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Allylamines

Indications: Treats fungal nail infections.
MOA: Stunts the growth of susceptible fungi by blocking an enzyme needed in producing ergosterol.
Adverse Reactions: Topical applications may cause burning, stinging, and itchiness of the skin. Oral terbinafine may alter a patient’s sense of taste.
Drug Interactions: Alcohol.
Contraindications/Cautions: Caution in patients with hepatic disease.

Comments:

Complete the full course of therapy.
Lamisil tablets should be taken with food.
Therapeutic levels of terbinafine are reached within 3-18 weeks after initiating therapy.
Therapeutic levels are maintained 2-3 weeks after treatment has ceased.

Examples of Allylamines

Generic Name	Brand Name(s)	Dosage Forms	Daily Dosage
Butenafine	Mentax	Cream	Apply 1-2 times a day for 7-14 days
Terbinafine	Lamisil	Tablet	250 mg PO qd × 6-12 wk

Polyenes

Indications: Candida infections of the skin and mucous membranes.
MOA: Inhibits the synthesis of the fungal cell membrane by binding irreversibly to ergosterol.
Adverse Reactions: Amphotericin B may cause kidney damage and hypokalemia.
Contraindications/Cautions: Patients with renal impairment.

Comments:

Complete full course of therapy.

Examples of Polyenes

Generic Name	Brand Name(s)	Dosage Forms	Daily Dosage
Amphotericin B	Amphotec	IV solution	3-4 mg/kg/day IV
Nystatin	-	Tablet, oral suspension, topical, vaginal cream	500,000 units PO tid

No longer available as a branded drug in the United States.

Echinocandins

Indications: Candida and Aspergillus infections.
MOA: Interferes with the synthesis of fungal cell wall.
Adverse Reactions: Elevated liver enzyme levels, hypokalemia, and hypotension.
Drug Interactions: Immunosuppressants.
Contraindications/Cautions: Patients with hepatic impairment.

Comments:

Oral absorption is poor, resulting in medication being administered parenterally.

Examples of Echinocandins

Generic Name	Brand Name(s)	Dosage Forms	Daily Dosage
Anidulafungin	Eraxis	Powder for injection	50 mg IV q24h
Caspofungin	Cancidas	Powder for injection	50 mg IV q24h
Micafungin	Mycamine	Powder for injection	100 mg IV qd

Miscellaneous Antifungal Agents

Griseofulvin

Indication: Onychomycosis (fungal nail infection).
MOA: Interferes with fungal mitosis.
Adverse Reactions: Gas, heartburn, nausea, and vomiting.
Drug Interactions: Warfarin, amlodipine, and oral contraceptives.
Contraindications/Cautions: Hepatic impairment, hepatic failure, and porphyria.

Comments:

Take for full course of therapy.
Griseofulvin should be taken with a fatty meal.

Example of Miscellaneous Antifungal Agent

Generic Name	Brand Name(s)	Dosage Forms	Daily Dosage
Griseofulvin	Gris-PEG	Capsule, tablet, oral suspension	500 mg PO qd × 2-4 wk

Antiviral Agents

Indications: Cytomegalovirus retinitis, genital herpes, herpes simplex, herpes simplex keratitis, herpes zoster (shingles), influenza prophylaxis, organ transplants, varicella, and chickenpox.
MOA: Inhibits penetration of the host cell.
Adverse Reactions: Headaches, nausea, vomiting, diarrhea, constipation, and renal disorders.
Drug Interactions: Antiviral drug interactions are a particular problem among immunocompromised patients, because these patients are often receiving multiple different drugs for various conditions.
Contraindications/Cautions: Renal or hepatic impairment and electrolyte impairments.

Comments:

Complete full course of therapy.
Oral products should be taken with plenty of water.
When acyclovir is reconstituted, the injection solution should be used within 12 hours.

