Hepatitis B Immune Globulin (HBIG)

A to Z Drug Facts

  Action Directly neutralizes hepatitis B virus.

  Indications For passive, transient prevention of hepatitis B infection after viral exposure via needlestick or mucous membrane contact; prevention of hepatitis B in infants born to HBsAg-positive mothers. Most effective when used within 7 days of exposure.

  Contraindications None well documented.

  Route/Dosage

Adults and Children: IM 0.06 mL/kg (usually 3 to 5 mL). Administer as soon as possible after exposure and repeat 28 to 30 days later. Newborns of HBsAg-Positive Mothers: IM 0.5 mL. Administer first HBIG dose as soon as possible, preferably < 12 hr after birth. Also give hepatitis B vaccine. If hepatitis B vaccine is declined, repeat HBIG at 3 and 6 mo of age.

  Interactions

Anticoagulants: Give HBIG with caution to people receiving anticoagulant therapy. Vaccines: To avoid inactivating vaccines containing live viruses (except measles vaccine) or bacteria, give live vaccines 3 mo after HBIG.

  Lab Test Interferences None well documented.

  Adverse Reactions OTHER Local pain and tenderness at injection site; urticaria; angioedema; anaphylactic reactions.

  Precautions

Pregnancy: Category C. Lactation: Undetermined.

  Administration/Storage

• Inspect solution for particulate matter and discoloration before administration.
• Administer IM, preferably in gluteal or deltoid muscle in adults and children. In newborns, administer IM in anterolateral thigh. Do not give IV.
• Always record manufacturer's name and lot number on vial in patient's permanent record file along with date of administration, name and title of person administering injection.
• Refrigerate vials. Do not freeze.

  Assessment/Interventions

• Obtain complete history, including drug history and any known allergies.
• Check patient's immunization history to verify that administration regimen is being followed.
• Review patient's medical history for history of serious adverse reactions to previous dose of HBIG.
• Monitor for hypersensitivity or anaphylaxis. Epinephrine should always be available to counteract any possible reactions.

  Patient/Family Education

• Instruct parent to vaccinate all at-risk infants as soon after birth as possible and again at 3 mo.
• Instruct patient that therapy is useful as postexposure prophylaxis as soon after exposure as possible (preferably within 7 days.)
• Provide patient or parent with immunization history record and record this injection in patient's medical records.
• Instruct patient to give analgesic for local pain. Avoid giving aspirin to children.
• Inform parent or patient of schedule for vaccination program if necessary.

Books@Ovid
Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts