Twinrix Preservative-Free (HepA-HepB)

Hepatitis A and B are serious illnesses caused by viruses. Hepatitis causes the liver to become inflamed, and can lead to symptoms like vomiting and jaundice (yellowing of the skin or eyes). Hepatitis can result in liver cancer, cirrhosis, or death.

The hepatitis A and B vaccine is used to help prevent these illnesses in adults. The vaccine works by giving you a small dose of the virus, which helps your body build immunity to the disease. This vaccine will not treat an infection that you already have.

This vaccine is recommended for adults who have risk factors for getting hepatitis A or B, including:

• having chronic liver problems, such as cirrhosis or hepatitis C, or needing a liver transplant;
• using intravenous (IV) drugs;
• living with someone who has either hepatitis A or B infection;
• having sexual contact with an infected person;
• having a blood clotting disorder such as hemophilia;
• being on dialysis or receiving blood transfusions;
• living in a correctional institution;
• being in the military or traveling to high-risk areas; and
• working in healthcare or public safety and being exposed to infected blood or body fluids.

Like any vaccine, the hepatitis A and B vaccine may not protect every person from the disease.

Tell your doctor if you take other medicines or have other medical conditions or allergies.

Hepatitis A and B vaccine will not protect you against infection with hepatitis C or E, or other viruses that affect the liver. It will also not protect you from hepatitis A or B if you are already infected with the virus, even if you do not yet show symptoms.

You should not receive this vaccine if you are allergic to yeast or neomycin, or if you have ever had a life-threatening allergic reaction to any vaccine containing hepatitis A or hepatitis B.

Tell your doctor if you have ever had:

• an allergy to latex rubber; or
• a weak immune system (caused by disease or by using certain medicine).

You can still receive a vaccine if you have a minor cold. In the case of a more severe illness with a fever or any type of infection, wait until you get better before receiving this vaccine.

Tell your doctor if you are pregnant or breastfeeding.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Keep track of any and all side effects you experience after receiving this vaccine. When you get a booster dose, you need to inform the doctor if the previous shot caused any side effects.

You should not receive a booster vaccine if you had a life-threatening allergic reaction after the first shot.

You may feel faint after receiving this vaccine. Some people have experienced seizure-like reactions after receiving this vaccine. Your doctor may want you to stay under observation for the first 15 minutes after the injection.

Twinrix Preservative-Free (HepA-HepB) may cause serious side effects. Call your doctor right away if you have:

• numbness, pain, tingling, weakness, burning or prickly feeling, vision or hearing problems, trouble breathing;
• red or blistering skin rash; or
• easy bruising or bleeding (nosebleeds, bleeding gums).

Common side effects of Twinrix Preservative-Free (HepA-HepB) may include:

• redness or tenderness where the shot was given;
• headache; or
• tiredness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You can report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.

This vaccine is given as an injection (shot) into a muscle. You will receive this injection in a doctor's office or other clinic setting.

The hepatitis A and B vaccine is given in a series of 3 shots. The booster shots are given 1 month and 6 months after the first shot.

If you have a high risk of hepatitis infection, you may be given 3 shots within 30 days, and a fourth shot 12 months after the first.

Your individual booster schedule may be different from these guidelines. Follow your doctor's instructions or the schedule recommended by the health department of the state you live in.

Contact your doctor if you miss a booster dose or if you fall behind schedule. The next dose should be given as soon as possible. You do not need to start over.

Make sure to receive all recommended doses of this vaccine or you may not be fully protected against disease.

An overdose of this vaccine is unlikely to happen.

Follow your doctor's instructions regarding any limits on food, drinks, or activities.

Before getting this vaccine, inform the doctor about any other vaccines you have had recently.

Also, let the doctor know if you have recently taken drugs or treatments that can weaken your immune system, such as:

• steroid medicine;
• cancer treatments;
• medicine to treat psoriasis, rheumatoid arthritis, or other autoimmune disorders; or
• medicines to treat or prevent organ transplant rejection.

If you are taking any of these medications, you may not be able to get the vaccine, or you may need to wait until your other treatments are completed.

This list is not complete. Other drugs may affect hepatitis A and B vaccine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are mentioned here.