Examples of Antiviral Agents

Generic Name	Brand Name	Dosage Forms	Dosage
Acyclovir	Zovirax	Capsule, tablet, suspension, ointment	200-800 mg q4h 5× daily for 7-10 days
Amantadine	-	Capsule, syrup	200 mg PO qd
Cidofovir*	-	Solution	5 mg/kg IV over 1h
Famciclovir	-	Tablet	200-1000 mg PO qd
Foscarnet*	Foscavir	Solution	90 mg/kg (over 1-1.5 h) q12h
Ganciclovir*	Cytovene	Capsule, solution	5 mg/kg IV over 1h q12h for 14-21 days
Oseltamivir	Tamiflu	Capsule, suspension	75 mg bid × 5 days
Penciclovir	Denavir	Cream	Apply q2h during waking hours × 4 days
Rimantadine	Flumadine	Tablet	100 mg bid × 7 days
Ribavirin*	Copegus	Tablet	400-700 mg bid
Valacyclovir	Valtrex	Caplet	1000 mg PO q12h × 7-10 days
Valganciclovir*	Valcyte	Tablet, solution	900 mg bid × 21 days
Zanamivir	Relenza	Inhalant	10 mg bid × 5 days

Medication carries a boxed warning.
No longer available as a branded drug in the United States.

Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

Indication: Limits the progression of the retrovirus that causes HIV, which may progress to AIDS.
MOA: Inhibits the release of neuraminidase, a viral enzyme, to prevent the spread of the virus to healthy cells.
Adverse Reactions: Nausea, vomiting, and peripheral neuropathy.
Drug Interactions: St. John’s wort and alcohol.
Contraindications/Cautions: Pancreatitis and lactic acidosis.

Comments:

Take exactly as directed; don’t skip doses.
Should not be used during lactation.

Examples of Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

Generic Name	Brand Name	Dosage Forms	Dosage
Abacavir (ABC)	Ziagen	Tablet, solution	300 mg PO bid or 600 mg PO qd
Didanosine (ddl)	Videx, Videx EC	Powder for oral solution, capsule, tablet	200 mg PO bid
Emtricitabine (FTC)	Emtriva	Capsule, solution	200 mg PO qd
Lamivudine (3TC)	Epivir	Tablet, solution	150 mg PO qd or 300 mg PO qd
Stavudine (d4T)	Zerit	Capsule, solution	30-40 mg PO qd
Tenofovir (TDF)	Viread	Tablet	300 mg PO qd
Zidovudine (AZT)	Retrovir	Capsule, syrup, solution	600 mg PO qd in divided doses
Abacavir/Lamivudine	Epzicom	Tablet	600 mg/300 mg PO qd
Emtricitabine/Tenofovir	Truvada	Tablet	200 mg/300 mg PO qd
Zidovudine/Lamivudine (CBV)	Combivir	Film-coated tablet	150 mg/300 mg PO bid
Efavirenz/Emtricitabine/Tenofovir	Atripla	Tablet	600 mg/200 mg/300 mg
Emtricitabine/Rilpivirine/Tenofovir	Complera	Tablet	200 mg/25 mg/300 mg PO qd
Zidovudine/Lamivudine/Abacavir (TRZ)	Trizivir	Tablet	300 mg/150 mg/300 mg PO bid

Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)

Indications: Aids in the treatment of HIV disease.
MOA: Inhibits the action of neuraminidase, preventing the formation of proviral DNA.
Adverse Reactions: Dizziness, headache, rashes, nightmares, hallucinations, and hepatotoxicity.
Drug Interactions: Benzodiazepines, oral contraceptives, and other HIV medications.
Contraindications/Cautions: Hepatic impairment, baseline CD4 >250 (female patients), baseline CD4 >400 (male patients), HBV or HCV co-infections.

Comments:

Take exactly as directed; don’t skip doses.
Can induce or inhibit the cytochrome P450 system.
Resistance to one NNRTI results in resistance to the others.

