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TWINRIX Dosing and Administration* 1

Adult and pediatric dosing for TWINRIX

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  • 3 doses complete a standard TWINRIX dosing series 1
  • All doses of TWINRIX are required to help provide adequate protection against hepatitis A or B 1
  • Adult patients (≥19 years of age) can receive TWINRIX at either the standard 3-dose (0, 1, 6 month) schedule or the rapid 4-dose (0, 7, 21 days, 12-month booster) schedule†1
  • Pediatric patients (1-18 years of age) can receive TWINRIX Junior at the standard 3-dose (0, 1, 6 month) schedule 1
  • Pediatric patients (1-15 years of age) can receive TWINRIX at an alternate 2-dose (0, between 
    6-12 month) schedule 1

Recommended dosing schedules for TWINRIX

Adapted from the TWINRIX Product Monograph. Please refer to the Product Monograph for additional dosing information.

* The recommended dosing schedule should be adhered to. Once initiated the primary course of vaccination should be completed with the same vaccine.
† In exceptional circumstances in adults, rapid dosing is recommended when travel is anticipated within one month or more after initiating the vaccination course, but where insufficient time is available to allow the standard schedule to be completed.
‡ A booster dose is recommended 12 months after administration of the first dose.
§ The alternate schedule should be used where completion of the 2-dose vaccination course can be assured, such as school-based vaccination programs.
 A second required dose should be given between 6 and 12 months after administration of the first dose.

 

The recommended schedule should be adhered to. Once initiated, the primary course of vaccination should be completed with the same vaccine. 1

 

Where to inject TWINRIX

  • TWINRIX is for intramuscular injection, preferably in the deltoid region or in the anterolateral thigh in infants 1
  • TWINRIX should not be administered intramuscularly in the gluteal region or subcutaneously/intradermally since administration by these routes may result in a less than optimal anti-HAV antibody response 1
  • TWINRIX should never be administered intravenously 1

Re-suspension1

The vaccine should be re-suspended before use. When re-suspended, the vaccine will have a uniform hazy white appearance. Upon storage, a fine white deposit with a clear colourless layer above may be observed. Re-suspension of the vaccine is done to obtain a uniform hazy white suspension.

NA

Adapted from TWINRIX Product Monograph

The vaccine can be re-suspended following the steps below:

  1. Hold the syringe upright in a closed hand.
  2. Shake the syringe by tipping it upside down and back again.
  3. Repeat this action vigorously for at least 15 seconds.
  4. Inspect the vaccine again:
    a. If the vaccine appears as a uniform hazy white suspension, it is ready to use – the appearance should not be clear.
    b. If the vaccine still does not appear as a uniform hazy white suspension, tip upside down and back again for at least another 15 seconds, then inspect again.

The vaccine should be inspected visually for any foreign particulate matter and/or abnormal physical appearance prior to administration. In the event of either being observed, do not administer the
vaccine.1

Co-administration with other vaccines

TWINRIX given in the alternate 2-dose schedule can be administered concomitantly at different injection sites with any of the following vaccine antigens in the second year of life:

  • Diphtheria
  • Tetanus
  • Acellular pertussis
  • Inactivated poliomyelitis
  • Haemophilus influenzae type b (DTPa-IPV/Hib)
  • Measles-Mumps-Rubella (MMR)

TWINRIX combined hepatitis A (inactivated) and hepatitis B (recombinant) vaccine is indicated for active immunization against hepatitis A and hepatitis B virus infection in adults, adolescents, children and infants. 1

TWINRIX will not protect against infection caused by other agents such as hepatitis C, hepatitis E and other pathogens known to infect the liver. It can be expected that hepatitis D will also be prevented by immunization with TWINRIX as hepatitis D (caused by the delta agent) does not occur in the absence of hepatitis B infection. 1

As with other vaccines, it may be expected that in patients receiving immunosuppressive treatment or patients with immunodeficiency, an adequate response may not be achieved.

* The recommended schedule should be adhered to. Once initiated, the primary course of vaccination should be completed with the same vaccine.
†Rapid dosing is recommended only for adults, when travel is anticipated within one month or more after initiating the vaccination course, but where insufficient time is available to allow the standard schedule to be completed. 1

Reference:

  1. TWINRIX Product Monograph. November 2023.

 

This page is for Healthcare Professionals only. If you are not a Healthcare Professional, please visit Twinrix.ca.

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