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hepatitis B immune globulin (H-BIG, Hep-B-Gammagee, HyperHep)

Indications: 1) provide temporary, prophylactic passive immunity to hepatitis B-exposed individuals 2) not indicated for treatment of active hepatitis B infection 3) ineffective in treatment of chronic active hepatitis Contraindications: - hypersensitivity to hepatitis B immune globulin or any component Caution: administer IM only pregnancy-category C safety in lactation ? Dosage: Newborns: 0.5 mL IM as soon as possible after birth Adults: 1) post-exposure prophylaxis 0.06 mL/kg 2) usual dose 3-5 mL, maximum dose 5 mL 3) administer as soon as possible after exposure (within 7 days) 4) repeat 28-30 days after exposure Injection: 1 mL & 5 mL vials. * may be administered simultaneously with hepatitis B vaccine (different sites) Pharmacokinetics: elimination: liver Adverse effects: 1) most common (1-10%) - local pain & tenderness at injection site, urticaria, angioedema, dizziness, malaise, rash, pain, tenderness, swelling, erythema, joint pains 2) uncommon (< 1%) - anaphylaxis Drug interactions: live virus vaccines

General

immune globulin (Gamastan, Gamimune N, Gammagard, Gammar, Sandoglobulin, Venoglobulin-I, Venoglobulin-S, ISG, Vivaglobulin, Gamunex, Privigen, Gammaplex, Flebogamma, Gammaked, Bivigam, Carimune, Hizentra)

References

  1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  2. Centers for Disease Control and Prevention CDC Guidance for Evaluating Health-Care Personnel for Hepatitis B Virus Protection and for Administering Posteexposure Management/ MMWR Weekly. Dec 20, 2013 http://www.cdc.gov/mmwr/PDF/rr/rr6210.pdf
  3. Department of Veterans Affairs, VA National Formulary