TWINRIX ADULT VACCINE PRE-FILLED SYRINGE  (1 ML)

Generic Name: hepatitis A vaccine - hepatitis B vaccine
Brand Name: Twinrix
Drug class: Vaccine combinations

WHAT IS THE DOSAGE OF THIS MEDICATION?

Twinrix is available as:

• Twinrix Junior
  Each 0.5 mL dose contains hepatitis A 360 ELISA units and hepatitis B 10 µg.

• Twinrix Adult
  Each 1 mL dose contains hepatitis A 720 ELISA units and hepatitis B 20 µg.

WHAT IS THIS MEDICATION USED FOR?

Twinrix is a vaccine used to prevent hepatitis A and hepatitis B infections by helping your body produce its own protection (antibodies or immunity) against the infection. Hepatitis A and hepatitis B are major causes of serious liver diseases such as viral hepatitis, cirrhosis, and primary hepatocellular carcinoma (liver cancer). This vaccine does not provide protection against infections caused by other agents such as hepatitis C or E.

This vaccine is recommended for people one year old and older, especially those at increased risk of infection with the hepatitis A and hepatitis B virus. These include but are not restricted to:

• health care professionals

• patients and patient contacts in certain hospital clinics (e.g., dialysis, cancer)

• sewage workers

• daycare employees

• military personnel

• people travelling to areas where hepatitis A and hepatitis B are common

• people who have multiple sexual partners

• people who use illicit injectable drugs

• people working or living in institutions

The standard dose for adults 19 years and over is 1 mL and adolescents and children aged 1 to 18 years old is 0.5 mL. Doses are injected into a muscle and repeated after 1 month and 6 months, for a total of 3 doses. A qualified health professional will inject the vaccine.

For children and adolescents aged 1 to 15 years, an alternate dosing schedule of a 1 mL dose followed by a second dose after 6 to 12 months can be used. If rapid protection is needed, the standard 3-dose schedule is recommended.

In exceptional cases for adults, when travel will take place within a month or less of starting the vaccine course, an "accelerated" dosing schedule may be used: one dose is given immediately, followed by additional doses at 7 days and 21 days. A fourth dose is recommended at 12 months if this schedule is used.

In general, most people do not require a booster dose as this vaccine can provide protection for a lifetime. However, some people, such as those with weakened immune systems, may require a booster dose. Your doctor will advise you whether a booster dose is needed.

The vaccine should be refrigerated and protected from light until it is used. It must not freeze, or it will have to be discarded.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

WHO SHOULD NOT TAKE THIS MEDICATION

Do not take this medication if you:

• is sensitive or allergic to any ingredients of the medication

• are allergic to neomycin

• has a severe illness associated with fever

POTENTIAL INTERACTION WITH OTHER MEDICATION

Immunosuppressant medications (e.g., medications that treat cancer or corticosteroids) may affect how this medication works or may increase the risk of side effects. If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,

• change one of the medications to another,

• change how you are taking one or both of the medications, or

• leave everything as is.

WHAT ARE THE SIDE EFFECTS OF THIS MEDICATION?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Inform your doctor about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

This is not a complete list of possible side effects. If you notice other effects not listed, please contact your doctor or pharmacist.

Possible side effects include:

• diarrhea

• drowsiness

• fatigue

• fever

• generally feeling unwell

• headache

• irritability or fussiness (children and infants)

• loss of appetite

• muscle aches

• nausea

• redness, pain, and swelling at the place of injection

• vomiting

• dizziness

• skin rash or itchiness

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