Examples of Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)

Generic Name	Brand Name	Dosage Forms	Dosage
Delavirdine (DLV)	Rescriptor	Tablet	400 mg PO tid (1-2 tablets PO tid)
Efavirenz (EFZ)	Sustiva	Capsule, tablet	600 mg PO qd
Etravirine	Intelence	Tablet	200 mg PO bid
Nevirapine (NVP)	Viramune	Tablet, suspension	200 mg PO qd × 14 days

Protease Inhibitors

Indication: Assists in the treatment of HIV.
MOA: Prevents the cleavage of certain HIV protein precursors, which are necessary for the replication of new viruses.
Adverse Reactions: Redistribution of body fat (“protease paunch” humped back), facial atrophy, breast enlargement, hyperglycemia, and hyperlipidemia.
Drug Interactions: Antianxiety agents.
Contraindications/Cautions: History of nephrolithiasis, diabetes, and hepatic impairment.

Comments:

Take exactly as prescribed; don’t skip doses.
Many protease inhibitors should be taken with food; however, check drug literature first.

Examples of Protease Inhibitors

Generic Name	Brand Name	Dosage Forms	Dosage
Atazanavir	Reyataz	Capsule	300-400 mg PO qd
Darunavir	Prezista	Tablet	800 mg PO qd
Fosamprenavir (FPV)	Lexiva	Tablet, suspension	700-1400 mg PO qd-bid
Indinavir (IDV)	Crixivan	Capsule	800 mg PO q8h
Lopinavir/Ritonavir (LPV/r)	Kaletra	Solution, capsule	400 mg/100 mg PO bid
Nelfinavir (NFV)	Viracept	Tablet, Powder	750 mg PO tid or 1250 mg PO bid
Ritonavir (RTV)	Norvir	Capsule, solution	600 mg PO bid
Saquinavir (SQV-SGC)	Invirase	Capsule, tablet	1000 mg PO bid
Tipranavir	Aptivus	Capsule, solution	500 mg PO bid

Note: Medication carries a boxed warning.

Fusion Inhibitors

Indication: Aids in the treatment of HIV.
MOA: Prevents the AIDS virus from entering immune cells.
Adverse Reactions: Skin reactions, which may cause bruising, cysts, itching, bumps, pain, and redness.
Drug Interactions: Orlistat.
Contraindications/Cautions: Pulmonary disease or risk of pneumonia.

Comments:

Take exactly as directed; don’t skip doses.
Enfuvirtide is diluted with sterile water.
Solution is stable for only 24 hours if refrigerated.

Example of Fusion Inhibitors

Generic Name	Brand Name	Dosage Form	Dosage
Enfuvirtide	Fuzeon	SC injection	90 mg SC bid

HIV Integrase Strand Inhibitors

Indication: Used in combination with other antiretroviral agents to treat HIV.
MOA: Binds to double-stranded viral DNA and mediates its integration into the infected host cell’s DNA to produce a provirus.
Adverse Reactions: Headache, dizziness, diarrhea, and gastrointestinal symptoms.
Drug Interactions: Aluminum hydroxide, magnesium carbonate, and magnesium citrate.
Contraindications: Anticonvulsants, lovastatin, and sildenafil.

Comments:

Take exactly as directed; don’t skip doses.
May be taken with or without food.

Examples of HIV Integrase Strand Inhibitors

Generic Name	Brand Name	Dosage Form	Dosage
Cobicistat	Tybost	Tablet	150 mg PO qd
Raltegravir	Isentress	Tablet	400 mg PO bid

Chemokine Receptor Type 5 Antagonists

Indication: Used in the treatment of HIV.
MOA: Inhibits HIV entry into host cells.
Adverse Reactions: Colds, cough, fever, and rash.
Drug Interactions: Eliguistat, carbamazepine, and St. John’s wort.
Contraindications: Patients with risk of cardiac disease, hepatic or renal impairment, and co-infection with HBV and HCV.

Comments:

May be taken with or without food.
Swallow the pill whole; do not crush, chew, or break the tablet.

