Hepatitis A

Twinrix by GlaxoSmithKline (Hep A/Hep B)

Captured 2022-11-08
Document Highlights

Initial U.S. Approval: 2001

TWINRIX is a vaccine indicated for active immunization against disease caused by hepatitis A virus and infection by all known subtypes of hepatitis B virus.

TWINRIX is approved for use in persons 18 years of age or older.

Incidence <1% of Injections
– Respiratory tract illnesses.
– Anorexia.
– Agitation, insomnia.
– Dizziness, migraine, paresthesia, somnolence, syncope.
– Vertigo.
– Flushing.
– Abdominal pain, vomiting.
– Erythema, petechiae, rash, sweating, urticaria.
– Arthralgia, back pain, myalgia.
– Injection site ecchymosis, injection site pruritus, influenza-like symptoms, irritability, weakness.
– Lymphadenopathy.
– Dysgeusia, hypertonia, tingling.
– Photophobia.
– Hypotension.
– Constipation.
– Creatine phosphokinase increased

Postmarketing Experience
– Herpes zoster, meningitis.
– Thrombocytopenia, thrombocytopenic purpura.
– Allergic reaction, anaphylactoid reaction, anaphylaxis, serum sickness–like syndrome days to weeks after vaccination (including arthralgia/arthritis, usually transient; fever; urticaria; erythema multiforme; ecchymoses; and erythema nodosum).
– Bell’s palsy, convulsions, encephalitis, encephalopathy, Guillain-Barré syndrome, hypoesthesia, myelitis, multiple sclerosis, neuritis, neuropathy, optic neuritis, paralysis, paresis, transverse myelitis.
– Conjunctivitis, visual disturbances.
– Earache, tinnitus.
– Palpitations, tachycardia.
– Vasculitis.
– Bronchospasm, including asthma-like symptoms; dyspnea.
– Dyspepsia.
– Hepatitis, jaundice.
– Alopecia, angioedema, eczema, erythema multiforme, erythema nodosum, hyperhidrosis, lichen planus.
– Arthritis, muscular weakness.
– Chills; immediate injection site pain,
stinging, and burning sensation; injection site reaction; malaise.
– Abnormal liver function tests.
– Keratitis.
– Stevens-Johnson syndrome.
– Congenital abnormality.

TWINRIX… s a bivalent vaccine containing the antigenic components used in producing HAVRIX… and ENGERIX-B…

The hepatitis A virus is propagated in MRC-5 human diploid cells

One dose of vaccine… contains 0.45 mg of aluminum in the form of aluminum phosphate and aluminum hydroxide as adjuvants…

From the manufacturing process, each 1-mL dose of TWINRIX also containsMRC-5 cellular proteins

TWINRIX has not been evaluated for its carcinogenic or mutagenic potential, or for impairment of male fertility in animals.

Comments

Twinrix is manufactured using human aborted fetal cells (MRC-5) and was not tested for safety in a placebo-controlled clinical trial.

Why this is important.