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VIVOTIF Hard Gastro-Resistant Capsules

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About the medicine

How to use VIVOTIF Hard Gastro-Resistant Capsules

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the User

Vivotif Hard Gastric-Resistant Capsules

SalmonellaTyphi Ty21a

Read all of this leaflet carefully before you start taking this vaccine because it contains important information for you.

  • Keep this leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor, pharmacist, or nurse.
  • This vaccine has been prescribed for you only, do not pass it on to others.
  • If you experience any side effects, talk to your doctor, pharmacist, or nurse, even if they are not listed in this leaflet. See section 4.

Contents of the Package Leaflet

  1. What is Vivotif and what is it used for
  2. What you need to know before you start taking Vivotif
  3. How to take Vivotif
  4. Possible side effects
  5. Storage of Vivotif
  6. Contents of the pack and further information

1. What is Vivotif and what is it used for

Vivotif is an oral vaccine that stimulates the immune response against a type of bacteria called SalmonellaTyphi, which causes typhoid fever. It is used for protection against typhoid fever in adults and children from 5 years of age.

How Vivotif works

The bacteria contained in Vivotif have been modified so that they cannot cause typhoid fever, but still stimulate the body's natural defense system (the immune system) to fight the bacteria that cause typhoid fever.

Other types of diseases caused by Salmonella

There are many other types of Salmonellabacteria. Most of them cause diseases with diarrhea, which are very different from typhoid fever and are less severe. Vivotif cannot protect against infections caused by these other types of Salmonella.

Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

2. What you need to know before you start taking Vivotif

Do not take Vivotif:

  • if you are allergic (hypersensitive) to SalmonellaTyphi Ty21 or to any of the other components of this vaccine (listed in section 6).
  • if you have had allergic reactions before when taking Vivotif.
  • if your immune system is weakened for any reason; for example, if you have had low immunity to infections since birth. You may also have low immunity due to certain infections or treatments that depress the immune system, such as high-dose corticosteroids, cancer medicines, or radiation therapy.
  • if you currently have a high fever (over 38.5°C) or an intestinal disease (such as diarrhea), do not take Vivotif until you have recovered.

Warnings and precautions

Not all people who take a complete cycle of Vivotif will be fully protected against typhoid fever. It is important to follow hygiene advice and be careful with food and water consumed in areas affected by typhoid fever.

Children

Do not give this vaccine to children under 5 years of age, as the capsule is not suitable for this age group.

Using Vivotif with other medicines

Tell your doctor, pharmacist, or nurse if you are taking, have recently taken, or might take any other medicine or vaccine. This includes medicines available without a prescription and herbal medicines. This is because Vivotif may affect the way other medicines and vaccines work.

In particular, tell your doctor, pharmacist, or nurse if you are taking:

  • antibiotics – Vivotif may not work if taken while also taking antibiotics. Do not take Vivotif until at least 3 days after the last dose of antibiotic.
  • medicines to prevent malaria – do not start taking these medicines until 3 days after the last dose of Vivotif, unless your doctor, pharmacist, or nurse tells you otherwise.

If any of the above applies to you, tell your doctor, pharmacist, or nurse before taking Vivotif.

Using Vivotif with food and drinks

Vivotif is taken on an empty stomach, and at least one hour before the next meal.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines

Vivotif has not been observed to affect the ability to drive and use machines. However, do not drive or use machines if you do not feel well.

Vivotif contains lactose and sucrose

If your doctor has told you that you have an intolerance to some sugars, consult your doctor before taking this medicine.

3. How to take Vivotif

Follow exactly the administration instructions of this vaccine given by your doctor, pharmacist, or nurse. If in doubt, consult your doctor, pharmacist, or nurse again.

The blister containing the vaccine capsules should be inspected to check that the aluminum foil and capsules are intact.

How much and when to take

The recommended dose is three capsules. One capsule is taken every other day.

  • Take the first capsule on a selected day. This is day 1.
  • Take the second capsule on day 3.
  • Take the third capsule on day 5.

How to take the capsules

  • Take the capsules on an empty stomach, and at least one hour before the next meal.
  • Do not crush or chew the capsules.
  • Swallow the capsules with cold or lukewarm water (not more than 37°C).
  • Swallow them as quickly as possible after putting them in your mouth.

Protection against typhoid fever begins between 7 and 10 days after taking the cycle of three capsules. Your doctor, pharmacist, or nurse will tell you how far in advance of your trip you should take the Vivotif cycle.

