Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

hepatitis b vaccine (Rx)Brand and Other Names:Engerix B, Recombivax HB

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

IM suspension (adult formulation)

  • 10mcg/mL (Recombivax HB)
  • 20mcg/mL (Engerix B)
  • 40mcg/mL (Recombivax HB [dialysis formulation])
more...

Hepatitis B vaccination

Engerix B: 1 mL (20 mcg) IM at 0, 1, and 6 months

Recombivax HB: 1 mL (10 mcg) IM at 0, 1, and 6 months

Adults receiving dialysis or other immunocompromising conditions

  • Recombivax HB (40 mcg/mL): 40 mcg IM at 0, 1, and 6 months, OR
  • Engerix-B (20 mcg/mL): 40 mcg IM at 0, 1, and 6 months

Adults with diabetes mellitus

  • CDC ACIP guidelines recommends immunization with hepatitis B vaccine for all unvaccinated adults with diabetes mellitus through age 59 years
  • Persons with diabetes are at increased risk of hepatitis B infection
  • Diabetics who 60 years or older at the discretion of the treating clinician based on increased need for assisted blood glucose monitoring in long-term care facilities, likelihood of acquiring hepatitis B infection, its complications or chronic sequelae, and likelihood of immune response to vaccination
  • Vaccination for older unvaccinated diabetic patients may be done at the physician's discretion MMWR Dec 23, 2011/Vol 60(50);1709-11

Dosing Considerations

Routine immunization against hepatitis B; also protects against hepatitis D which always occurs in the presence of hep B

Targeted groups that should receive HepB vaccination series include:

Sexually active persons who are not in a long-term, mutually monogamous relationship persons seeking evaluation or treatment for a sexually transmitted disease (STD); current or recent injection-drug users; and men who have sex with men

Health-care personnel and public-safety workers who are potentially exposed to blood or other infectious body fluids

Persons with diabetes

Persons with end-stage renal disease, including patients receiving hemodialysis; persons with HIV infection; and persons with chronic liver disease

Household contacts and sex partners of hepatitis B surface antigen-positive persons; clients and staff members of institutions for persons with developmental disabilities; and international travelers to countries with high or intermediate prevalence of chronic HBV infection

All adults in the following settings: STD treatment facilities; HIV testing and treatment facilities; facilities providing drug-abuse treatment and prevention services; health-care settings targeting services to injection-drug users or men who have sex with men; correctional facilities; end-stage renal disease programs and facilities for chronic hemodialysis patients; and institutions and nonresidential daycare facilities for persons with developmental disabilities

Administration

Administer IM in deltoid muscle

Do not give IV/intradermal

Additional Information

Up-to-date vaccination schedules available at http://www.cdc.gov/vaccines/schedules/hcp/index.html

Dosage Forms & Strengths

IM suspension (pediatric/adolescent formulations)

  • 5mcg/0.5mL (Recombivax HB)
  • 10mcg/0.5mL (Engerix B)
more...

Hepatitis B vaccination

Routine vaccination

  • First dose: Administer first dose to all newborns before hospital discharge
  • Infants born to HBsAg-positive mothers: 0.5 mL IM within 12 hr of birth PLUS hepatitis B immune globulin (HBIG); test for HBsAg and antibody to HBsAg (anti-HBs) 1-2 months after completion of hepatitis B vaccination series, at age 9 through 18 months
  • Mother's HBsAg status unknown: 0.5 mL IM within 12 hr of birth PLUS give HBIG if newborn wt <2 kg; determine mother's HBsAg status as soon as possible and, if she is HBsAg-positive, also administer HBIG for infants weighing 2 kg or more (no later than age 1 week)
  • Second dose: Administered at age 1-2 months Monovalent HepB vaccine should be used for doses administered before age 6 weeks
  • Infants who did not receive a birth dose should receive 3 doses of a HepB-containing vaccine on a schedule of 0, 1 to 2 months, and 6 months starting as soon as feasible
  • Minimum interval between dose 1 and dose 2 is 4 weeks, and between dose 2 and 3 is 8 weeks
  • Final (3rd or 4th) dose in the HepB vaccine series should be administered no earlier than age 24 weeks, and at least 16 weeks after the first dose
  • A total of 4 doses of HepB vaccine is recommended when a combination vaccine containing HepB is administered after the birth dose

Catch-up vaccination

  • Unvaccinated children should complete a 3-dose series
  • Children aged 11-15 years: 2-dose series (doses separated by at least 4 months) of adult formulation Recombivax HB is licensed for use in children aged 11 through 15 years

Administration

Administer in deltoid muscle for older children and adolescents; anterolateral thigh preferred for neonates/infants/small children

Do not give IV/intradermal

Next

Interactions

Interaction Checker

hepatitis b vaccine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            Sort by :  
             activity indicator 
            Previous
            Next

            Adverse Effects

            Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), 1-800-822-7967

            >10%

            Pain (10-29%)

            Pruritus (10-29%)

            Erythema (10-29%)

            Burning (10-29%)

            Nodules (10-29%)

            Fatigue (15%)

            Headache (15%)

            Fever (15%)

            Vertigo (15%)

            1-10%

            Lightheadedness

            Flushinig

            Insomnia

            Irritability

            Arthralgia

            Constipation

            Pruritus

            Lupus-like syndrome

            Lymphadenopathy

            Tachycardia

            Previous
            Next

            Warnings

            Contraindications

            Hypersensitivity to yeast

            Cautions

            Not protective against hepatitis A, C, or E

            Gluteal muscle not recommended

            Heptavax B (plasma-derived) no longer used in the US

            Previous
            Next

            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: not known if excreted in breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next

            Pharmacology

            Mechanism of Action

            Hepatitis B surface antigen (HBsAg) which stimulates active immunity

            Duration: not established

            Excretion: not established

            These products convey active immunity via stimulation of production of endogenously produced antibodies

            The onset of protection from disease is relatively slow, but duration is long lasting (years)

            Previous
            Next

            Images

            Previous
            Next

            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Add or Remove Plans
            Plans for
            Select State:
            Non-Medicare PlansMedicare Plans

            Select a box to add or remove a plan.

            Select a class to view formulary status for similar drugs

            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
             
             
             
            All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.