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VIVOTIF Hard Gastro-Resistant Capsules

This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
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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Lizaveta Trafimchuk Takhvaniuk

Dermatology 10 years exp.

Dr. Lizaveta Trafimchuk Takhvaniuk graduated in Medicine and subsequently specialized in Dermatology and Venereology. She has more than 10 years of clinical experience and is licensed to practice in Spain, where she focuses on the comprehensive diagnosis and treatment of dermatological conditions.

Throughout her education and professional career, Dr. Trafimchuk has gained extensive experience in managing diseases of the skin, hair, and nails, as well as in the diagnosis, treatment, and prevention of sexually transmitted infections (STIs). Her clinical approach is based on evidence-based medicine, combined with personalized care tailored to each patient’s needs.

In her daily practice, she treats a wide range of dermatological conditions, including chronic inflammatory dermatoses such as acne, rosacea, atopic dermatitis, psoriasis, and eczema. She also has experience in treating pigmentation disorders, including melasma, post-inflammatory hyperpigmentation, and dyschromia.

She has developed a particular interest in trichology, treating various types of alopecia, chronic hair loss, and scalp disorders. In addition, she has experience in managing infectious dermatoses of fungal, viral, and bacterial origin, as well as in evaluating benign and suspicious skin lesions, with referral to specialized care when necessary.

With a strong interest in a comprehensive approach to skin health, she also treats scars, post-procedural skin changes, and conditions related to hormonal factors and aging, including those associated with pregnancy, menopause, and age-related skin changes.

Thanks to her experience and continuous professional development, Dr. Trafimchuk provides high-quality medical care that is professional, confidential, and aligned with modern dermatology standards.

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Andrei Popov

General medicine 7 years exp.

Dr. Andrei Popov is a family physician with specialized training in the management of chronic pain. He provides video consultations for adults in Spain and across Europe: whether you have been living with pain for months that no one has been able to properly explain, or you need to resolve a health issue without waiting weeks for an appointment.

His approach is clear: to listen, organize your case, and provide you with a practical roadmap based on evidence-based medicine and adapted to your medical history and personal needs.

Pain: how he can help

  • Chronic pain (more than 3 months
  • Migraine and recurrent or high-intensity headaches
  •  Neck, lower back, back and joint pain
  •  Post-traumatic pain after injuries or surgeries
  •  Pain of neurological origin: neuralgia, neuropathic pain, fibromyalgia

General medicine

  • Frequent respiratory infections (cold, flu, persistent cough)
  • Hypertension, diabetes and metabolic disorders
  • Review of laboratory tests and MRI/CT reports (explained in clear language)
  • Preventive medicine and health monitoring
  • Second opinions and treatment adjustments (when clinically appropriate)

What the consultation is like
 Each session lasts up to 30 minutes. We review symptoms, medical history, medications and any tests you provide, and you finish the consultation with a clear treatment plan, defined next steps, and criteria to understand when follow-up may be needed. If warning signs are detected, he will clearly advise whether you need in-person care or urgent medical attention.

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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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Rita Isabel Calero Garcia

General medicine 2 years exp.

Dr. Rita Isabel Calero Garcia is a physician with extensive experience in emergency medical care, general medicine, and healthcare assistance in various clinical and out-of-hospital settings.

She currently works as a physician at the Canary Islands Emergency Service (Servicio de Urgencias Canario – SUC), where she is responsible for the assessment and care of patients in medical emergency situations, performing the initial diagnosis, patient stabilization, and coordination with hospital services when necessary.

She has also developed her professional activity within the Primary Care Management Service, providing consultations in general medicine. In this setting she is responsible for patient follow-up, management of acute and chronic conditions, as well as health promotion and disease prevention.

She has also worked as a physician in a mobile ICU unit, providing medical assistance in out-of-hospital emergencies, treating critical patients and participating in medicalized patient transport.

In addition, she has collaborated with the Red Cross, participating in healthcare support units, providing medical assistance at events and supporting emergency interventions.

Furthermore, she has provided medical services in the private sector with Salvaser, conducting clinical assessments of patients and providing healthcare services within private medical services.

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Joao Silva

General medicine 6 years exp.

Dr. João Silva is a physician with training and experience in the field of General and Family Medicine, dedicated to providing healthcare focused on the well-being and quality of life of his patients. Throughout his professional career, he has developed broad clinical competencies, striving to maintain a medical practice based on scientific evidence and continuous knowledge updates.

Between 2013 and 2019, he completed the Integrated Master's Degree in Medicine at the Abel Salazar Institute of Biomedical Sciences in Porto, where he acquired a solid academic and clinical education.

Subsequently, between January 2021 and December 2021, he completed the General Internship at the Entre Douro e Vouga Hospital Center in Santa Maria da Feira, where he had the opportunity to work in different hospital settings and deepen his competencies in several areas of medicine.

From January 2022 until March 2026, he works as a Resident Physician in General and Family Medicine at USF Salvador Machado in Oliveira de Azeméis, developing clinical activities in primary healthcare, follow-up of chronic patients, and health promotion in the community.

Complementing his medical training, Dr. João Silva also completed a Postgraduate Degree in Continuing and Palliative Care at CESPU, strengthening his preparation in the comprehensive approach to patient care, especially in situations requiring prolonged care and multidisciplinary support.

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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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Doctor

Antonio Cayatte

General medicine 44 years exp.

Dr Antonio Cayatte is a physician in General and Acute Medicine with over 30 years of experience across clinical care, medical research, and education. He offers online consultations for adults with a wide range of symptoms, both acute and chronic. His clinical background includes: 

  • assessment of sudden or unclear symptoms
  • ongoing care for chronic conditions
  • follow-up after hospital discharge
  • interpretation of test results
  • medical support while abroad

Dr Cayatte earned his degree from the University of Lisbon and taught internal medicine at Boston University School of Medicine. He holds active medical registrations in both Portugal and the UK and is a Fellow of the American Heart Association. Consultations are available in English and Portuguese. Patients value his clarity, professionalism, and balanced approach to evidence-based care.

Dr. Antonio Cayatte provides comprehensive care for a broad spectrum of common health concerns, including:

  • Respiratory & ENT: acute bronchitis, concerns related to pneumonia, sinusitis, tonsillitis, ear infections, sore throat conditions, and allergic rhinitis
  • Eye Health: allergic and infectious conjunctivitis, as well as red or irritated eyes
  • Digestive & Urinary: gastroesophageal reflux disease (GERD), gastritis, urinary tract infections, and cystitis
  • Chronic Conditions: hypertension, elevated cholesterol, and structured weight management planning

Get VIVOTIF Hard Gastro-Resistant Capsules Prescription Online

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4

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Electronic prescription sent to your email — valid across Spain.

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.

How to buy VIVOTIF Hard Gastro-Resistant Capsules in Spain?

Spain has a well-developed healthcare infrastructure across major cities such as Madrid, Barcelona, Valencia, and Seville. Pharmacies are widely available and operate under strict regulations, ensuring access to prescribed medications.

You can buy VIVOTIF Hard Gastro-Resistant Capsules in Madrid, Barcelona, Seville, or Valencia at any local pharmacy with a valid prescription.

To obtain a prescription, you can use Oladoctor:

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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