Example of Chemokine Receptor Type 5 Antagonists

Generic Name	Brand Name	Dosage Form	Dosage
Maraviroc	Selzentry	Tablet	300 mg PO bid

Multiclass Combination HIV Medications

Generic Name	Brand Name	Dosage Form	Dosage
Abacavir/Dolutegravir/Lamivudine	Triumeq	Tablet	600 mg/50 mg/300 mg PO qd
Reltegravir/Cobicistat/Emtricitabine/Tenofovir Disoproxil	Stribild	Tablet	150 mg/150 mg/300 mg PO qd

Note: Medication carries a boxed warning.

Adverse Reactions: Menopause symptoms, alopecia, nausea, and vomiting.
Drug Interactions: DHEA, estradiol (hormone replacement), and tamoxifen.
Contraindications/Cautions: Estrogen use, pregnancy, and postmenopausal women.

Comments:

Exercise precautions for handling, preparing, and administering cytotoxic drugs.
Take at the same time each day with water.
Take with meals.

Examples of Aromatase Inhibitors

Generic Name	Brand Name	Dosage Form	Dosage
Anastrozole	Arimidex	Tablet	1 mg PO qd
Exemestane	Aromasin	Tablet	25 mg PO qd
Letrozole	Femara	Tablet	2.5 mg PO qd

Note: Please note that all dosages are for adults and expressed in oral dosages unless otherwise indicated.

Gonadotropin-Releasing Hormone Agonists

Indications: Prostate cancer.
MOA: Increases hormone levels and is followed by desensitization to hormone’s effect.
Adverse Reactions: Anaphylaxis, bone density loss, and diabetes mellitus.
Drug Interactions: Cisapride, dronedarone, and pimozide.
Contraindications/Cautions: Pregnancy, depression, and cardiovascular disease.

Comments:

Exercise precautions for handling, preparing, and administering cytotoxic drugs.
Inject according to prescribed schedule.
Store at room temperature.

Example of Gonadotropin-Releasing Hormone Agonist

Generic Name	Brand Name	Dosage Form	Dosage
Goserelin	Zolvadex	Implant	3.6 mg SC q 28 days

Note: Please note that all dosages are for adults and expressed in oral dosages unless otherwise indicated.

Progestins

Indication: Breast cancer.
MOA: Suppresses the release of luteinizing hormone from the pituitary glands and increases the metabolism of estrogen.
Adverse Reactions: Hot flashes, breakthrough menstrual bleeding, and weight gain.
Drug Interactions: Dofetilide and oral hypoglycemic agents.
Contraindications/Cautions: Elderly patients, patients with diabetes mellitus, and patients with a history of thromboembolisms.

Comments:

Exercise precautions for handling, preparing, and administering cytotoxic drugs.
Take medication as instructed.
BUN/Cr should be monitored in elderly patients.

Examples of Progestins

Generic Name	Brand Name	Dosage Form	Dosage
Megestrol	b	Tablet, Suspension	400-800 mg PO qd

Note: No longer available as a branded drug in the United States.

Alkylating Agents

Indication: Hodgkin lymphoma.
MOA: Forms irreversible cross-links in DNA, resulting in cells being unable to reproduce.
Adverse Reactions: Myelosuppression, alopecia, nausea, vomiting, and weight loss.
Drug Interactions: Antigout medications and vaccines.
Contraindications/Cautions: Bone marrow depression, pregnancy during the first trimester, and breastfeeding.

Comments:

Exercise precautions for handling, preparing, and administering cytotoxic drugs.
Avoid aspirin, acetaminophen, and NSAIDs.
Take on an empty stomach.
Avoid dairy products within 2-3 hours of the dose.

Examples of Alkylating Agents

Generic Name	Brand Name	Dosage Form	Dosage
Cyclophosphamide	b	Tablet, Powder for Injection	1-5 mg/kg PO qd
Estramustine	Emcyt	Capsule	10-16 mg/kg/day PO divided tid-qid

Note: No longer available as a branded drug in the United States.

Taxanes

Indications: Breast and ovarian cancer.
MOA: Inhibits the mitosis process.
Adverse Reactions: Diarrhea, body alopecia, and nausea.
Drug Interactions: Antigout medications and live virus vaccines.
Contraindications/Cautions: Elderly patients, patients with hepatic impairment, and patients with ANC <1000 (Kaposi sarcoma).

