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TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION

TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION

Ask a doctor about a prescription for TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION

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Doctor

Tomasz Grzelewski

Dermatology21 years of experience

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

Patients commonly seek his care for:

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns
Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.
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This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION

Introduction

Prospect:information for the user

Twinrix Pediatric, Injectable Suspension in Pre-filled Syringe

Vaccine (HAB) (adsorbed) against hepatitis A (inactivated) and hepatitis B (ADNr)

Read the entire prospectus carefully before you/your child starts receiving this vaccine,as it contains important information for you.

  • Keep this prospectus, as you may need to read it again.
  • If you have any doubts, consult your doctor or pharmacist.
  • This vaccine has been prescribed to you/your child only, and you should not give it to others.
  • If you/your child experience side effects, consult your doctor or pharmacist, even if they are side effects not listed in this prospectus. See section 4.

This prospectus has been written assuming that the person receiving the vaccine is the one reading it. However, the vaccine can be administered to children and adolescents, so you may be reading it on behalf of your child.

Contents of the prospectus

  1. What is Twinrix Pediatric and what is it used for
  2. What you need to know before receiving Twinrix Pediatric
  3. How to administer Twinrix Pediatric
  4. Possible side effects
  5. Storage of Twinrix Pediatric
  6. Package contents and additional information

1. What is Twinrix Pediatric and what is it used for

Twinrix Pediatric is a vaccine used in children and adolescents from 1 year of age to 15 years inclusive to prevent two diseases: hepatitis A and hepatitis B. The vaccine works by making the body produce its own protection (antibodies) against these diseases.

  • Hepatitis A: Hepatitis A is an infectious disease that can affect the liver. This disease is caused by the hepatitis A virus. Hepatitis A can be transmitted from person to person through food and drink, or by swimming in waters contaminated with sewage. The symptoms of hepatitis A begin 3 to 6 weeks after contact with the virus. These include nausea (discomfort), fever, and pain. After several days, the whites of the eyes and skin may turn yellow (jaundice). The severity and type of symptoms can vary. Young children may not develop jaundice. Most people recover completely, but the disease is usually severe enough for patients to be unable to work for about a month.
  • Hepatitis B: Hepatitis B is caused by the hepatitis B virus. It causes liver inflammation. The virus is found in bodily fluids such as blood, semen, vaginal secretions, or saliva (sputum) of infected people.

Vaccination is the best way to protect against these diseases. None of the vaccine components are infectious.

2. What you need to know before receiving Twinrix Pediatric

Twinrix Pediatric should not be administered if:

  • you are allergic to:
  • the active substances or any of the other components of this vaccine (listed in section 6)
  • neomycin.

Signs of an allergic reaction may include skin rash with itching, difficulty breathing, and swelling of the face or tongue

  • you have previously had an allergic reaction to any hepatitis A and hepatitis B vaccine
  • you have a severe infection with fever (over 38°C). A minor infection, such as a cold, should not be a problem for vaccination, but tell your doctor first.

Warnings and precautions

Consult your doctor or pharmacist before receiving Twinrix Pediatric if:

  • you have suffered any health problems after previous administration of a vaccine
  • you have a weakened immune system due to a disease or pharmacological treatment
  • you have any bleeding problems or bruise easily.

Before or after any injection, fainting (especially in adolescents) may occur, so you should inform your doctor or nurse if you have fainted after receiving an injection in the past.

Other medicines and Twinrix Pediatric

Twinrix Pediatric can be administered with a human papillomavirus (HPV) vaccine at a different injection site (e.g., the other arm) during the same medical visit.

Tell your doctor or pharmacist if you are using, have recently used, or may need to use any other medicine.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before receiving this vaccine.

It is not known if Twinrix Pediatric passes into breast milk; however, it is not expected to cause problems for breastfed babies.

Twinrix Pediatric contains neomycin and sodium

Tell your doctor if you have had an allergic reaction to neomycin (an antibiotic).

This vaccine contains less than 1 mmol of sodium (23 mg) per dose; this is, essentially, "sodium-free".

3. How to administer Twinrix Pediatric

You will receive a total of three injections over a period of 6 months. Each injection will be administered during a separate visit. The first dose will be administered on the chosen date. The other two doses will be administered one month and six months after the first dose.

  • First dose: on the chosen date
  • Second dose: 1 month later
  • Third dose: 6 months after the first dose

Your doctor will inform you if additional doses and future booster doses are needed.

If you miss one of the scheduled injections, talk to your doctor to schedule another visit.

Make sure you complete the full vaccination cycle of three injections. Otherwise, you may not be fully protected against the diseases.

The doctor will administer the Twinrix Pediatric injection into the upper muscle of your arm or into the thigh muscle of your child.

The vaccine should never be injected into a vein.

If you have any other questions about the use of this vaccine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this vaccine can cause side effects, although not everyone gets them.

The side effects that may occur are as follows:

Side effects that occurred during clinical trials or during routine use of the vaccine or with individual hepatitis A and hepatitis B vaccines or with the adult formulation of Twinrix.

Very common(may occur in more than 1 in 10 doses of vaccine): pain and redness at the injection site.

Common(may occur in up to 1 in 10 doses of vaccine): drowsiness, headache, nausea, loss of appetite, swelling or bruising at the injection site, general malaise, fatigue, fever equal to or greater than 37.5°C, irritability.

Uncommon(may occur in up to 1 in 100 doses of vaccine): diarrhea, vomiting, stomach pain, skin rash, muscle pain, upper respiratory tract infection.

Rare(may occur in up to 1 in 1,000 doses of vaccine): inflammation of the neck, armpit, or groin glands (lymphadenopathy), dizziness, loss of skin sensation to pain or touch (hypoesthesia), tingling sensation (paresthesia), urticarial rash, itching, joint pain, low blood pressure, flu-like symptoms such as fever, sore throat, runny nose, cough, and chills.

Very rare(may occur in up to 1 in 10,000 doses of vaccine): reduction of platelets, which increases the risk of bleeding or bruising (thrombocytopenia), purple or brownish-red spots visible through the skin (thrombocytopenic purpura), inflammation or infection of the brain (encephalitis), degenerative brain disease (encephalopathy), inflammation of the nerves (neuritis), numbness or weakness of the arms and legs (neuropathy), paralysis, seizures, inflammation of the face, mouth, or throat (angioneurotic edema), purple or purplish-red swelling of the skin (lichen planus), severe skin rashes (erythema multiforme), inflammation of the joints, muscle weakness, infection around the brain that can cause severe headache with stiff neck and sensitivity to light (meningitis), inflammation of some blood vessels (vasculitis), abnormal laboratory liver test results, multiple sclerosis, inflammation of the spinal cord (myelitis), drooping eyelids and sinking of the muscles on one side of the face (facial paralysis), temporary inflammation of the nerves, which causes pain, weakness, and paralysis of the limbs and often progresses to the chest and face (Guillain-Barré syndrome), eye nerve disease (optic neuritis), immediate pain at the injection site, itching, and burning sensation.

Severe allergic reactions (anaphylaxis, anaphylactoid reactions, and serum sickness-like reaction) can also occur very rarely (in up to 1 in 10,000 doses of the vaccine). Some signs of severe allergic reactions may include skin rashes with itching or blisters, eye and face swelling, difficulty breathing or swallowing, sudden drop in blood pressure, and loss of consciousness. These reactions can occur before leaving the doctor's office. In any case, if any of these symptoms appear, you should see a doctor immediately.

Reporting side effects

If you experience any side effects, consult your doctor or pharmacist, even if they are possible side effects not listed in this prospectus. You can also report them directly through the national reporting system included in Appendix V. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Twinrix Pediatric

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiration date stated on the packaging. The expiration date is the last day of the month indicated.

Store in a refrigerator (between 2°C and 8°C).

Store in the original packaging to protect it from light.

Do not freeze. Freezing destroys the vaccine.

Medicines should not be disposed of through wastewater or household waste. Ask your pharmacist how to dispose of the packaging and any unused medicine. This will help protect the environment.

6. Package contents and additional information

Composition of Twinrix Pediatric

  • The active substances are:

Hepatitis A virus (inactivated) 1,2 360 ELISA Units

Hepatitis B surface antigen 3,4 10 micrograms

1 Produced in human diploid cells (MRC-5)

2 Adsorbed on hydrated aluminum hydroxide 0.025 milligrams Al3+

3 Produced by recombinant DNA technology in yeast cells (Saccharomyces cerevisiae)

4 Adsorbed on aluminum phosphate 0.2 milligrams Al3+

  • The other components of Twinrix Pediatric are: sodium chloride, water for injections.

Appearance of Twinrix Pediatric and package contents

Injectable suspension in pre-filled syringe.

Twinrix Pediatric is a white, slightly milky liquid.

Twinrix Pediatric is available in a pre-filled syringe with or without a separate needle, package sizes of 1, 10, and 50.

Not all package sizes may be marketed.

Marketing authorization holder and manufacturer

GlaxoSmithKline Biologicals s.a.

Rue de l’Institut 89

B-1330 Rixensart

Belgium

You can request more information about this medicine by contacting the local representative of the marketing authorization holder:

België/Belgique/Belgien

GlaxoSmithKline Pharmaceuticals SA/NV

Tél/Tel: + 32 10 85 52 00

Lietuva

GlaxoSmithKline Biologicals SA

Tel. +370 80000334

????????

