Please check your internet connection and try again.
# Tabvoihep
## Overview
Tabvoihep is a brand name for hepatitis B immune globulin (human). It is a sterile preparation of immunoglobulin G (IgG) from the plasma of individuals with high titers of antibodies to the hepatitis B virus (HBV).
## Primary Indications
* **Post-exposure prophylaxis against HBV infection:** In individuals exposed to the hepatitis B virus, particularly after accidental parenteral exposure (e.g., needlestick injury) or sexual exposure to an HBV-infected source.
* **Prevention of HBV infection in neonates:** Born to mothers who are positive for the hepatitis B surface antigen (HBsAg).
* **Management of HBV infection in specific situations:** Such as after liver transplantation in HBsAg-positive recipients.
## Adult Dosing
* **Post-exposure prophylaxis (parenteral):** 0.06 mL/kg intramuscularly (IM) as a single dose, given as soon as possible within 7 days of exposure.
* **Post-exposure prophylaxis (sexual exposure):** 0.06 mL/kg IM as a single dose, given as soon as possible within 14 days of exposure. Often given concurrently with the first dose of hepatitis B vaccine.
* **Neonatal prophylaxis:** 0.5 mL IM, given within 12 hours of birth. Often given concurrently with the first dose of hepatitis B vaccine.
* **Post-liver transplant:** Dosing varies significantly based on institutional protocols, HBV DNA levels, and presence of HBsAg. It often involves repeated doses or continuous infusions.
## Pediatric Dosing
* **Neonatal prophylaxis:** 0.5 mL IM, given within 12 hours of birth.
## Dose Adjustments
* Dosing is based on body weight. No specific adjustments are typically needed for hepatic or renal impairment, but caution is advised.
## Contraindications
* Known severe allergic reaction (e.g., anaphylaxis) to human immune globulin products or any component of the formulation.
* Individuals with a history of IgA deficiency may develop anti-IgA antibodies and could have anaphylactic reactions.
## Adverse Effects
* **Common:** Headache, injection site reactions (pain, redness, swelling), fever, rash, nausea, fatigue.
* **Less Common/Serious:** Aseptic meningitis syndrome, thrombosis (especially in older adults or those with risk factors), renal dysfunction, hemolytic anemia, acute renal failure, transfusion-related acute lung injury (TRALI).
## Key Drug Interactions
* **Hepatitis B Vaccine:** Can be administered concurrently at a different injection site or sequentially. If given sequentially, it's recommended to administer the vaccine at least 1 month after immune globulin administration.
* **Live Vaccines:** Administration of immune globulin can interfere with the immune response to live virus vaccines (e.g., measles, mumps, rubella, varicella). Postpone live virus vaccination for at least 3 months after administration of immune globulin.
## Monitoring
* Monitor for signs and symptoms of allergic reactions, including anaphylaxis.
* Monitor for signs of thrombosis (e.g., pain, swelling, redness in extremities, chest pain, shortness of breath).
* Monitor renal function if risk factors for renal dysfunction are present.
* For post-liver transplant patients, monitor HBV DNA levels and HBsAg status closely.
## Clinical Pearls
* The primary mechanism of action is passive antibody transfer, providing immediate but temporary protection.
* Administration via the intramuscular route is preferred. Intravenous administration should only be considered if IM is not feasible and only with specific formulations intended for IV use, following strict guidelines to avoid adverse events.
* Ensure adequate vaccination status for hepatitis B in all at-risk individuals. Immune globulin is a prophylaxis measure and does not replace the need for vaccination.
***
*This information is intended as a clinical resource and does not replace the need to consult the official prescribing information and current institutional protocols for complete details.*
