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Hepatitis B Immune Globulin
Pronunciation
U.S. Brand Names
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Adverse Reactions
Drug Interactions
Stability
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Administration
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Nursing Implications
Dosage Forms

Pronunciation
(hep a TYE tis bee i MYUN GLOB yoo lin)

U.S. Brand Names
H-BIG®; HyperHep®

Generic Available

No


Synonyms
HBIG

Pharmacological Index

Immune Globulin


Use

Provide prophylactic passive immunity to hepatitis B infection to those individuals exposed; newborns of mothers known to be hepatitis B surface antigen positive; hepatitis B immune globulin is not indicated for treatment of active hepatitis B infections and is ineffective in the treatment of chronic active hepatitis B infection


Pregnancy Risk Factor

C


Contraindications

Hypersensitivity to hepatitis B immune globulin or any component; allergies to gamma globulin or anti-immunoglobulin antibodies; allergies to thimerosal; IgA deficiency; I.M. injections in patients with thrombocytopenia or coagulation disorders


Adverse Reactions

1% to 10%:

Central nervous system: Dizziness, malaise

Dermatologic: Urticaria, angioedema, rash, erythema

Local: Pain and tenderness at injection site

Neuromuscular & skeletal: Arthralgia

<1%: Anaphylaxis


Drug Interactions

Interferes with immune response of live virus vaccines


Stability

Refrigerate at 2°C to 8°C (36°F to 46°F); do not freeze


Mechanism of Action

Hepatitis B immune globulin (HBIG) is a nonpyrogenic sterile solution containing 10% to 18% protein of which at least 80% is monomeric immunoglobulin G (IgG). HBIG differs from immune globulin in the amount of anti-HBs. Immune globulin is prepared from plasma that is not preselected for anti-HBs content. HBIG is prepared from plasma preselected for high titer anti-HBs. In the U.S., HBIG has an anti-HBs high titer >1:100,000 by IRA. There is no evidence that the causative agent of AIDS (HTLV-III/LAV) is transmitted by HBIG.


Pharmacodynamics/Kinetics

Absorption: Slow

Time to peak serum concentration: 1-6 days


Usual Dosage

I.M.:

Adults: Postexposure prophylaxis: 0.06 mL/kg as soon as possible after exposure (ie, within 24 hours of needlestick, ocular, or mucosal exposure or within 14 days of sexual exposure); usual dose: 3-5 mL; repeat at 28-30 days after exposure

Note: HBIG may be administered at the same time (but at a different site) or up to 1 month preceding hepatitis B vaccination without impairing the active immune response


Administration

Administration of HBIG preceding or concomitantly with hepatitis B vaccine does not interfere with the immune response to vaccine; the two together provide more rapid protective antibodies to hepatitis B than when vaccine is used alone; rapid levels may be necessary in certain settings


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

No effects or complications reported


Patient Information

Be aware of adverse effects


Nursing Implications

I.M. injection only; to prevent injury from injection care should be taken when administering to patients with thrombocytopenia or bleeding disorders; do not administer I.V.


Dosage Forms

Injection:

HyperHep®: 0.5 mL, 1 mL, 5 mL


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