine
- vinorelbine
- voclosporin
- zanidatamab
- zanubrutinib
- zenocutuzumab
- zongertinib
Adverse Reactions .
Serious Reactions
- hypersensitivity rxn
- radiculopathy
- Guillain-Barre syndrome
- cellulitis
- thrombocytopenia w/ prior stable ITP
- hemolytic anemia (patients w/ prior hematologic disorders)
Common Reactions
- injection site rxn
- headache
- asthenia
- fatigue
- myalgia
- rigors
- fever
- nausea
- vomiting
- arthralgia
- rash
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Look/Sound-Alike Drug Names
Pneumovax 23 confused with: Prevnar
pneumococcal vaccine polyvalent confused with: pneumococcal conjugate vaccine
pneumococcal vaccine, 23-valent confused with: pneumococcal vaccine, 7-valent; pneumococcal vaccine, 13-valent; pneumococcal vaccine, 15-valent; pneumococcal vaccine, 20-valent
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; risk of fetal harm not expected based on limited human data
Lactation
Clinical Summary
may use while breastfeeding; no human data available, though risk of infant harm not expected based on vaccine properties; no human data available to assess effects on milk production
Pharmacology .
Metabolism: other; CYP450: unknown
Excretion: other; Half-life: unknown
Subclass: Pneumococcal Vaccines ; Routine Adult Vaccines ; Routine Pediatric Vaccines
Mechanism of Action
exact mechanism of action unknown; induces antibody formation
Formulary .
No Formulary Selected
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