After three years, you may need to take Vivotif again if you continue to visit areas where typhoid fever is present. In this case, consult your doctor, pharmacist, or nurse.

If you take more Vivotif than you should

If you accidentally take all three doses at once, tell your doctor, pharmacist, or nurse. It is unlikely that you will become ill, but you may not be well protected against typhoid fever.

If you forget to take Vivotif

If you miss a dose, take it as soon as you remember. Then take the next dose about 48 hours later.

If you have any further questions on the use of this medicine, ask your doctor, pharmacist, or nurse.

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

4. Possible side effects

Like all vaccines, this vaccine can cause side effects, although not everybody gets them.

Contact your doctor immediately if you experience the following serious side effects:

  • severe allergic reactions that cause swelling of the face or throat and shortness of breath, and/or a drop in blood pressure and fainting.

Other side effects:

Common side effects (may affect up to 1 in 10 people)

  • stomach pain,
  • feeling or being sick,
  • diarrhea,
  • fever,
  • headache,
  • redness of the skin.

Other side effects (frequency cannot be estimated from the available data):

  • skin irritation, rash, red or prominent eruptions, and itching,
  • weakness,
  • general malaise,
  • chills,
  • feeling of tiredness,
  • tingling,
  • feeling of pins and needles,
  • dizziness,
  • muscle or joint pain,
  • back pain,
  • decreased appetite, abdominal gases, inflammation,
  • flu-like symptoms.

Reporting of side effects

If you experience any side effects, talk to your doctor, pharmacist, or nurse, even if they are not listed in this leaflet. You can also report side effects directly through the Spanish Medicines Agency's website: www.notificaRAM.es.

By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Vivotif

Keep this vaccine out of the sight and reach of children.

Do not use Vivotif after the expiry date stated on the label. The expiry date is the last day of the month stated.

Store in a refrigerator (between 2°C and 8°C).

Keep the blister in the outer packaging to protect it from light.

Do not use this vaccine if you notice that the blister or capsules are not intact.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. This will help protect the environment.

6. Contents of the pack and further information

Composition of Vivotif

  • Each capsule contains at least 2 x 10^9 viable cells of SalmonellaTyphi Ty21a.
  • The other ingredients are anhydrous lactose, sucrose, acid hydrolysate of casein, ascorbic acid (E300), magnesium stearate (E470), inactivated SalmonellaTyphi Ty21a cells. Capsule shell: gelatin, titanium dioxide (E171), erythrosine (E127), yellow iron oxide (E172), and red iron oxide (E172). Capsule coating: hydroxypropylmethylcellulose phthalate, ethylene glycol, and diethyl phthalate.

Appearance of the product and contents of the pack

The pack contains a blister pack with three enteric-coated capsules of Vivotif. The capsules are bicolored white and salmon.

Marketing authorization holder

Bavarian Nordic A/S,

Philip Heymans Alle 3,

DK-2900 Hellerup,

Denmark

Manufacturer

IL-CSM GmbH

Marie-Curie-Strasse 8

D-79539 Lörrach

Germany

You can obtain further information on this medicine by contacting the local representative of the marketing authorization holder:

Bavarian Nordic Spain, S.L.U.

This medicine is authorized in the Member States of the European Economic Area and in the United Kingdom (Northern Ireland) under the following names:

Austria, Belgium, Czech Republic, Denmark, Finland, France, Italy, Luxembourg, Netherlands, Norway, Poland, Portugal, Slovakia, Sweden, United Kingdom (Northern Ireland): Vivotif

Germany: Typhoral L

Date of last revision of this leaflet: December 2021

Other sources of information

Detailed information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS)

http://www.aemps.es/

Online doctors for VIVOTIF Hard Gastro-Resistant Capsules

Discuss questions about VIVOTIF Hard Gastro-Resistant Capsules, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

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Doctor

Hocine Lokchiri

General medicine 21 years exp.

Dr. Hocine Lokchiri is a French consultant with over 20 years of experience in General and Emergency Medicine. He works with adults and children, helping patients with urgent symptoms, infections, sudden health changes and everyday medical concerns that require timely evaluation. His background includes clinical practice in France, Switzerland and the United Arab Emirates, which allows him to navigate different healthcare systems and manage a wide range of conditions with confidence. Patients value his calm, structured approach, clear explanations and evidence-based decision-making.

