Uses

This vaccine is used to prevent infections caused by certain bacteria (V. cholerae and E. coli). People can get infected by eating food or drinking water that has been contaminated. This vaccine is recommended for people 2 years of age or older who are traveling to areas where these infections are common. It works by causing the body to produce its own protection (antibodies) against the bacteria. This vaccine may help to prevent traveler's diarrhea and cholera.

Vaccines may not fully protect everyone who receives them. While traveling, you should still take precautions to avoid contact with contaminated food or water (such as by drinking only bottled or boiled water, eating only fully cooked food). Ask your health care professional for more details.

How To Use

Read all vaccine information available from your health care professional before taking the vaccine. If you have any questions, ask your health care professional.

Take this vaccine by mouth as directed by the health care professional, usually once a week. Do not eat or drink or take any medications 1 hour before and 1 hour after taking this vaccine.

To prepare the vaccine dose, open the buffer packet and pour its contents into 5 ounces/150 milliliters of cool water. Do not mix with any other liquids. Stir well until the powder dissolves completely (2 to 3 minutes). Shake the vaccine vial well and add it to the liquid. Mix well and drink the mixture right away. The mixture may also be stored at room temperature but it must be taken within 2 hours of mixing.

If you are giving this vaccine to a child younger than 6 years old, open the buffer packet and pour its contents into 5 ounces/150 milliliters of cool water. Stir until the powder dissolves completely, then pour out half of the liquid. Shake the vaccine vial well and pour it into the liquid. Mix well and have the child drink it right away. If the child cannot take the mixture right away, the mixture can be stored at room temperature for up to 2 hours.

Vaccines are usually given in a series of doses to provide the best protection. Closely follow the vaccination schedule provided by your health care professional. To help you remember, mark on a calendar when to take the next dose. You should complete the course of the vaccine at least 1 week before traveling to at-risk areas.

This vaccine should not be taken at the same time as other vaccines taken by mouth (such as typhoid vaccine). Ask the health care professional for more details.

Side Effects

Vomiting may occur. If this effect lasts or gets worse, tell your health care professional promptly.

Remember that this medication has been prescribed because your health care professional has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, such as:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your health care professional.

Contact the health care professional for medical advice about side effects. The following numbers do not provide medical advice, but in the US you may report side effects to the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967. In Canada, you may call the Vaccine Safety Section at Public Health Agency of Canada at 1-866-844-0018.

Precautions

Before you take this vaccine, tell the health care professional if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your health care professional for more details.

Before taking this vaccine, tell your health care professional your medical history, especially of:

• current fever/illness
• current stomach problems (such as diarrhea/vomiting that doesn't go away)
• immune system disorders (such as due to HIV infection, certain cancers such as leukemia/lymphoma, cancer or radiation treatment)

This vaccine contains sodium. Consult your health care professional if you are on a salt-restricted diet or if you have a condition that could be worsened by an increase in salt intake (such as congestive heart failure).

During pregnancy, this vaccine should be taken only when clearly needed. Discuss the risks and benefits with your health care professional.

It is unknown if this vaccine passes into breast milk. Consult your health care professional before breast-feeding.

Drug Interactions

See also How to Use section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (such as prescription/nonprescription drugs and herbal products) and share it with your health care professional. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this vaccine are:

• drugs that weaken the immune system (including cyclosporine, tacrolimus, cancer chemotherapy, corticosteroids such as prednisone)

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Notes

Keep all regular medical and lab appointments.

Missed Dose

It is important to take each dose of this medication as scheduled. If you miss a dose, ask your health care professional right away for a new dosing schedule. Do not double the dose to catch up.

Storage

See also How to Use section.

Store in the refrigerator. Do not freeze. The powder packets may be stored separately at room temperature. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.