ProQuad and Vorapaxar Sulfate

• Generic Name: measles virus vaccine / mumps virus vaccine / rubella virus vaccine / varicella virus vaccine
• Dosage Forms: injection, powder, lyophilized, for suspension
• Other Brand Names: ProQuad

ProQuad is a measles, mumps, rubella and varicella virus vaccine. Measles, mumps, rubella, and varicella are serious diseases caused by viruses spread from person to person through the air or by skin to skin contact.

Measles virus can cause minor symptoms such as skin rash, cough, runny nose, eye irritation, or mild fever. It can also cause more serious symptoms such as ear infection, pneumonia, seizures, permanent brain damage, or death.

Mumps virus causes fever, headache, muscle aches, and swollen glands. More more serious symptoms include hearing loss, painful swelling of the testicles or ovaries, swelling around the brain or spinal cord, or (rarely) death.

Rubella virus (also called German Measles) causes skin rash, fever, sore throat, headache, eye irritation, and joint pain. Becoming infected with rubella during pregnancy can result in a miscarriage or serious birth defects.

Varicella (chickenpox) can cause fever, tiredness, headache, loss of appetite, and a breakout of fluid-filled blisters on the skin. Chickenpox is usually mild, but it can lead to severe skin infection, breathing problems, brain damage, or death. A person who has had chickenpox can develop herpes zoster (also called shingles) later in life, which causes severe nerve pain, and hearing or vision problems, which may last for months or years.

The ProQuad vaccine is used to help prevent these diseases in children. This vaccine works by exposing your child to a small dose of the virus or a protein from the virus, which causes the body to develop immunity to the disease. ProQuad will not treat an active infection that has already developed in the body.

ProQuad vaccine is for use in children between the ages of 12 months and 12 years old.

Like any vaccine, ProQuad vaccine may not provide protection from disease in every person.

• Generic Name: vorapaxar
• Dosage Forms: n.a.
• Other Brand Names: Zontivity

Reduction of the risk of thrombotic cardiovascular events (e.g., cardiovascular death, MI, stroke, urgent coronary revascularization) in patients with a history of MI or with peripheral arterial disease (PAD).

Use in conjunction with aspirin and/or clopidogrel; data lacking on use of vorapaxar in combination with other antiplatelet agents (e.g., prasugrel, ticagrelor) or as monotherapy.

Efficacy and safety established in patients with stable atherosclerotic disease; favorable benefit versus risk not established in the setting of acute coronary syndrome (ACS). (See Acute Coronary Syndrome under Uses.)

The American Heart Association (AHA), American College of Cardiology Foundation (ACCF), American College of Chest Physicians (ACCP), and other experts recommend long-term antiplatelet therapy (e.g., aspirin and/or clopidogrel) in patients with established coronary artery disease. Long-term antiplatelet therapy (e.g., clopidogrel, aspirin) also recommended in patients with symptomatic PAD, including those with intermittent claudication, critical limb ischemia, or prior revascularization or amputation of the lower extremity. When added to aspirin and/or clopidogrel therapy, vorapaxar reduces cardiovascular events (e.g., composite outcome of cardiovascular death, MI, stroke, and urgent coronary revascularization) but increases risk of bleeding, including intracranial hemorrhage.

Balance incremental benefits against risk of bleeding; certain patients (e.g., those with a history of MI who are at high risk of recurrence but low risk of bleeding and who have not had a previous stroke or TIA) may have greater potential for net clinical benefits. Overall risk-benefit of vorapaxar in routine clinical practice remains to be fully elucidated.

Has been used in patients with ACS; however, current evidence suggests that the addition of vorapaxar to standard antiplatelet therapy in such patients does not substantially reduce rate of ischemic events but substantially increases risk of clinically important bleeding.

Many clinicians currently advise against use of vorapaxar in patients with ACS.