HepaGam B

DRUG DESCRIPTION

HepaGam B, Hepatitis B Immune Globulin Intravenous (Human), is a solvent/detergent- treated sterile solution of purified gamma globulin containing anti-HBs. It is prepared from plasma donated by healthy, screened donors with high titers of anti-HBs that is purified by an anion- exchange column chromatography manufacturing method9,10. HepaGam B (hepatitis b immune globulin human) is formulated as a 5% (50 mg/mL) protein solution with 10% maltose and 0.03% polysorbate 80 at pH 5.6. It is available in 1 mL and 5 mL single dose vials. The product appears as a clear to opalescent liquid. It contains no preservatives and is intended for single use. HepaGam B (hepatitis b immune globulin human) may be administered intravenously or intramuscularly dependent upon indication [see INDICATIONS]. The source plasma used in the manufacture of this product was tested by FDA licensed Nucleic Acid testing (NAT) for HIV-1 and HCV and found to be negative. An investigational NAT for HBV was performed on all Source Plasma used, and found to be negative; however, the significance of a negative result has not been established. Plasma also has been tested by in-process NAT for hepatitis A virus (HAV) and parvovirus B19 (B19) via minipool testing and the limit for B19 in the manufacturing pool is set not to exceed 104 IU of B19 DNA per mL.

The manufacturing process contains two steps implemented specifically for virus clearance. The solvent and detergent step (using tri-n-butyl phosphate and Triton X-100) is effective in the inactivation of enveloped viruses, such as hepatitis B, hepatitis C and HIV11. Virus filtration, using a Planova 20N virus filter, is effective for the removal of viruses based on their size, including some non-enveloped viruses12. These two viral clearance steps are designed to increase product safety by reducing the risk of transmission of enveloped and non-enveloped viruses. In addition to these two specific steps, the process step of anion-exchange chromatography was identified as contributing to the overall viral clearance capacity for small non-enveloped viruses.

The inactivation and reduction of known enveloped and non-enveloped model viruses were validated in laboratory studies as summarized in Table 5. The viruses employed for spiking studies were selected to represent those viruses that are potential contaminants in the product, and to represent a wide range of physiochemical properties in order to challenge the manufacturing process's ability for viral clearance in general.

Table 5 - Virus Reduction Values Obtained Through Validation Studies8

Enveloped Enveloped Non-Enveloped
Genome RNA DNA RNA DNA
Virus HIV-1 BVDV PRV HAV EMC MMV PPV
Family retro flavi herpes picorna parvo
Size (nm) 80-100 50-70 120-200 25-30 30 20-25 18-24
Anion Exchange Chromatography (partitioning) Not evaluated 2.3 n.e. 3.4 n.e.
20N Filtration (size exclusion) ? 4.7 ? 3.5 ? 5.6 a n.e. 4.8 n.e. 4.1
Solvent/Detergent (inactivation) ? 4.7 ? 7.3 ? 5.5 Not evaluated
Total Reduction (log10) ? 9.4 ? 10.8 ? 11.1 2.3 4.8 3.4 4.1
Abbreviations:
HIV-1: human immunodeficiency virus-1; relevant virus for human immunodeficiency virus-1 and model for HIV-2
BVDV: bovine viral diarrhea virus; model virus for hepatitis C virus (HCV) and West Nile virus (WNV)
PRV: pseudorabies virus; model for large enveloped DNA viruses, including herpes
HAV: human hepatitis A virus; relevant virus for HAV and model for small non-enveloped viruses in general
EMC: encephalomyocarditis virus; model for HAV and for small non- enveloped viruses in general
MMV: murine minute virus; model for human parvovirus B19 and for small non-enveloped viruses in general
PPV: porcine parvovirus; model for human parvovirus B19 and for small non- enveloped viruses in general n.e.: not evaluated
a The PRV was retained by the 0.1 Ám pre-filter during the virus validation. Since manufacturing employs a 0.1 Ám pre-filter before the 20N filter, the claim of ? 5.6 reduction is considered applicable.

The product potency is expressed in international units (IU) by comparison to the World Health Organization (WHO) standard Hepatitis B Immune Globulin. Each vial contains greater than 312 IU/mL. The measured potency of each lot is stamped on the vial label [see Dosage Forms and Strengths].

