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Hepatitis B Immune Globulin Dosage

Medically reviewed by Drugs.com. Last updated on Aug 16, 2023.

Usual Adult Dose for Exposure to Hepatitis B Virus

Prevention of recurrence following liver transplantation:
HBIG 20,000 international units IV once with the grafting of the transplanted liver (the anhepatic phase)
Week 1 postoperative: 20,000 international units IV daily from day 1 to 7
Week 2 to 12 postoperative: 20,000 international units IV every two weeks from day 14
Month 4 onwards: 20,000 international units IV monthly

If patients fail to reach anti-HBs levels of 500 international units/L within the first week post-liver transplantation, dosage adjustments may be required.

Dosage regimen should be increased to 10,000 international units IV every 6 hours until the target anti-HBs are reached in patients who are especially susceptible to extensive loss of circulated anti-HBs, such as those who have surgical bleeding or abdominal fluid drainage (greater than 500 mL) or patients who undergo plasmapheresis.

Percutaneous or permucosal blood exposure:
Source is HBsAg-positive and exposed person has been vaccinated:
If exposed person's anti-HBs level is less than 10 sample ratio units (10 million international units) by RIA or negative by EIA:
Hepatitis B immune globulin (HBIG) 0.06 mL/kg IM once plus
hepatitis B vaccine booster dose or second dose of hepatitis B immune globulin 1 month later.

Source is HBsAg-positive and exposed person is unvaccinated:
HBIG 0.06 mL/kg IM once plus start hepatitis B vaccine series.

Source is high risk for HBsAg-positive and exposed person has been vaccinated:
Previously vaccinated exposed person:
If vaccine nonresponder and source is HBsAg-positive, give HBIG 0.06 mL/kg IM once plus hepatitis B vaccine booster dose or second dose of hepatitis B immune globulin 1 month later.
If exposed person does not respond to at least 4 doses of vaccine, give 2 doses of HBIG.

Source is high risk for HBsAg-positive and exposed person is unvaccinated:
Start hepatitis B vaccine series within 7 days of exposure
plus HBIG 0.06 mL/kg IM once if source tests positive for HBsAg.

Source unknown or low risk for HBsAg-positive and exposed person is vaccinated:
No treatment required.

Source unknown or low risk for HBsAg-positive and exposed person is unvaccinated:
Start hepatitis B vaccine series within 7 days of exposure.

Sexual exposure to HBsAg-positive source:
HBIG 0.06 mL/kg IM once
plus start hepatitis B vaccine series within 14 days of last contact or if contact will continue.

Usual Pediatric Dose for Exposure to Hepatitis B Virus

Nabi-HB(R), prophylaxis of infants born to HBsAg positive mothers:



Nabi-HB(R), postexposure prophylaxis:





HepaGam B(R), Postexposure prophylaxis:

Acute exposure to blood containing HBsAg: 0.06 mL/kg intramuscularly as soon as possible after exposure

Sexual exposure to HBsAg-positive persons: 0.06 mL/kg intramuscularly (concurrently with hepatitis B vaccine series) within 14 days of sexual contact or if sexual contact with infected person will continue

Household exposure to person with acute HBV infection:

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Prevention of hepatitis B recurrence following liver transplantation:

Precautions

CONTRAINDICATIONS:


Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Hepatitis B immune globulin should stored under refrigeration. Do not freeze and do not use solution that has been frozen. Use within 6 hours of entering the vial; discard partially used vials.

Administer HBIG as soon as possible after exposure, preferably within 24 hours. Its efficacy is unknown when given beyond 7 days.

If hepatitis B vaccine is given concomitantly, it should be administered into a different site.

HBIG should be administered through a separate intravenous line using an intravenous administration set via infusion pump.

The rate of administration should be set at 2 mL per minute. It should be decreased to 1 mL per minute or slower if the patient develops discomfort, infusion-related adverse events or there is concern about the speed of infusion.

Regular monitoring of serum HBsAg and levels of anti-HBs antibody should be performed pre-infusion to track treatment responses and allow for treatment adjustment.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.