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Hepatitis A & B Vaccine (Twinrix) Side Effects & Dosage

What is the hepatitis B/hepatitis A vaccine? What is it for?

Hepatitis A/B vaccine is a man-made combination vaccine containing inactivated hepatitis A virus strain and non-infectious hepatitis B virus surface antigen. Inactive Hepatitis A virus combined with hepatitis B antigens stimulates the immune system to develop immunity against hepatitis A and B virus infections. The FDA approved hepatitis A/B vaccine in May 2001.

What brand names are available for hepatitis B/hepatitis A vaccine?


Is hepatitis B/hepatitis A vaccine available as a generic drug?


Do I need a prescription for hepatitis B/hepatitis A vaccine?


What are the side effects of hepatitis B/hepatitis A vaccine?

Side effects of hepatitis A/B vaccine are injection site
soreness and pain, headache, fatigue, redness, diarrhea, nausea, and fainting.
The tip caps of pre-filled syringes may contain latex which can cause
reactions in latex-sensitive people. Serious allergic reactions, abnormal heart
beats, and hair loss have also been reported.


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What is the dosage for hepatitis B/hepatitis A vaccine?

Adults of 18 years of age or older:

  • Standard dosing: Standard dosing schedule consists of 3 doses of 1 ml each.
    Administer 1 ml, intramuscularly on deltoid muscle, at 0, 1, and 6 months.
  • Accelerated dosing: Accelerated dosing schedule consists 4 doses of 1 ml
    each. Administer 1 ml intramuscularly into the deltoid muscle on days 0, 7, and
    21 to 30, followed by a 4th dose at month 12.

Safe and effective use of hepatitis A/B vaccine in patients younger than 18
years of age has not been established.

Which drugs or supplements interact with hepatitis B/hepatitis A vaccine?

: Hepatitis A/B vaccine vaccines should not be used with
medications and therapies that suppress the immune system such as adalimumab (Humira),
belimumab (Benlysta), cyclosporine (Gengraf, Neoral, Sandimmune), azathioprine (Imuran),
irradiation, and high doses of steroids because suppressing the immune system
reduces the effectiveness of hepatitis A/B vaccine.

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Is hepatitis B/hepatitis A vaccine safe to take if I’m pregnant or breastfeeding?

There are no adequate studies done on hepatitis A/B vaccine to
determine safe and effective use in
pregnant women. Hepatitis A/B vaccine should
be given to pregnant women only if clearly needed.

NURSING MOTHERS: It is not known whether hepatitis A/B vaccine enters breast
milk; therefore, it is best to be cautious before using it in mothers who are

What else should I know about hepatitis B/hepatitis A vaccine?

What preparations of hepatitis B/hepatitis A vaccine are available?


  • Hepatitis A/B vaccine is available as sterile,
    preservative-free, intramuscular injections.
  • Hepatitis A/B vaccine injections
    are available in 1 ml single-dose vials and 1 ml single-dose pre-filled
    disposable syringes.
  • Each 1 ml dose of vaccine contains 720 ELISA Units of inactivated Hepatitis A
    virus and 20 mcg of recombinant Hepatitis B antigen protein.
How should I keep hepatitis B/hepatitis A vaccine stored?

Store hepatitis A/B vaccine under refrigeration between 2 C and 8 C
(36 F and 46 F). Do not freeze hepatitis A/B vaccine vaccines and discard if
they have been frozen.


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