Many medications can cause side effects. A side effect is an unwanted response to a medication when it is used in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who received Zostavax (Shingles-vaccine-live). If you are concerned about side effects, discuss the risks and benefits of Zostavax (Shingles-vaccine-live) with your doctor.

The following side effects have been reported by at least 1% of people receiving Zostavax (Shingles-vaccine-live). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• Diarrhea
• Fever
• flu-like symptoms
• headache
• joint or muscle pain
• nausea
• rash
• redness, pain, swelling, itching, warmth, and bruising at the injection site
• respiratory infections (such as lung infections, sinus infections, or colds)
• shingles
• swollen glands near the injection site
• runny nose
• weakness

Seek immediate medical attention if any of the following occur:

• loss of facial muscle movements
• serious allergic reaction (e.g., hives, face swelling, difficulty breathing or swallowing)
• symptoms of Guillain-Barre syndrome (e.g., abnormal sensations, muscle weakness, tingling in the arms, legs or upper body)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Zostavax (Shingles-vaccine-live).

Zoster vaccine should not be used by anyone who:

• is allergic to zoster vaccine or to any of the ingredients of the medication (including gelatin)
• is pregnant
• has a weakened immune system (e.g., due to cancer, HIV/AIDS, problems with bone marrow, or other immune system problems)
• has active untreated Tuberculosis
• has had a serious allergic reaction (Hives, face swelling, difficulty breathing) to neomycin
• has active untreated tuberculosis
• takes immunosuppressant medications such as Cyclosporine, Tacrolimus, or high doses of steroids (e.g., Prednisone, Methylprednisolone) by injection or by mouth

There may be an interaction between zoster vaccine and any of the following:

• Acetaminophen
• acyclovir
• Azathioprine
• corticosteroids taken by mouth (e.g., high doses of prednisone, methylprednisolone)
• famciclovir
• Fingolimod
• Leflunomide
• Mercaptopurine
• Methotrexate
• medications that weaken the immune system (e.g., medications for cancer or organ transplants, Multiple Sclerosis, Rheumatoid Arthritis, and inflammatory bowel disease)
• tuberculin tests
• certain other vaccines
• Valacyclovir

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Zostavax (Shingles-vaccine-live). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Zostavax (Shingles-vaccine-live).

Illness with fever: If you have an illness with fever, talk to your doctor about whether you should receive the vaccine.

Length of protection: It is not known if the vaccine will protect from shingles for longer than 4 years.

Pregnancy: No studies have been done to determine the effect of Zostavax (Shingles-vaccine-live) on the developing baby or mother if it is given during pregnancy. Naturally occurring varicella-zoster infection is known to cause harm to the unborn baby. This vaccine should not be used during pregnancy. Women should not become pregnant for at least 3 months after receiving this vaccine.

Breast-feeding: It is not known if zoster vaccine passes into breast milk. If you are a breast-feeding mother and are taking Zostavax (Shingles-vaccine-live), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: Zostavax (Shingles-vaccine-live) is not recommended for children.