Hepatitis B Immune Globulin (HBIG)

Hepatitis B Immune Globulin (HBIG) are antibodies used for preventing hepatitis infection in people who:

• got exposed to the virus
• are nonresponders to vaccines 
• refuse vaccines, 
• underwent liver transplant. 

• Hepatitis B Immune Globulin (HBIG) is available under the following different brand names: h big, Hep B Gammagee, HepaGam B, HyperHep, HyperHEP B S/D.

Adult and pediatric dosage

Injectable solution

• 312 Units/mL
• 220 Units/mL

Post Exposure Prophylaxis

Adult dosage

• Include uninfected sexual partners
• 0.06 mL/kg IM once AND HepB vaccine (subsequently a complete full course of vaccination, 28-30 days post initial

Post-Exposure timeline for vaccination

• Within 24-hour post needle stick, ocular, or mucosal exposure
• Within 14-days post sexual exposure

Pediatric dosage

• Children younger than 12 months of age: 0.05 mL/kg IM; initiate HepB vaccine
• Children older than 12 months of age: 0.06 mL/kg IM once AND HepB vaccine (subsequently complete full course of vaccination, 28-30 days post initial)

Post-Exposure timeline for vaccination

• Within 24-hours post needle stick, ocular, or mucosal exposure
• Within 14-days post sexual exposure

Prophylaxis for Known Nonresponders to Vaccine or Vaccine Refusal

Adult dosage 

• 0.06 mL/kg IM immediately AND a second dose 1 month later

Liver Transplant (HepaGam only)

Adult dosage

• Designated to attain serum levels of HBsAb over 500 IU/L
• 20,000 IU IV per dose
• First dose admin concurrently w/grafting or transplanted liver, THEN
• once daily for 7 days, THEN every 2 weeks 2-12 weeks post-op, THEREAFTER once per month starting on month 4

Newborns Born to HBsAg-positive Mothers

• 0.5 mL IM within 12 hours after birth
• If vaccination delayed by 3 months, repeat HBIG at 3 months
• If not vaccinated at all, repeat HBIG at 3 and 6 months

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

Common side effects of Hepatitis B Immune Globulin (HBIG) include:

• nausea, 
• vomiting, 
• diarrhea, 
• upset stomach, 
• back pain, 
• tired feeling, 
• tremors, 
• memory problems, 
• agitation, 
• vision problems, 
• stuffy nose, 
• sneezing, 
• sore throat, 
• mild rash, and
• pain, redness, bruising, or tenderness at the injection site

Serious side effects of Hepatitis B Immune Globulin (HBIG) include:

• hives, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• fever, 
• mouth sores, 
• red or swollen gums, 
• lightheadedness, 
• upper stomach pain, 
• loss of appetite, 
• dark urine, 
• clay-colored stools, 
• yellowing of the skin or eyes (jaundice), 
• chest pain, 
• pain while breathing, 
• rapid heart rate, 
• shortness of breath, 
• sudden numbness or weakness (especially on one side of the body), 
• rapid heart rate, 
• coughing up blood, and
• pain, swelling, warmth, or redness in the arms or legs

Rare side effects of Hepatitis B Immune Globulin (HBIG) include:

• none 

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Hepatitis B Immune Globulin (HBIG) has severe interactions with no other drugs. 
• Hepatitis B Immune Globulin (HBIG) has serious interactions with no other drugs.
• Hepatitis B Immune Globulin (HBIG) has moderate interactions with the following drugs:
  • BCG vaccine live
  • efgartigimod alfa
  • measles (rubeola) vaccine
  • measles mumps and rubella vaccine, live
  • measles, mumps, rubella and varicella vaccine, live
  • rubella vaccine
  • smallpox (vaccinia) vaccine, live
  • varicella virus vaccine live
• Hepatitis B Immune Globulin (HBIG) has minor interactions with the following drug: 
  • protein a column 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns

Contraindications

• Hypersensitivity to human globulin
• Severe thrombocytopenia or coagulation disorders

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Hepatitis B Immune Globulin (HBIG)?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Hepatitis B Immune Globulin (HBIG)?”

Cautions

• IgA deficiency, thrombocytopenia, coagulopathies
• May elevate alkaline phosphatase, AST, creatinine levels
• May decrease WBC
• Use caution in patients with bleeding disorders
• Thrombotic events reported
• Do NOT give IV
• Separate live vaccines by 3 months

Pregnancy and Lactation

• Use with caution if benefits outweigh risks during pregnancy.
• Lactation: Not known if excreted in breast milk.