GlaxoSmithKline Biologicals SA

???. + 359 80018205

Luxembourg/Luxemburg

GlaxoSmithKline Pharmaceuticals SA/NV

Tél/Tel: + 32 10 85 52 00

Ceská republika

GlaxoSmithKline s.r.o.

Tel: + 420 2 22 00 11 11

[email protected]

Magyarország

GlaxoSmithKline Biologicals SA

Tel.: + 36 80088309

Danmark

GlaxoSmithKline Pharma A/S

Tlf: + 45 36 35 91 00

[email protected]

Malta

GlaxoSmithKline Biologicals SA

Tel: + 356 80065004

Deutschland

GlaxoSmithKline GmbH & Co. KG

Tel: + 49 (0)89 360448701

[email protected]

Nederland

GlaxoSmithKline BV

Tel: + 31 (0)33 2081100

Eesti

GlaxoSmithKline Biologicals SA

Tel: +372 8002640

Norge

GlaxoSmithKline AS

Tlf: + 47 22 70 20 00

Ελλ?δα

GlaxoSmithKline Μονοπρ?σωπη A.E.B.E.

Tηλ: + 30 210 68 82 100

Österreich

GlaxoSmithKline Pharma GmbH

Tel: + 43 (0)1 97075 0

[email protected]

España

GlaxoSmithKline, S.A.

Tel: + 34 900 202 700

[email protected]

Polska

GSK Services Sp. z o.o.

Tel.: + 48 (22) 576 9000

France

Laboratoire GlaxoSmithKline

Tél: + 33 (0) 1 39 17 84 44

[email protected]

Hrvatska

GlaxoSmithKline Biologicals SA

Tel.: + 385 800787089

Portugal

Smith Kline & French Portuguesa - Produtos Farmacêuticos, Lda.

Tel: + 351 21 412 95 00

[email protected]

România

GlaxoSmithKline Biologicals SA

Tel: +40 800672524

Ireland

GlaxoSmithKline (Ireland) Ltd

Tel: + 353 (0)1 495 5000

Slovenija

GlaxoSmithKline Biologicals SA

Tel: + 386 80688869

Ísland

Vistor hf.

Sími: +354 535 7000

Slovenská republika

GlaxoSmithKline Biologicals SA

Tel.: + 421 800500589

Italia

GlaxoSmithKline S.p.A.

Tel: + 39 (0)45 7741 111

Suomi/Finland

GlaxoSmithKline Oy

Puh/Tel: + 358 10 30 30 30

Κ?προς

GlaxoSmithKline Biologicals SA

Τηλ: + 357 80070017

Sverige

GlaxoSmithKline AB

Tel: + 46 (0)8 638 93 00

[email protected]

Latvija

GlaxoSmithKline Biologicals SA

Tel: + 371 80205045

United Kingdom(Northern Ireland)

GlaxoSmithKline Biologicals SA

Tel: +44 (0)800 221441

[email protected]

Date of last revision of this prospectus:

Other sources of information

Detailed information on this medicine is available on the European Medicines Agency website http://www.ema.europa.eu, and on the website of the Spanish Agency for Medicines and Health Products (AEMPS) (http://www.aemps.gob.es/).

---------------------------------------------------------------------------------------------------------------------

This information is intended only for healthcare professionals:

During storage, a fine white deposit with a clear and colorless layer above may be observed.

The vaccine should be resuspended before use. Once resuspended, the vaccine will have a uniform white, cloudy appearance.

Resuspension of the vaccine to obtain a uniform white, cloudy suspension

The vaccine should be resuspended by following the steps below.

  1. Hold the syringe upright with your hand closed.
  2. Shake the syringe by turning it upside down and then back upright.
  3. Repeat this action vigorously for at least 15 seconds.
  4. Inspect the vaccine again:
    1. If the vaccine appears as a uniform white, cloudy suspension, it is ready to use (it should not have a clear appearance).
    2. If the vaccine still does not appear as a uniform white, cloudy suspension, turn it upside down and then back upright for at least another 15 seconds and then inspect again.

Before administration, the vaccine should be visually inspected for any foreign particles and/or abnormal physical appearance. If any of these conditions are observed, do not administer the vaccine.

Instructions for the pre-filled syringe after resuspension

Syringe with luer-lock adapter showing parts such as plunger, body, stopper, and needle base, arrows indicate connection and rotation

Disposal of waste

Disposal of unused medicine and all materials that have come into contact with it will be carried out in accordance with local regulations.

Alternatives to TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION in other countries

The best alternatives with the same active ingredient and therapeutic effect.

