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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
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Doctor

Daniel Cichi

Family medicine 24 years exp.

Dr Daniel Cichi is a family medicine doctor with over 20 years of clinical experience. He provides online consultations for adults, supporting patients with acute symptoms, chronic conditions, and everyday health concerns that require timely medical guidance. His background includes work in emergency care, ambulance services, and family medicine, which allows him to assess symptoms quickly, identify warning signs, and help patients choose the safest next steps – whether that means home care, treatment adjustment, or in-person evaluation. Patients commonly consult Dr Daniel Cichi for: 

  • acute symptoms: fever, infections, flu-like illness, cough, sore throat, shortness of breath;
  • chest discomfort, palpitations, dizziness, fatigue, and blood pressure concerns;
  • digestive problems: abdominal pain, nausea, diarrhoea, constipation, reflux;
  • sexually transmitted infections, erectile dysfunction;
  • muscle, joint, and back pain, minor injuries, post-traumatic symptoms;
  • chronic conditions: hypertension, diabetes, high cholesterol, thyroid disorders, weight loss, hair loss;
  • review and interpretation of lab tests, imaging reports, and medical documents;
  • medication review and treatment adjustment;
  • medical advice while travelling or living abroad;
  • second opinions and guidance on whether in-person care is needed.

Dr Cichi’s consultations are structured and practical. He focuses on clear explanations, risk assessment, and actionable recommendations, helping patients understand their symptoms and make informed decisions about their health.

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€55
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Doctor

Dmytro Horobets

Family medicine 7 years exp.

Dr. Dmytro Horobets is a licensed family medicine physician in Poland, specialising in endocrinology, diabetology, obesity management, gastroenterology, pediatrics, general surgery, and pain medicine. He offers online consultations for adults and children, providing personalised medical support for a wide range of acute and chronic health concerns.

Areas of expertise:

  • Endocrinology: diabetes type 1 and type 2, prediabetes, thyroid disorders, metabolic syndrome, hormonal imbalance.
  • Obesity medicine: structured weight management plans, nutritional counselling, obesity-related health risks.
  • Gastroenterology: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), liver and biliary conditions.
  • Pediatric care: infections, respiratory symptoms, digestive issues, growth and development monitoring.
  • General surgery support: pre- and post-surgical consultations, wound care, rehabilitation.
  • Pain management: chronic and acute pain, back pain, joint pain, post-traumatic pain syndromes.
  • Cardiovascular health: hypertension, cholesterol control, risk assessment for heart disease.
  • Preventive medicine: regular check-ups, health screenings, long-term management of chronic conditions.

Dr. Horobets combines evidence-based medicine with a patient-centred approach. He carefully evaluates each patient’s medical history and symptoms, offering clear explanations and structured treatment plans adapted to individual needs.

Whether you need help managing diabetes, tackling weight-related health issues, interpreting lab results, or receiving general family medicine support, Dr. Horobets provides professional online care tailored to your specific health goals.

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€60
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Doctor

Tomasz Grzelewski

Dermatology 21 years exp.

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques. For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance. Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults. In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions. Patients commonly seek his care for: 

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns

Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.

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€80
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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

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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