Twinrix

Twinrix is a vaccine used for the prevention of disease caused by hepatitis A virus and infection by all known subtypes of hepatitis B virus. 

Twinrix is given as a shot into the muscle in the upper arm. 

Common side effects of Twinrix include soreness, redness, and swelling at the injection site. 

Twinrix is a vaccine used for the prevention of disease caused by hepatitis A virus and infection by all known subtypes of hepatitis B virus.

Twinrix is approved for use in persons 18 years of age or older.

Standard dosing schedule consists of 3 doses (1 mL each), given intramuscularly (into muscle) at 0, 1, and 6 months.

Alternatively, an accelerated schedule of 4 doses (1 mL each), given intramuscularly (into muscle) on days 0, 7, and 21 to 30 followed by a booster dose at month 12 may be followed.

Serious side effects have been reported with Twinrix including the following:

• Allergic reactions. Tell your healthcare provider about any signs or symptoms of  allergic reactions, which include the following:
  • chest pain
  • swelling of the face, eyes, lips, tongue, arms, or legs
  • difficulty breathing or swallowing
  • rash
• Latex. The tip caps of the prefilled syringes may contain natural rubber latex which may cause allergic reactions in latex-sensitive individuals.
• Fainting. Fainting can occur in association with administration of Twinrix.
• Limitations of vaccine effectiveness. Vaccination with Twinrix may not protect all individuals.
• Altered immunocompetence. If Twinrix is administered to immunocompromised persons, including persons receiving immunosuppressive therapy, the expected immune response may not be obtained.
• Moderate or severe illness. To avoid confusion when diagnosing between illness and possible vaccine adverse effects, vaccination with Twinrix should be postponed in persons with moderate or severe illness associated with fever unless they are at immediate risk of hepatitis A or hepatitis B infection.
• Multiple sclerosis. Results from 2 clinical studies indicate that there is no association between hepatitis B vaccination and the development of multiple sclerosis, and that vaccination with hepatitis B vaccine does not appear to increase the short-term risk of relapse in multiple sclerosis.

Do not get Twinrix if you had a severe allergic reaction (e.g., anaphylaxis) after a previous dose of any hepatitis A-containing or hepatitis B-containing vaccine, or to any component of Twinrix, including yeast and neomycin.

Serious side effects have been reported with Twinrix. See the “Twinrix Precautions” section.

Side effects reported with Twinrix include:

• soreness, redness, and swelling at the injection site
• headache
• fatigue
• diarrhea
• nausea
• fever
• vomiting

This is not a complete list of Twinrix side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to VAERS at 1-800-822-7967.

Tell your doctor about all the medicines you take including prescription and nonprescription medicines, vitamins and herbal supplements. Especially tell your doctor if you use:

• immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids
• immunoglobulin

This is not a complete list of Twinrix drug interactions. Ask your doctor or pharmacist for more information. 

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Twinrix falls into category C. No studies have been conducted in animals, and no well-controlled studies have been done in pregnant women. Twinrix should only be given to a pregnant woman if clearly needed. 

Tell your doctor is you are breastfeeding or plan to breastfeed. 

It is not known if Twinrix crosses into human milk. Because some vaccines can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this vaccine, caution should be exercised if Twinrix is given to a nursing woman.