What are the possible side effects of hepatitis B immune globulin (HepaGam B, HepaGam B NovaPlus, Hyperhep B, Nabi-HB)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);
  • left-sided stomach pain; or
  • nausea, stomach pain, low fever, loss of appetite, dark urine,...

Read All Potential Side Effects and See Pictures of HepaGam B

What are the precautions when taking hepatitis b immune globulin (human) (HepaGam B)?

Before receiving hepatitis B immune globulin, tell your doctor or pharmacist if you are allergic to it; or had a previous reaction to other immune globulins; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding/blood clotting problems, a certain immune system problem (immunoglobulin A deficiency).

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

This medication is made from human blood. Even though...

Read All Potential Precautions of HepaGam B

What are the possible side effects of hepatitis B immune globulin (HepaGam B, HepaGam B NovaPlus, Hyperhep B, Nabi-HB)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);
  • left-sided stomach pain; or
  • nausea, stomach pain, low fever, loss of appetite, dark urine,...

Read All Potential Side Effects and See Pictures of HepaGam B

What are the precautions when taking hepatitis b immune globulin (human) (HepaGam B)?

Before receiving hepatitis B immune globulin, tell your doctor or pharmacist if you are allergic to it; or had a previous reaction to other immune globulins; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding/blood clotting problems, a certain immune system problem (immunoglobulin A deficiency).

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

This medication is made from human blood. Even though...

Read All Potential Precautions of HepaGam B

What are the possible side effects of hepatitis B immune globulin (HepaGam B, HepaGam B NovaPlus, Hyperhep B, Nabi-HB)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);
  • left-sided stomach pain; or
  • nausea, stomach pain, low fever, loss of appetite, dark urine,...

Read All Potential Side Effects and See Pictures of HepaGam B

What are the precautions when taking hepatitis b immune globulin (human) (HepaGam B)?

Before receiving hepatitis B immune globulin, tell your doctor or pharmacist if you are allergic to it; or had a previous reaction to other immune globulins; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding/blood clotting problems, a certain immune system problem (immunoglobulin A deficiency).

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

This medication is made from human blood. Even though...

Read All Potential Precautions of HepaGam B

What are the possible side effects of hepatitis B immune globulin (HepaGam B, HepaGam B NovaPlus, Hyperhep B, Nabi-HB)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);
  • left-sided stomach pain; or
  • nausea, stomach pain, low fever, loss of appetite, dark urine,...

Read All Potential Side Effects and See Pictures of HepaGam B

What are the precautions when taking hepatitis b immune globulin (human) (HepaGam B)?

Before receiving hepatitis B immune globulin, tell your doctor or pharmacist if you are allergic to it; or had a previous reaction to other immune globulins; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding/blood clotting problems, a certain immune system problem (immunoglobulin A deficiency).

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

This medication is made from human blood. Even though...

Read All Potential Precautions of HepaGam B

What are the possible side effects of hepatitis B immune globulin (HepaGam B, HepaGam B NovaPlus, Hyperhep B, Nabi-HB)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);
  • left-sided stomach pain; or
  • nausea, stomach pain, low fever, loss of appetite, dark urine,...

Read All Potential Side Effects and See Pictures of HepaGam B

What are the precautions when taking hepatitis b immune globulin (human) (HepaGam B)?

Before receiving hepatitis B immune globulin, tell your doctor or pharmacist if you are allergic to it; or had a previous reaction to other immune globulins; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding/blood clotting problems, a certain immune system problem (immunoglobulin A deficiency).

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

This medication is made from human blood. Even though...

Read All Potential Precautions of HepaGam B

What are the possible side effects of hepatitis B immune globulin (HepaGam B, HepaGam B NovaPlus, Hyperhep B, Nabi-HB)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);
  • left-sided stomach pain; or
  • nausea, stomach pain, low fever, loss of appetite, dark urine,...

Read All Potential Side Effects and See Pictures of HepaGam B

What are the precautions when taking hepatitis b immune globulin (human) (HepaGam B)?

Before receiving hepatitis B immune globulin, tell your doctor or pharmacist if you are allergic to it; or had a previous reaction to other immune globulins; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding/blood clotting problems, a certain immune system problem (immunoglobulin A deficiency).

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

This medication is made from human blood. Even though...

