Drugs List

Therapeutic Indications

Uses

Prophylaxis against meningococcal meningitis group A, C, W135 and Y

Active immunisation of children (from 2 years of age), adolescents and adults at risk of exposure to Neisseria meningitidis groups A, C, W135 and Y, to prevent invasive disease.

For comprehensive information or advice on this product or the immunisation programme in the UK, the following website should be accessed.

https://www.gov.uk/government/organisations/public-health-england/series/immunisation-against-infectious-disease-the-green-book

Administration

To be given by intramuscular injection, preferably into the deltoid muscle.

Contraindications

Children under 3 months
Severe febrile conditions

Precautions and Warnings

Children 3 months to 2 years
Immunosuppression
Patients over 65 years
Breastfeeding
Coagulopathy
Immunodeficiency syndromes
Pregnancy
Thrombocytopenia

Postpone immunisation if there is active or suspected infection
Advise ability to drive/operate machinery may be affected by side effects
Protection against meningococci groups A, C, W135 and Y only
Vaccine may not be effective in 100% of patients
Presentation (e.g. syringe, needle cap) may contain a derivative of latex
Do not mix with other vaccines in the same syringe
Do not use if solution is discoloured or particulates are apparent
Inject other vaccines at different sites
Resuscitation facilities must be immediately available
Establish full medical history and health status prior to vaccine
Remain alert to possible coincidental meningitis
Follow national immunisation guidelines

Pregnancy and Lactation

Pregnancy

Meningococcal vaccines may be given to pregnant women when protection is required without delay. There is no evidence of risk from vaccinating pregnant women with inactivated viral or bacterial vaccines or toxoids.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Meningococcal oligosaccharides A, C, W135 and Y conjugated vaccine may be used during breastfeeding. There is no evidence of risk from vaccinating those who are breastfeeding with inactivated viral or bacterial vaccines or toxoids.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Anaphylactic reaction
Arthralgia
Cellulitis (injection site)
Chills
Decreased appetite
Diarrhoea
Dizziness
Drowsiness
Erythema at injection site
Fever
Gastro-intestinal disturbances
Headache
Hypersensitivity reactions
Induration (injection site)
Irritability
Itching (injection site)
Local pain (injection site)
Malaise
Meningism
Myalgia
Nausea
Rash
Syncope
Vertigo
Vomiting

Presentation

One dose (0.5 ml of reconstituted vaccine) contains:

Meningococcal group A oligosaccharide 10 micrograms
Conjugated to Corynebacterium diphtheriae CRM 197 protein 16.7 to 33.3 micrograms

Meningococcal group C oligosaccharide 5 micrograms
Conjugated to Corynebacterium diphtheriae CRM 197 protein 7.1 to 12.5 micrograms

Meningococcal group W135 oligosaccharide 5 micrograms
Conjugated to Corynebacterium diphtheriae CRM 197 protein 3.3 to 8.3 micrograms

Meningococcal group Y oligosaccharide 5 micrograms
Conjugated to Corynebacterium diphtheriae CRM 197 protein 5.6 to 10 micrograms

Drugs List

Therapeutic Indications

Uses

Prophylaxis against meningococcal meningitis group A, C, W135 and Y

Active immunisation of children (from 2 years of age), adolescents and adults at risk of exposure to Neisseria meningitidis groups A, C, W135 and Y, to prevent invasive disease.

For comprehensive information or advice on this product or the immunisation programme in the UK, the following website should be accessed.

https://www.gov.uk/government/organisations/public-health-england/series/immunisation-against-infectious-disease-the-green-book

Dosage

Adults

Elderly

Children

Additional Dosage Information

Administration

To be given by intramuscular injection, preferably into the deltoid muscle.

Contraindications

Children under 3 months
Severe febrile conditions

Precautions and Warnings

Children 3 months to 2 years
Immunosuppression
Patients over 65 years
Breastfeeding
Coagulopathy
Immunodeficiency syndromes
Pregnancy
Thrombocytopenia

Postpone immunisation if there is active or suspected infection
Advise ability to drive/operate machinery may be affected by side effects
Protection against meningococci groups A, C, W135 and Y only
Vaccine may not be effective in 100% of patients
Presentation (e.g. syringe, needle cap) may contain a derivative of latex
Do not mix with other vaccines in the same syringe
Do not use if solution is discoloured or particulates are apparent
Inject other vaccines at different sites
Resuscitation facilities must be immediately available
Establish full medical history and health status prior to vaccine
Remain alert to possible coincidental meningitis
Follow national immunisation guidelines

Pregnancy and Lactation

Pregnancy

Meningococcal vaccines may be given to pregnant women when protection is required without delay. There is no evidence of risk from vaccinating pregnant women with inactivated viral or bacterial vaccines or toxoids.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Meningococcal oligosaccharides A, C, W135 and Y conjugated vaccine may be used during breastfeeding. There is no evidence of risk from vaccinating those who are breastfeeding with inactivated viral or bacterial vaccines or toxoids.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Anaphylactic reaction
Arthralgia
Cellulitis (injection site)
Chills
Decreased appetite
Diarrhoea
Dizziness
Drowsiness
Erythema at injection site
Fever
Gastro-intestinal disturbances
Headache
Hypersensitivity reactions
Induration (injection site)
Irritability
Itching (injection site)
Local pain (injection site)
Malaise
Meningism
Myalgia
Nausea
Rash
Syncope
Vertigo
Vomiting

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: June 2013

Reference Sources

British National Formulary, 65th Edition (March - September 2013) Pharmaceutical Press, London.

BNF for Children (2012-2013) Pharmaceutical Press, London.

Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.

Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

Martindale: The Complete Drug Reference, 37th edition (2011) ed. Sweetman, S. Pharmaceutical Press, London.

Summary of Product Characteristics: Menveo Group A,C W135 and Y conjugate vaccine. Novartis vaccines. Revised November 2012.

Immunisation against infectious diseases: 'The Green Book', Department of Health.
Available at: https://www.gov.uk/government/organisations/public-health-england/series/immunisation-against-infectious-disease-the-green-book
Last accessed: June 18, 2013.

US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
Meningococcal Vaccines. Last revised: August 14, 2012.
Last accessed: June 18, 2013.