Online consultations with Dr. Lokchiri are suitable for many situations when someone needs quick medical guidance, reassurance or a clear next step. Common reasons for booking include:

  • fever, chills, fatigue and viral symptoms
  • cough, sore throat, nasal congestion, breathing discomfort
  • bronchitis and mild asthma flare-ups
  • nausea, diarrhoea, abdominal pain, digestive infections
  • rashes, allergic reactions, redness, insect bites
  • muscle or joint pain, mild injuries, sprains
  • headache, dizziness, migraine symptoms
  • stress-related symptoms, sleep disturbances
  • questions about test results and treatment plans
  • management of chronic conditions in stable phases
Many patients reach out when symptoms appear suddenly and cause concern, when a child becomes unwell unexpectedly, when a rash changes or spreads, or when it’s unclear whether an in-person examination is necessary. His emergency medicine background is particularly valuable online, helping patients understand risk levels, identify warning signs and choose safe next steps.

Some situations are not suitable for online care. If a patient has loss of consciousness, severe chest pain, uncontrolled bleeding, seizures, major trauma or symptoms suggesting a stroke or heart attack, he will advise seeking immediate local emergency services. This improves safety and ensures patients receive the right level of care.

Dr. Lokchiri’s professional training includes:

  • Advanced Trauma Life Support (ATLS)
  • Basic and Advanced Cardiac Life Support (BLS/ACLS)
  • Pediatric Advanced Life Support (PALS)
  • Prehospital Trauma Life Support (PHTLS)
  • eFAST and critical care transthoracic echocardiography
  • aviation medicine
He is an active member of several professional organisations, including the French Society of Emergency Medicine (SFMU), the French Association for Emergency Physicians (AMUF) and the Swiss Society of Emergency and Rescue Medicine (SGNOR). In consultations, he works with clarity and precision, helping patients understand their symptoms, possible risks and the safest treatment options.
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€58
5.0 (25)
Doctor

Lina Travkina

Family medicine 13 years exp.

Dr. Lina Travkina is a licensed family and preventive medicine doctor based in Italy. She provides online consultations for adults and children, supporting patients across all stages of care – from acute symptom management to long-term health monitoring and prevention.

Areas of medical care include:

  • Respiratory conditions: colds, flu, acute and chronic bronchitis, mild to moderate pneumonia, bronchial asthma.
  • ENT and eye conditions: sinusitis, tonsillitis, pharyngitis, otitis, infectious and allergic conjunctivitis.
  • Digestive issues: gastritis, acid reflux (GERD), IBS, dyspepsia, bloating, constipation, diarrhoea, functional bowel symptoms, intestinal infections.
  • Urological and infectious diseases: acute and recurrent cystitis, bladder and kidney infections, prevention of recurrent UTIs, asymptomatic bacteriuria.
  • Chronic conditions: hypertension, diabetes, hypercholesterolemia, metabolic syndrome, thyroid disorders, excess weight.
  • Neurological and general symptoms: headache, migraine, dizziness, fatigue, sleep disturbances, reduced concentration, anxiety, asthenia.
  • Chronic pain support: back, neck, joint, and muscle pain, tension syndromes, pain associated with osteochondrosis and chronic conditions.

Additional care areas:

  • Preventive consultations and check-up planning.
  • Medical advice and follow-up consultations.
  • Test interpretation and diagnostic guidance.
  • Structured support for undiagnosed complaints.
  • Second opinion on diagnoses and treatment plans.
  • Nutritional and lifestyle support for vitamin deficiencies, anaemia, metabolic issues.
  • Post-operative recovery support and pain management.
  • Preconception counselling and postpartum support.
  • Immunity support and strategies to reduce frequency of infections.

Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

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€70
5.0 (764)
Doctor

Alina Tsurkan

Family medicine 13 years exp.

Dr. Alina Tsurkan is a licensed family medicine physician based in Portugal, offering online consultations for adults and children. She provides professional primary care, with a focus on prevention, accurate diagnosis, and long-term management of acute and chronic conditions.

Dr. Tsurkan supports patients with a wide range of health issues, including:

  • Respiratory infections: cold, flu, bronchitis, pneumonia, and lingering coughs.
  • ENT conditions: sinusitis, tonsillitis, otitis (ear infections), sore throat, allergic rhinitis.
  • Eye conditions: allergic or infectious conjunctivitis, red eyes, irritation.
  • Digestive issues: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), constipation, bloating, nausea.
  • Urinary and reproductive health: urinary tract infections (UTIs), cystitis, prevention of recurrent infections.
  • Chronic diseases: hypertension, elevated cholesterol, weight management.
  • Neurological complaints: headaches, migraines, sleep disturbances, fatigue, general weakness.
  • Children’s health: fever, infections, digestive issues, follow-ups, vaccination guidance.

