Usual Adult Dose for Hepatitis B Prophylaxis

Primary immunization: 1 mL IM in the deltoid area at 0, 1 and 6 months.
Alternatively, a 4 dose schedule given on days 0, 7, and 21 to 30 followed by a booster at month 12 may be used.

Usual Adult Dose for Hepatitis A Prophylaxis

Primary immunization: 1 mL IM in the deltoid area at 0, 1 and 6 months.
Alternatively, a 4 dose schedule given on days 0, 7, and 21 to 30 followed by a booster at month 12 may be used.

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

No adjustment recommended.

Precautions

The safety and efficacy of hepatitis A-hepatitis B vaccine has not been established in children < 18 years.

Hepatitis A-hepatitis B vaccine is contraindicated in patients who have had signs of hypersensitivity after a previous dose of this vaccine or of the monovalent vaccines, or who are allergic to yeast or other trace substances (thimerosal, neomycin) which may be present in the vaccine.

The cap and plunger of the prefilled syringes contain latex, which may cause allergic reactions in sensitive patients.

Hepatitis A and B have long incubation periods. This vaccine may not prevent infection in persons with unrecognized infection at time of vaccination.

Anaphylaxis may occur, even in patients with no previous hypersensitivity to the vaccine ingredients. Epinephrine and other medications and equipment should be readily available to treat anaphylactic or severe allergic reactions.

Delaying vaccination should be considered if the patient has a moderate or severe acute illness. Minor illnesses such as mild upper respiratory tract infections with or without low grade fever are not considered contraindications to vaccination.

Caution is recommended in patients with thrombocytopenia or coagulation disorders that would contraindicate intramuscular injection.

The expected immune response may not occur in immunosuppressed patients. It may be advisable to defer vaccination for at least 3 months after immunosuppressive therapy.

Hepatitis A-hepatitis B vaccine is only intended for intramuscular administration. Injection into a blood vessel should be avoided.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available.

Other Comments

The vaccine should be refrigerated to maintain potency. Avoid freezing and discard any vaccine that has been frozen.

The vaccine should be shaken well before withdrawing a dose and administering it.

Injection into the deltoid muscle is preferred in adults. Injection into the buttocks may result in a lower seroconversion rate.

Health care providers should report any allergic or unusual adverse reactions to the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967 (USA) and the manufacturer.