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Twinrix Adult suspension for injection – hepatitis A and hepatitis B vaccine
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- Stock: Zabrana online prodaje
- Brand: GSK
- Model: BR-60516263285460003
Twinrix Adult is a combined hepatitis A (inactivated) and hepatitis B (recombinant, adsorbed) vaccine. It is intended for adults and adolescents aged 16 years and older to prevent both diseases.
The vaccine prompts the body to produce its own antibodies against hepatitis A and B viruses. None of the vaccine components is infectious. Hepatitis A is spread through contaminated food and drink or water contaminated with sewage, while hepatitis B virus is found in the blood, semen, vaginal secretions and saliva of an infected person.
Important warning
- Twinrix Adult is used only in a healthcare institution (regime Z in Serbia); the vaccine is given by a doctor or nurse as an injection into the upper arm muscle.
- The vaccine must not be given in case of allergy to its ingredients or to neomycin, or after an allergic reaction to a previous hepatitis A and B vaccine.
- Vaccination is postponed in a more severe infection with a temperature above 38 °C; a mild cold is not a problem.
- For full protection the complete vaccination schedule must be received.
- This page is for information only and is not an offer to buy online. Read the official leaflet before vaccination.
What is the Twinrix Adult vaccine used for and what is the vaccination schedule?
Basic information about the medicine
| Name of the medicine | Twinrix® Adult, 720 ELISA units/ml + 20 micrograms/ml, suspension for injection in a pre-filled syringe |
|---|---|
| Active substances | inactivated hepatitis A virus (720 ELISA units) and hepatitis B surface antigen – HBsAg (20 micrograms) per 1 ml dose |
| Strength | 1 dose = 1 ml |
| Pharmaceutical form | suspension for injection in a pre-filled syringe |
| Therapeutic group | hepatitis vaccines (ATC J07BC20) |
| Pack | 1 pre-filled syringe with 1 ml suspension, with a needle |
| Marketing authorisation holder / manufacturer | Evropa Lek Pharma d.o.o. Belgrade / GlaxoSmithKline Biologicals S.A., Rixensart, Belgium |
| Dispensing regime | for use in a healthcare institution (Z) |
What is Twinrix Adult used for?
Twinrix Adult is used in adults and adolescents aged 16 years and older to prevent two diseases:
- hepatitis A – an infectious liver disease spread through food, drink and contaminated water; symptoms (nausea, fever, aches, jaundice) begin 3–6 weeks after contact with the virus and the illness can last about a month;
- hepatitis B – inflammation of the liver caused by a virus transmitted through blood and body fluids.
Vaccination is the best way to protect against these diseases.
How is it used and dosed?
The vaccine is given by a doctor or nurse as an injection into the upper arm muscle; it is not given into the skin, into the buttock muscle or into a vein.
| Standard schedule (3 doses) | first dose on a chosen day; second dose 1 month later; third dose 6 months after the first |
|---|---|
| Rapid schedule – adults only, when quick protection is needed (e.g. travel to high-risk areas) | first dose on a chosen day; second after 7 days; third on day 21 after the first dose; a fourth dose 12 months after the first |
The doctor will advise you on any need for additional and booster doses. If you miss an appointment, arrange a new one as soon as possible – without the complete schedule protection may be incomplete.
Special patient groups
- Children under 16: Twinrix Adult is intended for people aged 16 years and older.
- Older people, men, smokers, overweight people and those with chronic diseases: the immune response to the hepatitis B component may be weaker; the doctor may advise a blood test after vaccination and an additional dose.
- Overweight people: a weaker response to the hepatitis A component has also been seen.
- Weakened immune system or immunosuppressive treatment: an adequate response may not be achieved; patients on haemodialysis may need additional doses (SmPC).
Contraindications – when the medicine must not be used
- allergy to the active substances, excipients or neomycin (signs: itchy rash, shortness of breath, swelling of the face or tongue);
- an allergic reaction to any previous hepatitis A and hepatitis B vaccine;
- a more severe infection with a temperature above 38 °C (vaccination is postponed).
Precautions and warnings
- Tell the doctor if you had health problems after a previous vaccination.
- Tell the doctor if you have a weakened immune system due to illness or medicines.
- Tell the doctor if you have a bleeding problem or bruise easily.
- Fainting can occur after, or even before, an injection, especially in young people – tell the doctor if you have fainted with a previous injection.
- The vaccine must never be given into a vein.
Interactions with other medicines, food and drink
Tell the doctor about all medicines you are taking. According to the SmPC, use with other vaccines has not been specifically studied, but no interaction is expected if different syringes and injection sites are used. With immunosuppressive treatment the response to the vaccine may be weaker. Giving the monovalent vaccines with specific immunoglobulins did not affect seroconversion, although antibody titres may be lower.