Comments:

Docetaxel and paclitaxel
Refrigerate; don’t freeze.
Protect from light.
Do not mix in PVC bags or use PVC sets.
Reconstituted docetaxel is stable for 4 hours, whereas reconstituted paclitaxel is stable for 27 hours.
Exercise precautions for handling, preparing, and administering cytotoxic drugs.
Avoid aspirin, acetaminophen, and NSAIDs.
Avoid pregnancy.

Examples of Taxanes

Generic Name	Brand Name	Dosage Form	Dosage
Docetaxel	b	Powder for Injection	60-100 mg/m² IV on day 1 of a 21-day cycle
Paclitaxel	b	Solution	135 mg/m² IV x 1 on day 1 of a 21-day cycle

Note: Medication carries a boxed warning. No longer available as a branded drug in the United States.

Vinca Alkaloids

Indications: Lung cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, and testicular cancer.
MOA: Inhibits the mitosis process.
Adverse Reactions: Alopecia, joint and muscle pain, and nausea/vomiting.
Drug Interactions: Antigout medications and live virus vaccines.
Contraindications/Cautions: Granulocytopenia, neuropathy, and pulmonary disease.

Comments:

Exercise precautions for handling, preparing, and administering cytotoxic drugs.
Avoid aspirin, acetaminophen, and NSAIDs.
Avoid pregnancy.
Syringes must be labeled: "Fatal if given intrathecally. For IV use only."

Examples of Vinca Alkaloids

Generic Name	Brand Name	Dosage Form	Dosage
Vinblastine	b	Solution, Powder for Injection	Doses may vary
Vincristine	b	Solution	1.4 mg/m² IV q wk
Vinorelbine	Navelbine	Solution	30 mg/m² x 2 IV q wk

Note: Medication carries a boxed warning. No longer available as a branded drug in the United States.

Anthracyclines

Indications: See anthracycline table.
MOA: Damages cellular DNA.
Adverse Reactions: Anorexia, alopecia, and hepatotoxicity.
Drug Interactions: Antigout medications and live virus vaccines.
Contraindications/Cautions: History of cardiovascular disease, hepatic impairment, and myelosuppression.

Comments:

Doxorubicin
Protect from light.
May cause discoloration of urine.
Exercise precautions for handling, preparing, and administering cytotoxic drugs.
Shake well (powder for injection).
Avoid pregnancy.

Examples of Anthracyclines

Generic Name	Brand Name	Indication	Dosage Form	Dosage
Doxorubicin	b	Breast Cancer	Solution, Powder for Injection	60-75 mg/m² IV on day 1 of a 21-day cycle
Doxorubicin Liposomal	Doxil	Ovarian Cancer, Kaposi Sarcoma	Liposomal Dispersion	50 mg/m² IV on day 1 of a 21-day cycle
Epirubicin	Ellence	Breast Cancer	Solution	75 mg/m² IV on day 1 of a 21-day cycle
Mitoxantrone	b	Prostate Cancer, Multiple Sclerosis	Solution	2-14 mg/m² IV on day 1 of a 21-day cycle

Note: Medication carries a boxed warning. No longer available as a branded drug in the United States.

Indications: See topoisomerase inhibitor table.
MOA: Prevents the enzyme topoisomerase from replicating DNA or RNA transcription.
Adverse reactions: Alopecia, drowsiness, flu-like symptoms, and skin rash.
Drug interactions: Vaccines.
Contraindications/cautions: Elderly patients, patients with renal impairment, and patients with low albumin.

Comments:

Exercise precautions for handling, preparing, and administering cytotoxic drugs.
Avoid aspirin, acetaminophen, and NSAIDs.
Reconstituted solution is stable for 24 hours.
Etoposide should be swallowed whole; should not be crushed or chewed.
Avoid pregnancy.

