hepatitis A and hepatitis B (recombinant) vaccine (Twinrix) (cont.)

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Medical and Pharmacy Editor:

STORAGE: 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.

PRESCRIBED FOR: Hepatitis A/B vaccine is used for active immunization against hepatitis A and all types of hepatitis B virus infections. Immunization is recommended for all susceptible adults who will be at risk for exposure to hepatitis A and hepatitis B virus. The CDC website can be consulted by travelers to determine regions that are at high risk for hepatitis A and B.


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.

DRUG INTERACTIONS: 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.

PREGNANCY: 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.

Medically Reviewed by a Doctor on 11/20/2014

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