Pregnancy and breastfeeding
If you are pregnant or breastfeeding, think you may be pregnant or are planning a pregnancy, ask your doctor for advice before vaccination. According to the SmPC, vaccination is preferably given after delivery unless there is an urgent need to protect the mother against hepatitis B.
It is not known whether the vaccine passes into breast milk, but it is not expected to cause problems in breastfed infants.
Driving and using machines
According to the SmPC, the vaccine has no or negligible influence on the ability to drive and use machines. If you feel light-headed after vaccination, wait until the symptoms pass.
Possible side effects
- Very common: headache, pain and redness at the injection site, tiredness.
- Common: diarrhoea, nausea, swelling, bruising or itching at the injection site, generally feeling unwell.
- Uncommon: dizziness, vomiting, abdominal pain, muscle pain, upper respiratory tract infection, temperature of 37.5 °C or higher.
- Rare: swollen lymph glands, reduced skin sensation or tingling, rash, itching, joint pain, loss of appetite, low blood pressure, flu-like symptoms.
- Very rare: low platelet count, inflammation of the brain or nerves, seizures, angioneurotic oedema, erythema multiforme, meningitis, vasculitis, Guillain-Barré syndrome, optic neuritis and other neurological reactions; serious allergic reactions (anaphylaxis) in up to 1 in 10,000 doses.
Overdose, missed dose and stopping treatment
- Overdose: the vaccine is given by a healthcare professional in the prescribed dose of 1 ml.
- Missed dose: talk to your doctor and arrange a new appointment.
- Incomplete schedule: without all doses, protection against hepatitis A and B may be incomplete.
When to seek medical help immediately?
- itchy or blistering rash, swelling of the eyes and face;
- difficulty breathing or swallowing;
- a sudden drop in blood pressure or loss of consciousness;
- severe headache with a stiff neck and sensitivity to light;
- weakness, numbness or paralysis of the arms and legs, fits or convulsions.
Pharmacist's advice
Write down the dates of the doses you have received and book the next appointments right after the first dose – protection depends on completing the schedule. If you are travelling to a higher-risk area, see your doctor in good time, as the rapid schedule is only completed on day 21, with a fourth dose after one year.
Pain and redness at the injection site are very common and usually pass quickly; a cold compress may feel soothing. The vaccine does not replace hand hygiene and care with food and water when travelling, nor protection during sexual intercourse.
Availability and price
Twinrix Adult is used in a healthcare institution and cannot be ordered online – this page is for information only.
Ask your doctor or the competent healthcare institution about vaccination, vaccine availability and the dosing schedule.
Related information
For more information about hepatitis A and B vaccination, ask your doctor or the competent healthcare institution; there is no substitute for the vaccine among products available without prescription.
Composition, pack and manufacturer
- active substances per dose (1 ml): 720 ELISA units of inactivated hepatitis A virus (produced on human diploid MRC-5 cells, adsorbed on aluminium hydroxide, 0.05 mg Al3+) and 20 micrograms of hepatitis B surface antigen (produced in yeast cells by recombinant DNA technology, adsorbed on aluminium phosphate, 0.4 mg Al3+);
- excipients: aluminium phosphate; aluminium hydroxide; sodium chloride; water for injections; according to the leaflet the vaccine also contains neomycin (an antibiotic);
- the vaccine is essentially sodium-free (less than 1 mmol per dose);
- appearance: opalescent suspension that is easily resuspended after shaking;
- pack: pre-filled syringe (type I glass) with 1 ml suspension and a needle;
- marketing authorisation holder: Evropa Lek Pharma d.o.o. Belgrade; manufacturer: GlaxoSmithKline Biologicals S.A., Rixensart, Belgium;
- authorisation: 000457281 2023 of 27.09.2024.
Storage
- Keep out of the sight and reach of children.
- Store in a refrigerator at 2 °C to 8 °C; do not freeze – freezing destroys the vaccine.
- Store in the original package to protect from light.
- Do not use after the expiry date.
Frequently asked questions
How many doses of Twinrix Adult are needed?
The standard schedule has three doses: the first on a chosen day, the second one month later and the third six months after the first. Adults who need quick protection can receive a rapid schedule (days 0, 7 and 21) with a fourth dose after 12 months.
From what age can Twinrix Adult be given?
The vaccine is intended for adults and adolescents aged 16 years and older.
Can the vaccine cause hepatitis?
No. According to the leaflet, none of the vaccine components is infectious – the vaccine contains inactivated hepatitis A virus and hepatitis B surface antigen.
What if I miss the second or third dose?
Talk to your doctor and arrange a new appointment as soon as possible. The full vaccination schedule is needed, otherwise protection against hepatitis A and B may be incomplete.
Sources
- ALIMS – Patient information leaflet Twinrix Adult (PIL)
- ALIMS – Summary of product characteristics Twinrix Adult (SmPC)
Sources checked on: 25 October 2026.
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Additional information
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