Precautions and warnings

Do not give by IV. Use the subcutaneous method for people with bleeding disorders. Do not vaccinate if the person has a moderate or severe fever. Use caution in people who are pregnant, breastfeeding, or have had Guillain-Barre syndrome.

Drug Interactions

Taking immunosuppressant medications can weaken your immune response. If tetanus immune globulin and tetanus toxoid vaccine are given at the same location or with the same syringe, they can interfere with each other and not work as well. To avoid this, they should be given at different sites using separate syringes.

Contraindications

Do not use this vaccine, or any similar vaccine, if someone had a serious reaction like a severe allergic response (anaphylaxis) after a previous dose. Anyone who had a severe allergic or nerve reaction to a previous Tetanus Toxoid dose should never get it again.

If a person can’t safely receive tetanus toxoid—for example, due to a previous reaction—and they have not finished their initial series of shots, and they get a wound that is not just a clean, minor cut, they should only get passive protection with TIG (Tetanus Immune Globulin).

Vaccination should be postponed if the person has a fever or an active infection. However, a mild illness, like a cold without fever, is not a reason to delay. Avoid routine vaccination during a polio outbreak.

Mode of actions

Tetanus toxoid adsorbed helps the body build protection (immunity) against tetanus by causing the immune system to make special antibodies. However, it should not be used to treat someone who already has a tetanus infection.

Dosage & Administration

Primary immunization for persons 7 years of age and older: A series of three doses of 0.5 ml each, of adsorbed tetanus vaccine should be given intramuscularly; First dose: At appropriate date, Second dose: 4 to 8 weeks after the first dose, Third dose: 6 to 12 months after the second dose.

Children older than 7 years who did not complete primary immunization series (e.g., previously received only two doses of DTaP or DTP) need to receive only one dose of tetanus toxoid adsorbed vaccine to complete the primary series of tetanus.
Interruption of the recommended schedule with a delay between doses does not interfere with the final immunity achieved with adsorbed tetanus vaccine. There is no need to start the series over again, regardless of the time elapsed between doses.

Routine booster injections: To maintain adequate protection, a booster dose of 0.5 ml of adsorbed tetanus vaccine every 10 years thereafter is recommended.

Vaccination of injured persons:
Clean and minor wound:
• If primary immunization confirmed and receiving booster dose within previous 5 years, no need of additional vaccine.
• If primary immunization confirmed and receiving booster dose more than previous 5 years, 1 dose of 0.5 ml required.

All other dirty wounds (contaminated with feces, soil, and saliva):
• If primary immunization confirmed and receiving booster dose within previous 5 years, 1 dose of 0.5 ml required.
• If primary immunization confirmed and receiving booster dose more than previous 5 years, 1 dose of 0.5 ml along with tetanus immunoglobulin required.

If a person has no previous vaccination or uncertain, the primary series of 3 doses of 0.5ml adsorbed tetanus vaccine should be given along with tetanus immunoglobulin with 1st dose.
Protection of neonatal tetanus
For prevention of neonatal tetanus, adsorbed tetanus vaccine is recommended for immunization of women of childbearing age.

For pregnant woman who have not had previous immunization, 2 doses of tetanus toxoid at four weeks interval preferably during the last two trimester or at least 2 weeks before delivery should be given during pregnancy so that protective antibody would be transferred to the infant in order to prevent neonatal tetanus. e.g. 1 dose of 0.5 ml at 6th month of pregnancy and 1 dose of 0.5 ml at 7th month of pregnancy.

Pregnant woman who have completed the course of tetanus, next 10 years no need of additional dose during pregnancy. Thereafter a single booster dose would be sufficient to extend immunity.

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

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