She also provides:

  • IMT medical certificates for driving licence exchange in Portugal.
  • Personalised preventive care and wellness consultations.
  • Interpretation of test results and medical reports.
  • Follow-up care and medication review.
  • Support in managing multiple coexisting conditions.
  • Remote prescription management and medical documentation.

Dr. Tsurkan’s approach is evidence-based and holistic. She works closely with each patient to develop an individualised care plan that addresses both symptoms and root causes. Her goal is to empower patients to take control of their health and maintain well-being through lifestyle adjustments, routine check-ups, and early intervention.

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€55
5.0 (140)
Doctor

Yevgen Yakovenko

General surgery 12 years exp.

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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€50
5.0 (29)
Doctor

Anna Biriukova

General medicine 6 years exp.

Dr Anna Biriukova is an internal medicine doctor with clinical experience in cardiology, endocrinology, and gastroenterology. She provides online consultations for adults, offering expert medical support for heart health, hormonal balance, digestive issues, and general internal medicine.

Cardiology – Diagnosis and treatment of:

  • High blood pressure, blood pressure fluctuations, and cardiovascular risk prevention.
  • Chest pain, shortness of breath, arrhythmias (tachycardia, bradycardia, palpitations).
  • Leg swelling, chronic fatigue, reduced exercise tolerance.
  • EKG interpretation, lipid profile evaluation, cardiovascular risk assessment (heart attack, stroke).
  • Post-COVID-19 cardiac monitoring and care.
Endocrinology – Diabetes, thyroid, metabolism:
  • Diagnosis and management of type 1 and type 2 diabetes, and prediabetes.
  • Individual treatment plans including oral medications and insulin therapy.
  • GLP-1 therapy– modern pharmacological treatment for weight management and diabetes control, including drug selection, monitoring, and safety follow-up.
  • Thyroid disorders – hypothyroidism, hyperthyroidism, autoimmune thyroid diseases (Hashimoto’s, Graves’ disease).
  • Metabolic syndrome – obesity, lipid disorders, insulin resistance.
Gastroenterology – Digestive health:
  • Abdominal pain, nausea, heartburn, gastroesophageal reflux (GERD).
  • Stomach and intestinal conditions: gastritis, irritable bowel syndrome (IBS), indigestion.
  • Management of chronic digestive disorders and interpretation of tests (endoscopy, ultrasound, labs).
General internal medicine and preventive care:
  • Respiratory infections – cough, colds, bronchitis.
  • Lab test analysis, therapy adjustments, medication management.
  • Adult vaccinations – planning, contraindications assessment.
  • Cancer prevention – screening strategies and risk assessment.
  • Holistic approach – symptom relief, complication prevention, and quality of life improvement.
Dr Biriukova combines internal medicine with specialist insight, offering clear explanations, personalised treatment plans, and comprehensive care tailored to each patient.
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€60

Frequently Asked Questions

Is a prescription required for VIVOTIF Hard Gastro-Resistant Capsules?
VIVOTIF Hard Gastro-Resistant Capsules requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in VIVOTIF Hard Gastro-Resistant Capsules?
The active ingredient in VIVOTIF Hard Gastro-Resistant Capsules is typhoid, oral, live attenuated. This information helps identify medicines with the same composition but different brand names.
How much does VIVOTIF Hard Gastro-Resistant Capsules cost in pharmacies?
The average pharmacy price for VIVOTIF Hard Gastro-Resistant Capsules is around 26.96 EUR. Prices may vary depending on the manufacturer and dosage form.
Who manufactures VIVOTIF Hard Gastro-Resistant Capsules?
VIVOTIF Hard Gastro-Resistant Capsules is manufactured by Bavarian Nordic A/S. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of VIVOTIF Hard Gastro-Resistant Capsules online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether VIVOTIF Hard Gastro-Resistant Capsules is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to VIVOTIF Hard Gastro-Resistant Capsules?
Other medicines with the same active substance (typhoid, oral, live attenuated) include TYPHIM VI INJECTABLE SOLUTION, BEXSERO Injectable Suspension in Pre-filled Syringe, BEXSERO Injectable Suspension in Pre-filled Syringe. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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