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Engerix-B
hepatitis B vaccine (recombinant) (HepB)
Adult Dosing .
Dosage forms: INJ
hepatitis B infection prevention, immunocompetent pts
- [<20 yo]
- Dose: 0.5 mL IM x1 at mo 0, 1, and 6 for 3 total doses; Info: may give SC if hemorrhage risk w/ IM; repeat series if anti-HBs level <10 milliunits/mL at least 1-2mo after 3rd dose in healthcare workers or pts w/ HBsAg-positive partner; search 'immunization' for epocrates Adult Immunization and CDC Pre-Travel Vaccine decision tools incl. links to CDC/ACIP schedules and recommendations; see pkg insert for alt schedules for high-risk pts
- [20 yo and older]
- Dose: 1 mL IM x1 at mo 0, 1, and 6 for 3 total doses; Info: give to pts 60 yo and older w/ risk factors; may give to pts 60 yo and older w/o risk factors; may give SC if hemorrhage risk w/ IM; repeat series if anti-HBs level <10 milliunits/mL at least 1-2mo after 3rd dose in healthcare workers or pts w/ HBsAg-positive sex partner; search 'immunization' for epocrates Adult Immunization and CDC Pre-Travel Vaccine decision tools incl. links to CDC/ACIP schedules and recommendations; see pkg insert for alt schedules for high-risk pts
hepatitis B infection prevention, immunocompromised pts (off-label)
- [pts w/ HIV infection]
- Dose: 2 mL IM x1 at mo 0, 1, and 6 for 3 total doses; Info: may give SC if hemorrhage risk w/ IM; repeat series if anti-HBs level <10 milliunits/mL at least 1-2mo after 3rd dose; refer to DHHS guidelines for dosing in pts w/ isolated anti-HBc
- [pts w/o HIV infection]
- Dose: 2 mL IM x1 at mo 0, 1, 2, and 6 for 4 total doses; Info: for pts 20 yo and older; may give SC if hemorrhage risk w/ IM; repeat series if anti-HBs level <10 milliunits/mL at least 1-2mo after 4th dose
renal dosing
- [<20 yo]
- renal impairment: consider incr. usual dose or frequency if eGFR <30
- HD/PD: no adjustment; no supplement
- [20 yo and older]
- renal impairment: consider incr. usual dose or frequency if eGFR <30
- HD/PD: 2 mL x1 at mo 0, 1, 2, and 6 for 4 total doses; repeat series if anti-HBs level <10 milliunits/mL 1-2mo after 4th dose; give 2 mL booster x1 if annual anti-HBs level <10 milliunits/mL; no supplement
hepatic dosing
- [no adjustment]
Peds Dosing .
- Dosage forms: INJ
hepatitis B infection prevention, primary
- [newborn w/ HBsAg-negative mother]
- Dose: 0.5 mL IM x1 at birth, 1-2 mo, and 6-18 mo for 3 total doses; Start: w/in 24h of birth if wt >2 kg, otherwise at 1 mo or hospital discharge; Info: may give SC if hemorrhage risk w/ IM; search 'immunization' for epocrates Child/Adolescent Immunization and CDC Pre-Travel Vaccine decision tools incl. links to CDC/ACIP schedules and recommendations; see pkg insert for alt schedules for high-risk pts
- [newborn w/ HBsAg-positive mother]
- Dose: 0.5 mL IM x1 at birth, 1-2 mo, and 6-18 mo for 3 total doses; Start: w/in 12h of birth; Info: may give SC if hemorrhage risk w/ IM; give w/ hepatitis B immune globulin; if wt <2 kg, give 1 dose at birth, then start 3-dose series at 1 mo for 4 total doses; search 'immunization' for epocrates Child/Adolescent Immunization and CDC Pre-Travel Vaccine decision tools incl. links to CDC/ACIP schedules and recommendations; see pkg insert for alt schedules for high-risk pts
- [newborn w/ HBsAg status unknown mother]
- Dose: 0.5 mL IM x1 at birth, 1-2 mo, and 6-18 mo for 3 total doses; Start: w/in 12h of birth; Info: may give SC if hemorrhage risk w/ IM; if wt <2 kg, give 1 dose at birth w/ hepatitis B immune globulin, then start 3-dose series at 1 mo for 4 total doses; search 'immunization' for epocrates Child/Adolescent Immunization and CDC Pre-Travel Vaccine decision tools incl. links to CDC/ACIP schedules and recommendations; see pkg insert for alt schedules for high-risk pts
- [immunocompetent pts]
- Dose: 0.5 mL IM x1 at mo 0, 1-2, and 6-18 for 3 total doses; Info: may give SC if hemorrhage risk w/ IM; search 'immunization' for epocrates Child/Adolescent Immunization and CDC Pre-Travel Vaccine decision tools incl. links to CDC/ACIP schedules and recommendations; see pkg insert for alt schedules for high-risk pts
- [immunocompromised adolescents (off-label)]
- Dose: 2 mL IM x1 at mo 0, 1, and 6 for 3 total doses; Info: for pts w/ HIV infection; may give SC if hemorrhage risk w/ IM; repeat series if anti-HBs level <10 milliunits/mL at least 1-2mo after 3rd dose; refer to DHHS guidelines for dosing in pts w/ isolated anti-HBc
hepatitis B infection prevention, booster (off-label)
- [[0.5 mL IM x1]]
- Info: for pts >9 mo w/ HBsAg-positive or HBsAg status unknown mother and anti-HBs level <10 milliunits/mL at least 1-2mo after last dose of primary series; may give SC if hemorrhage risk w/ IM; give subsequent doses per schedule to complete second series if anti-HBs level <10 milliunits/mL at least 1-2mo after booster dose
renal dosing
- [see below]
- renal impairment: consider incr. usual dose or frequency if eGFR <30
- HD/PD: no adjustment; no supplement
hepatic dosing
- [no adjustment]