Immunosupressants and Shingles

[idlebrain]

Hello,
I found some posts where people reported coming down with Shingles after being on immunosuppressants but could not find follow-up discussions regarding recurrence or suppressive treatment options.

I recently had an attack of Shingles and the GI and Dermatologist team confirmed it is because of lowered immunity due to the drugs being taken for Crohns (Humira+6MP). I was also advised to hold off on Humira and 6MP while being treated for Shingles. I recovered in a week fortunately and am back on my usual medications.

My GI however suggests that I should be on a daily suppressive treatment (1g of valtrex) to prevent recurrence of Shingles and that I may be prone to more severe attacks if I don't. His concern, which I think is a valid one, is that I will not be able to take Crohns medications if that were to happen and that may in turn trigger Crohns, which is in remission. My PCP however warned against the side effects of daily Valtrex and felt it is not warranted unless I tend to have multiple incidents of Shingles.

I am wondering if anyone here is faced with a similar situation and what actions may have been taken/suggested.

Thanks in advance!!!

 

[nogutsnoglory]

I got shingles on 6mp. No action was taken except to give me an anti-viral to fight shingles. If you want you can get the shingles vaccine as a preventative.

 

[Axelfl3333]

I,ve had shingles didnt get any treatment as its a virus it's never recurred,the shin lesions disappeared after a couple of months but it is damned sore.

 

[idlebrain]

@nogutsnoglory and @Axelfl3333: Thanks for your responses.

I understand shingles vaccination is not a viable/recommended option in conjunction with immunosuppresssants, unfortunately. Are you currently on 6MP or other similar drugs? I am assuming you did not have a recurrence of shingles then?

 

[rubberduckie1313]

I got shingles while on Remicade. I was put on a month of antivirals and pain meds and then given the vaccines. I was not put on something to prevent the reoccurance of them though.

 

[idlebrain]

I got shingles while on Remicade. I was put on a month of antivirals and pain meds and then given the vaccines. I was not put on something to prevent the reoccurance of them though.

Hi,
Thanks for your response. By vaccines, do you mean the shingles vaccination?
I thought they don't recommend administering it while on Remicade/Humira?

 

[rubberduckie1313]

They gave one to me. I think it was a booster shot, not the full vaccine.

 

[nogutsnoglory]

Sorry didn't realize shingles is a live vaccine. You are right that would be contraindicated.

 

[jjk308]

Get the vaccine BEFORE you get shingles, even if you're on immunosuppressants. The lower age limit is 60 but you might consider it at an earlier age because the suppression of the immune system may reactivate the chicken pox virus that causes shingles.

I had the vaccine, have been taking Entyvio for Crohn's and started low dose Methotrexate, for bad arthritic symptoms, 3 weeks ago. I just got an attack of shingles. Started a few days ago with an eyelid hurting - thought I'd just rubbed it and scraped it with a nail in the night, it was that minor. Then the side of my head began to get painful to the touch, pink spots appeared, then raised red bumps with little blisters.

But the pain is nowhere near as bad as the shingles horror stories. Way less than a tenth of what I've been told is usual and nothing hurts unless I touch it. According to my internist this is typical with patients who get shingles after having the vaccine. You cut your chances of getting it by 50%, and even if you do get it its not nearly as bad as if you were unvaccinated.

So by all means get the Shingles vaccine.

 

[Scipio]

The shingles vaccine is NOT recommended for patients taking immunosuppressant drugs because it is a weakened but live virus vaccine. In immunosuppressed patients there is significant risk of the weakened virus blooming into a full active infection rather than just inducing immunity.

 

[Dasha]

I've had crohns foe the last 6 years, got shingles a few months back and got it again (I'm on infliximab for the last year). Although shingles recurred I wouldn't get shingles vaccinated!

 

[Lisa]

I've had crohns foe the last 6 years, got shingles a few months back and got it again (I'm on infliximab for the last year). Although shingles recurred I wouldn't get shingles vaccinated!

Sorry to see this Dasha...I feel your pain....I am recovering from a bout of shingles myself, and hoping it doesn't reoccur!!!