Type and form of vaccine:
This vaccine is a sterile combination of diphtheria and tetanus toxoids (dT) absorbed on aluminum phosphate (adjuvant). 
Vaccine compositions:
Each dose of the vaccine (0.5 ml) contains:
Diphtheria toxoid       ≤ 2.5 Lf
Tetanus toxoid    ≤10 Lf
Aluminum phosphate (based on Aluminum ions)    max. 1.25 mg
Thiomersal (as preservative)    max. 50 micrograms
Indication:
This vaccine is used for active immunization against diphtheria and tetanus in adults and children over the age of 6 years.
Administration route and dosage:
After stirring the vaccine, aseptically inject 0.5 ml intramuscularly.
Recommended vaccination program:
In individuals without prior vaccination history or their immunization program is not complete, perform the below actions: 

• Individuals between 7 and 18 years: First injection in the first visit, 2nd   injection a month later, 3rd injection one month after 2nd  injection, and 4th injection 6-12 months after 3rd  injection'
• Individuals over 18 years: First injection in the first visit, 2nd injection a month later, 3rd injection six months after 2nd injection.

In order to maintain immunity, it is recommended to repeat vaccination every 10 years
Use during pregnancy and lactation:
Vaccination of pregnant women is performed according to the schedule and guidelines of immunization approved by the National Immunization Committee and under the supervision of an obstetrician.
Contraindications:
In rare cases, kidney and nervous system problems have been reported following the injection of this vaccine. If these issues are observed, do not administer the next doses.
Side effects:

• Topical Reactions: redness and sensitivity in the injection site.
• Intense Reactions: fever, headache, rashes, and in rare case anaphylactic reactions.

Drug interactions:
A comprehensive study about the medicinal interactions of this product has not been performed. However, administering this vaccine with other vaccines covered by the National Immunization Committee is permissible on the condition that they are injected in different locations, and different syringes are used.
Precautions and warnings:

• Shake the vaccine vial (or ampoule) gently before each injection until it is uniformed thoroughly
• If one or more doses of vaccine have been removed during an immunization session, vaccine may be used up to a month if cold chain and aseptic conditions are observed
• Do not use vaccine after the expiration date    -
• Prevent vaccine from freezing. Do not use if frozen
• Observe aseptic conditions during injection
• Using this vaccine on children under 6-years-old is not recommended due to incomplete immunity
• If a history of fever and febrile convulsions (unrelated to the vaccine) exist, it is suggested to monitor body temperature for 48 hours after vaccination, and treat with Anti fever medications
• Treatment with medications weakening the immune system or immunodeficiency illnesses, causes reduction of immune response
• In case of occurrence of anaphylactic reactions, injection of adrenaline under a physician's supervision is recommended 

Safe disposal of waste or partially used vaccines:
Single-use equipment used, and empty vaccine vials should be placed in the sharp-equipment container, and sterilized correctly (autoclave, burning, or using appropriate chemicals), and then buried hygienically.
Storage:
This vaccine should be stored and transported at 2 to 8°C and away from sunlight. In these conditions, it may be used until the expiration date written on the label.
Packaging:
This vaccine is distributed in 7-ml (14-dose) vials and single-dose ampoules.
Last reviewed:
22.12.2018
References:
1-    Immunization schedule and guidelines approved by the National Immunization Committee, 1394
2-    Martindale, the complete drug reference, 39th edition.
3-    WHO Technical Report Series No. 980