Pharmacybrands Final Algorithm for Dukoral Supply May 2012

Dukoral Dosage
Dosage for ETEC: 2 doses of vaccine in an interval of at least 1 week (no more than 6 weeks).
Complete doses at least 1 week before travelling to the affected area. See pack insert.
Dosage for cholera in adults and children over 6 years: 2 doses.
Dosage for cholera in children aged 2-6 years: 3 doses.
Administer doses at intervals of at least a week (no more than 6 weeks apart).[14]
Don’t forget to advise the consumer to keep the second dose in the fridge.
Avoid food and drink 2 hours before and 1 hour after vaccination (otherwise the vaccination may be
less effective).[14]
See datasheet for further information about boosters.
Precautions
Postpone vaccination in cases of acute illness.[14]
Protection is 80-85% for cholera and up to 67% for ETEC (short-term); clean hygiene practices are
still required.
Dukoral provides protection specific to Vibrio cholerae serogroup O1. Immunisation does not protect
against V. cholerae serogroup O139 or other species of Vibrio.[17]
Limited data is available on immunogenicity and safety of the vaccine in people infected with HIV.
Antibody response may be insufficient in people with immunosuppression.[17]
Trace amounts of formaldehyde used in manufacture may be present; care in known
hypersensitivity to formaldehyde.[17]
Pregnancy
Dukoral is a category B2 drug in pregnancy. According to the NZ datasheet: “The vaccine may be
administered during pregnancy. No specific studies have been conducted to investigate the safety of
Dukoral during pregnancy. However, Dukoral is an inactivated, non-replicating vaccine given orally
and it is not taken up by the blood stream. It is therefore considered to be safe. It has been given to
lactating women in several studies.”[14]
The UK prescribing information is more cautious:[17] “No animal data on reproduction toxicity are
available. Following careful benefit/risk assessment the vaccine may be administered during
pregnancy and to breast-feeding women although no specific clinical studies have been performed
to address this issue.”
Travelling to less developed countries carries other risks for pregnancy – refer to a doctor.
Adverse Events
The NZ datasheet lists only: upset stomach related to the sodium hydrogen carbonate may occur
occasionally.[14]
Copyright Pharmacybrands May 2012 Community Pharmacy Dukoral training material.