by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.Monitor Closely (17)anthrax immune globulinanthrax immune globulin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Immune globulin administration may impair the efficacy of live attenuated vaccines. Defer vaccination with live virus vaccines until ~3 months after administration of anthrax IG. Revaccinate people who received anthrax IG shortly after live virus vaccination following 3 months after the administration of anthrax IG.belataceptbelatacept decreases effects of BCG vaccine live by Other (see comment). Use Caution/Monitor. Comment: The use of live vaccines should be avoided during treatment with belatacept. Inform patients that vaccinations may be less effective while they are being treated with belatacept.betibeglogene autotemcelbetibeglogene autotemcel, BCG vaccine live. Other (see comment). Use Caution/Monitor. Comment: Follow institutional guidelines for vaccine administration. Safety of live vaccines during or following treatment not studied. .cytomegalovirus immune globulin (CMV IG)cytomegalovirus immune globulin (CMV IG) decreases effects of BCG vaccine live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.hepatitis B immune globulin (HBIG)hepatitis B immune globulin (HBIG) decreases effects of BCG vaccine live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.imipenem/cilastatinimipenem/cilastatin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. BCG vaccine prescribing information states that antimicrobial or immunosuppressive agents may interfere with the development of the immune response and should be used only under medical supervision.imipenem/cilastatin/relebactamimipenem/cilastatin/relebactam decreases effects of BCG vaccine live by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. BCG vaccine prescribing information states that antimicrobial or immunosuppressive agents may interfere with the development of the immune response and should be used only under medical supervision.immune globulin IM (IGIM)immune globulin IM (IGIM) decreases effects of BCG vaccine live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.immune globulin IV (IGIV)immune globulin IV (IGIV) decreases effects of BCG vaccine live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.immune globulin SCimmune globulin SC decreases effects of BCG vaccine live by pharmacodynamic antagonism. Use Caution/Monitor.leniolisibleniolisib decreases effects of BCG vaccine live by immunosuppressive effects; risk of infection. Use Caution/Monitor. Live, attenuated vaccinations may be less effective if administered during leniolisib treatment.obinutuzumabobinutuzumab decreases effects of BCG vaccine live by immunosuppressive effects; risk of infection. Use Caution/Monitor. Immunization with live virus vaccines is not recommended during obinutuzumab treatment and until after B-cell recovery.ponesimodponesimod decreases effects of BCG vaccine live by immunosuppressive effects; risk of infection. Use Caution/Monitor. If possible, complete all age-appropriate vaccinations at least 4 weeks before initiating ponesimod.rabies immune globulin, human (RIG)rabies immune globulin, human (RIG) decreases effects of BCG vaccine live by Other (see comment). Use Caution/Monitor. Comment: High dose rabies immunoglobulin may impair response to active immunization.tetanus immune globulin (TIG)tetanus immune globulin (TIG) decreases effects of BCG vaccine live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.ublituximabublituximab decreases effects of BCG vaccine live by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.vaccinia immune globulin intravenousvaccinia immune globulin intravenous decreases effects of BCG vaccine live by pharmacodynamic antagonism. Use Caution/Monitor. Defer live vaccines for 3 months after immune globulin administration.Minor (2)chloroquinechloroquine decreases effects of BCG vaccine live by pharmacodynamic antagonism. Minor/Significance Unknown.Rho(D) immune globulinRho(D) immune globulin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Minor/Significance Unknown. Separate by 3 months.abrocitinibSerious - Use Alternative (1)abrocitinib decreases effects of BCG vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Administration of live vaccines is not recommended during abrocitinib treatment and immediately before or after treatment.adalimumabSerious - Use Alternative (1)adalimumab decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.alefaceptSerious - Use Alternative (1)alefacept decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.amikacinSerious - Use Alternative (1)amikacin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.amoxicillinSerious - Use Alternative (1)amoxicillin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.ampicillinSerious - Use Alternative (1)ampicillin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.anakinraSerious - Use Alternative (1)anakinra decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.anifrolumabSerious - Use Alternative (1)anifrolumab decreases effects of BCG vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Before initiation, update immunization according to current guidelines.anthrax immune globulinMonitor Closely (1)anthrax immune globulin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Immune globulin administration may impair the efficacy of live attenuated vaccines. Defer vaccination with live virus vaccines until ~3 months after administration of anthrax IG. Revaccinate people who received anthrax IG shortly after live virus vaccination following 3 months after the administration of anthrax IG.antithymocyte globulin equineSerious - Use Alternative (1)antithymocyte globulin equine decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.antithymocyte globulin rabbitSerious - Use Alternative (1)antithymocyte globulin rabbit decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.atoltivimab/maftivimab/odesivimabSerious - Use Alternative (1)atoltivimab/maftivimab/odesivimab decreases