Read All Potential Precautions of HepaGam B


HepaGam B Consumer (continued)

SIDE EFFECTS: Redness, pain, or tenderness at the injection site may occur. Nausea, vomiting, fever, chills, dizziness, headache, or back/joint pain may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist promptly.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before receiving hepatitis B immune globulin, tell your doctor or pharmacist if you are allergic to it; or had a previous reaction to other immune globulins; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding/blood clotting problems, a certain immune system problem (immunoglobulin A deficiency).

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

This medication is made from human blood. Even though the blood is carefully tested, and this medication goes through a special manufacturing process, there is an extremely small chance that you may get infections (such as hepatitis A) from the medication. Consult your doctor or pharmacist for more information.

Some immune globulin products are made with maltose. This substance can cause false high blood sugar levels when your blood sugar is normal or even low. If you have diabetes, check with your doctor or pharmacist whether the product you are using contains maltose and whether your blood sugar testing supplies will work with this product. Rarely, serious problems have occurred when too much insulin was given because of false high sugar readings or when low blood sugar went untreated.

Tell your doctor of any recent/planned vaccinations. This medication may prevent a good response to live virus vaccines (such as measles, mumps, varicella). If you are vaccinated less than 14 days before receiving this medication or during the 3 months after receiving this medication, you may need to be vaccinated again or tested to see whether the vaccine was effective.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.


HepaGam B Patient Information Including Side Effects

Brand Names: HepaGam B, HepaGam B NovaPlus, Hyperhep B, Nabi-HB

Generic Name: hepatitis B immune globulin (Pronunciation: HEP a TYE tis B im MYOON GLOB yoo lin)

  • What is hepatitis B immune globulin (HepaGam B)?
  • What are the possible side effects of hepatitis B immune globulin (HepaGam B)?
  • What is the most important information I should know about hepatitis B immune globulin (HepaGam B)?
  • What should I discuss with my health care provider before receiving hepatitis B immune globulin (HepaGam B)?
  • How is hepatitis B immune globulin given (HepaGam B)?
  • What happens if I miss a dose (HepaGam B)?
  • What happens if I overdose (HepaGam B)?
  • What should I avoid while receiving hepatitis B immune globulin (HepaGam B)?
  • What other drugs will affect hepatitis B immune globulin (HepaGam B)?
  • Where can I get more information?

What is hepatitis B immune globulin (HepaGam B)?

Hepatitis B immune globulin is made from human plasma containing proteins that protect against the type B form of hepatitis (inflammation of the liver).

Hepatitis B immune globulin is used to prevent hepatitis B in people receiving a liver transplant, and in babies born to mothers infected with hepatitis B. It is also used to prevent hepatitis B in people who have been exposed to contaminated blood products, or through household or sexual contact with an infected person.

Hepatitis B immune globulin is not a vaccine. Therefore it will not provide long-term protection from hepatitis B. For long-term protection you must receive a hepatitis B vaccine such as Engerix-B, Recombivax HB, or Twinrix.

Hepatitis B immune globulin may also be used for other purposes not listed in this medication guide.

What are the possible side effects of hepatitis B immune globulin (HepaGam B)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);
  • left-sided stomach pain; or
  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • upset stomach, diarrhea;
  • tremors or shaking;
  • joint or back pain;
  • fever, chills;
  • headache; or
  • tired feeling.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about hepatitis B immune globulin (HepaGam B)?

Hepatitis B immune globulin is not a vaccine. Therefore it will not provide long-term protection from hepatitis B. For long-term protection you must receive a hepatitis B vaccine such as Engerix-B, Recombivax HB, or Twinrix.

You should not receive this medication if you are allergic to human globulins, or if you have an immunoglobulin A deficiency. Hepatitis B immune globulin should not be injected into your muscle if you have a bleeding or blood clotting disorder such as hemophilia.

Hepatitis B immune globulin is made from human plasma (part of the blood) and may contain viruses and other infectious agents that can cause disease. Although donated human plasma is screened, tested, and treated to reduce the risk of it containing anything that could cause disease, there is still a small possibility it could transmit disease. Talk with your doctor about the risks and benefits of using this medication.

To be sure this medication is helping your condition, your blood will need to be tested often. This will help your doctor determine how long to treat you with hepatitis B immune globulin. Your liver function will also need to be tested. Do not miss any scheduled visits to your doctor.

Do not receive a "live" vaccine while you are being treated with hepatitis B immune globulin, and for at least 3 months after your treatment ends. The live vaccine may not work as well during this time, and may not fully protect you from disease.

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