Examples of topoisomerase inhibitors

Generic name	Brand name	Indication	Dosage forms	Dosage
etoposide*	Etopophos	Testicular cancer	Powder for injection	50–100 mg/m² IV on days 1–5 of 21-day cycle
irinotecan*	Camptosar	Colorectal cancer	Solution	25 mg/m² IV x on days 1, 8, 15, 22 of 42-day cycle
topotecan*	Hycamtin	Ovarian cancer	Capsule, powder for injection	1.5 mg/m² IV on days 1–5 of 21-day cycle

*Medication carries a boxed warning.

Platinum compounds

Indications: See platinum compound table.
MOA: Causes faulty cross-linkage and defective DNA.
Adverse reactions: Loss of appetite, loss of hair, and metallic taste.
Drug interactions: NSAIDs, loop diuretics, and alcohol.
Contraindications/cautions: Renal impairment, hepatic impairment, and myelosuppression.

Comments:

Exercise precautions for handling, preparing, and administering cytotoxic drugs.
Avoid pregnancy.
Avoid aspirin, acetaminophen, and NSAIDs.
Protect from light.
Reconstituted solution and IVs are stable for 24 hours if refrigerated.

Examples of platinum compounds

Generic name	Brand name	Indication	Dosage forms	Dosage
carboplatin*	—	Ovarian cancer	Solution	360 mg/m² IV x 1 on day 1 of 28-day cycle
cisplatin*	—	Testicular and ovarian cancer	Solution	100 mg/m² IV x 1 on day 1 of 28-day cycle
oxaliplatin*	Eloxatin	Colon and colorectal cancer	Solution	85 mg/m² IV on day 1 of 14-day cycle

*Medication carries a boxed warning.

Fluoropyrimidones

Indications: See fluoropyrimidone table.
MOA: Inhibits the enzyme responsible for making thymidine, inhibits RNA formation, and causes mismatched DNA pairs.
Adverse reactions: Upset stomach, loss of appetite, and muscle/bone pain.
Drug interactions: Vaccines.
Contraindications/cautions: Hepatic impairment, CAD, and elderly patients.

Comments:

Exercise precautions for handling, preparing, and administering cytotoxic drugs.
Avoid pregnancy.

Examples of fluoropyrimidones

Generic name	Brand name	Indication	Dosage forms	Dosage
capecitabine*	Xeloda	Stage III colon cancer, colorectal and breast cancer	Tablet	1250 mg/m² PO bid on days 1–14 of 21-day cycle
cytarabine*	—	Leukemia	Solution, powder for injection	100 mg/m²/day IV x 1 on days 1–7 of each cycle
fluorouracil (5-FU)	Efudex	Basal cell cancer	Cream, solution	Apply twice a day for 2–4 weeks
gemcitabine*	—	Ovarian cancer	Powder for injection	1000 mg/m² IV x 1 on days 1 and 8 of 21-day cycle

*Medication carries a boxed warning.

Antimetabolites

Indications: See antimetabolite table.
MOA: Inhibit DNA synthesis by forming abnormal nucleic acid–base pairs, resulting in abnormal DNA.
Adverse reactions: Alopecia, photosensitivity, and loss of appetite.
Drug interactions: NSAIDs, digoxin, penicillin.
Contraindications/cautions: Active infections, hepatic or renal impairment.

Comments:

Exercise precautions for handling, preparing, and administering cytotoxic drugs.
Avoid aspirin, acetaminophen, and NSAIDs.
Avoid pregnancy.

Examples of antimetabolites

Generic name	Brand name	Indication	Dosage forms	Dosage
mercaptopurine*	—	Lymphocytic leukemia	Tablet	2.5–5 mg/kg PO qd
methotrexate*	Trexall	Lung, breast, bladder, T-cell lymphomas, non-Hodgkin lymphoma	Tablet	3.3 mg/m² PO qd
pemetrexed	Alimta	Mesothelioma	Powder for injection	500 mg/m² IV x 1 on day 1 of 21-day cycle
pentostatin*	Nipent	Leukemia	Powder for injection	4 mg/m² IV every other week
thioguanine	Tabloid	Lymphocytic leukemia	Tablet	2 mg/kg PO qd

*Medication carries a boxed warning.
No longer available as a branded drug in the United States.