effects of BCG vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Ebola monoclonal antibodies may interfere with immune response of live vaccines. Refer to vaccine guidelines for vaccination timing during and following treatment. .azathioprineSerious - Use Alternative (1)azathioprine decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.azithromycinSerious - Use Alternative (1)azithromycin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.aztreonamSerious - Use Alternative (1)aztreonam decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.baricitinibSerious - Use Alternative (1)baricitinib decreases effects of BCG vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid use of live vaccines with baricitinib. Update immunizations in agreement with current immunization guidelines before initiating baricitinib.basiliximabSerious - Use Alternative (1)basiliximab decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.beclomethasone, inhaledSerious - Use Alternative (1)beclomethasone, inhaled increases effects of BCG vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. May interfere with generation of an adequate immune response to BCG vaccine.bedaquilineSerious - Use Alternative (1)BCG vaccine live decreases effects of bedaquiline by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid concomitant use of intravesical BCG and antibiotics, particulary those given via IV or oral routes and those with activity against mycobacteria.belataceptMonitor Closely (1)belatacept decreases effects of BCG vaccine live by Other (see comment). Use Caution/Monitor. Comment: The use of live vaccines should be avoided during treatment with belatacept. Inform patients that vaccinations may be less effective while they are being treated with belatacept.belimumabContraindicated (1)belimumab decreases effects of BCG vaccine live by immunosuppressive effects; risk of infection. Contraindicated. Do not administer live vaccines 30 days before or concurrently with belimumab.betibeglogene autotemcelMonitor Closely (1)betibeglogene autotemcel, BCG vaccine live. Other (see comment). Use Caution/Monitor. Comment: Follow institutional guidelines for vaccine administration. Safety of live vaccines during or following treatment not studied. .brodalumabSerious - Use Alternative (1)brodalumab, BCG vaccine live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating brodalumab, complete all age appropriate immunizations. No data are available on the ability of live or inactive vaccines to elicit an immune response in patients being treated with brodalumab.budesonideSerious - Use Alternative (1)budesonide decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.cabazitaxelSerious - Use Alternative (1)cabazitaxel decreases effects of BCG vaccine live by Mechanism: pharmacodynamic antagonism. Avoid or Use Alternate Drug. Live attenuated vaccines should not be used in patients receiving immunosuppressive therapy. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects.canakinumabSerious - Use Alternative (1)canakinumab decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.cefaclorSerious - Use Alternative (1)cefaclor decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cefadroxilSerious - Use Alternative (1)cefadroxil decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cefamandoleSerious - Use Alternative (1)cefamandole decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cefazolinSerious - Use Alternative (1)cefazolin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cefdinirSerious - Use Alternative (1)cefdinir decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cefditorenSerious - Use Alternative (1)cefditoren decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cefepimeSerious - Use Alternative (1)cefepime decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cefiximeSerious - Use Alternative (1)cefixime decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cefotaximeSerious - Use Alternative (1)cefotaxime decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cefotetanSerious - Use Alternative (1)cefotetan decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cefoxitinSerious - Use Alternative (1)cefoxitin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cefpiromeSerious - Use Alternative (1)cefpirome decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cefpodoximeSerious - Use Alternative (1)cefpodoxime decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cefprozilSerious - Use Alternative (1)cefprozil decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.ceftazidimeSerious - Use Alternative (1)ceftazidime decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.ceftibutenSerious - Use Alternative (1)ceftibuten decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.ceftriaxoneSerious - Use Alternative (1)ceftriaxone decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cefuroximeSerious - Use Alternative (1)cefuroxime decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.cephalexinSerious - Use Alternative (1)cephalexin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.certolizumab pegolContraindicated (1)certolizumab pegol decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Do not give live vaccines concurrently with certolizumab.chloramphenicolSerious - Use Alternative (1)chloramphenicol decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.chlorhexidine oralSerious - Use Alternative (1)chlorhexidine oral decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.chloroquineMinor (1)chloroquine decreases effects of BCG vaccine live by pharmacodynamic antagonism. Minor/Significance Unknown.ciprofloxacinSerious - Use Alternative (1)ciprofloxacin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Antibiotics may diminish therapeutic effects of BCG. Wait until Abx Tx complete to administer live bacterial vaccine.clarithromycinSerious - Use Alternative (1)clarithromycin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.clindamycinSerious - Use Alternative (1)clindamycin decreases effects of BCG