Alternative to TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION in Ukraine

Dosage form: suspension, 1 dose (1 ml/dose)
Active substance: combinations
Prescription required

Online doctors for TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION – subject to medical assessment and local rules.

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Svetlana Kovalenko

Family medicine15 years of experience

Dr Svetlana Kovalenko is a family medicine doctor with over 14 years of experience and a medical degree from Kharkiv National Medical University. She offers online consultations for adults, supporting patients with both acute and chronic conditions, preventive care, and personalised medical advice.

What patients commonly consult her for:

  • High blood pressure, type 2 diabetes, cholesterol management
  • Cold and flu symptoms: fever, cough, sore throat
  • Fatigue, sleep problems, headaches, general discomfort
  • Ongoing care for chronic conditions and medication review
  • Help interpreting test results and lab reports
  • Preventive check-ups and advice on healthy lifestyle habits

Dr Kovalenko combines evidence-based practice with a respectful, patient-centred approach. She takes time to explain, listens attentively, and helps each person make confident, informed decisions about their health.

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Tomasz Grzelewski

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Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

Patients commonly seek his care for:

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns
Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.
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  • Digestive issues including gastritis, acid reflux, and irritable bowel syndrome (IBS).
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  • Management of chronic diseases: high blood pressure, diabetes, thyroid disorders.
  • Acute conditions requiring urgent medical attention.
  • Headaches, migraines, and minor injuries.
  • Wound care, health check-ups, and ongoing prescriptions.

With a patient-focused and evidence-based approach, Dr. Ben Ami supports individuals at all stages of life — offering clear medical guidance, timely interventions, and continuity of care.

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  • Chronic pain lasting more than 3 months.
  • Migraines and recurring headaches.
  • Neck, back, lower back, and joint pain.
  • Post-traumatic pain following injury or surgery.
  • Nerve-related pain, fibromyalgia, and neuralgia.
In addition to pain management, Dr. Popov helps patients with:
  • Respiratory infections (colds, bronchitis, pneumonia).
  • High blood pressure and metabolic conditions such as diabetes.
  • Preventive care and routine health check-ups.

Online consultations last up to 30 minutes and include a detailed symptom review, personalised treatment planning, and medical follow-up when needed.

Dr. Popov’s approach is rooted in evidence-based medicine, combined with individualised care tailored to each patient’s history, lifestyle, and clinical needs.

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She integrates medical analysis, psychological insight, and real-life behaviour change tools to offer treatment plans tailored to each patient’s biochemistry, mental state, and lifestyle.

Main areas of practice:

  • Chronic condition management and medical counselling
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  • Emotional support and psychosomatic symptom care
Her approach is never one-size-fits-all – each consultation begins with a deep dive into your unique health history, test results, and emotional landscape. Consultations are available in Ukrainian, Polish, and Russian.
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Areas of medical expertise:

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  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
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Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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Dr Biriukova combines internal medicine with specialist insight, offering clear explanations, personalised treatment plans, and comprehensive care tailored to each patient.
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  • blood pressure monitoring and antihypertensive therapy
  • arrhythmias: diagnosis, follow-up, and treatment adjustment
  • cardiovascular care and recovery support after Covid-19
Dr Kuznetsova helps patients manage cardiovascular risk factors, optimise long-term treatment, and gain clarity in complex health situations – all through accessible and structured online care.
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€50
January 714:00
January 714:50
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5.0(19)
Doctor

Taisiya Minorskaya

Family medicine13 years of experience

Dr Taisiya Minorskaya is a family medicine doctor with an official licence to practise in Spain and over 12 years of clinical experience. She provides online consultations for adults and children, combining evidence-based medicine with a personalised, modern European approach.

She helps with:

  • Viral infections and cold symptoms (flu, sore throat, cough, runny nose)
  • Review and adjustment of antibiotics
  • Skin rashes and allergic reactions
  • Chronic condition flare-ups, high blood pressure, headaches, fatigue
  • Lab and test interpretation
  • Medication review and adaptation to European standards
  • Patient navigation: what tests are needed, which specialists to see, when an in-person visit is required
Dr Minorskaya also specialises in the diagnosis and management of gastrointestinal conditions, including bloating, abdominal pain, chronic nausea, IBS, and SIBO. She supports patients with unexplained physical symptoms that may be linked to somatisation or stress, helping them find relief and improve quality of life.

She offers care for people undergoing GLP-1 therapy (Ozempic, Mounjaro, and others) for weight management. Her support follows Spanish clinical guidelines, from treatment planning and side effect counselling to regular follow-ups and coordination with private or public healthcare providers.

CameraBook a video appointment
€65
January 715:00
January 715:30
January 716:00
January 716:30
January 717:00
More times

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