Miscellaneous Antineoplastics

Indications: See miscellaneous antineoplastic table.
Adverse reactions: Pain at the injection site, fatigue, and decreased appetite.
Drug interactions: Vaccines.
Contraindications/cautions: Herpes zoster infection, varicella infection, and in elderly patients.

Comments:

Exercise precautions for handling, preparing, and administering cytotoxic drugs.
Avoid pregnancy.

Examples of miscellaneous antineoplastics

Generic name	Brand name	Indication	Dosage forms	Dosage
bleomycin*	—	Squamous cell cancer	Powder for injection	10–20 units/m² IV/IM/SC 1–2x/wk
dactinomycin*	Cosmegen	Testicular cancer	Powder for injection	1000 mcg/m² IV x on day 1 of 21-day cycle for 4 cycles
hydroxyurea*	Droxia, Hydrea	Squamous cell head/neck cancer	Capsule	500–1000 mg PO q 12h x 11 doses of each cycle
mitomycin*	—	Stomach cancer	Powder for injection	20 mg/m² IV on day 42 of 56-day cycle
porfimer	Photofrin	Esophageal cancer	Powder for injection	2 mg/kg IV x 1

*Medication carries a boxed warning.
No longer available as a branded drug in the United States.

Vaccines

Indication: Provide artificial immunity.
MOA: Causes the recipient’s immune system to produce antibodies for the antigen or microbe found in the vaccine.
Adverse reactions: Slight fever, soreness at the injection site, and rashes.
Drug interactions: Refer to specific vaccine for information.

Contraindications/cautions:

Patients receiving steroids, radiation therapy, or antineoplastics.
Patients who are immunosuppressed or have a current moderate or severe infection that suppresses the immune system.
Patients who have received immune serum within the past 3 months.

Comments:

Extremely important for the patient to be current with their immunizations.
Many states permit the pharmacist to administer vaccines.

Examples of vaccines

Generic name	Brand name	Dosage forms
diphtheria and tetanus toxoids (Td)	Tenivac	Suspension
diphtheria + tetanus toxoids + pertussis vaccine + tetanus toxoid conjugate vaccine	ActHIB	Powder for injection
diphtheria and tetanus toxoids, and pertussis (DTaP)	Infanrix, Adacel, Boostrix, Daptacel	Suspension
diptheria toxoid + hepatitis B surface antigen + pertussis vaccine + poliovirus vaccine + tetanus toxoid	Pediarix	Suspension
Haemophilus influenzae b (Hib) conjugate vaccine	PedvaxHIB	Vaccine suspension
hepatitis A vaccine	Havrix, Vaqta	Suspension
hepatitis A vaccine + hepatitis B vaccine	Twinrix	Suspension
hepatitis B vaccine	Recombivax HB	Suspension
herpes zoster vaccine	Zostavax	Solution
human papillomavirus*	Gardasil	Suspension
inactivated polio vaccine	Ipol	Inactivated suspension
influenza vaccine (formulated for selected strains)	Afluria, Fluarix Quadrivalent, FluMist Quadrivalent, FluLaval Quadrivalent, Fluvirin	Suspension
measles, mumps, and rubella (MMR)	MMR II	Powder for injection
measles/mumps/rubella/varicella vaccine (live)	ProQuad	Powder for injection
meningococcal polysaccharide conjugate vaccine with diptheria toxoid	Menactra	Solution
meningococcal vaccine	Menomune-A/C/Y/W-135	Powder for injection
pneumococcal polysaccharide 23-polyvalent vaccine	Pneumovax 23	Solution
pneumococcal polysaccharide polyvalent vaccine	Prevnar 13	Suspension
rabies immune globulin	HyperRAB S/D, Imovax, RabAvert	Powder for injection, solution
rotavirus vaccine	RotaTeq	Suspension
tetanus toxoid polysaccharide conjugate vaccine	Hiberix	Powder for injection
varicella vaccine (live)	Varivax	Powder for injection