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TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION

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About the medicine

How to use TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Prospect:Information for the user

Twinrix Pediatric, Suspension for injection 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 consist of 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 yourself against these diseases. None of the vaccine components are infectious.

Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

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 drug 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 whether 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 given on a separate visit. The first dose will be given on the chosen date. The other two doses will be given 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.

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

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), hives, 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), brain inflammation or infection (encephalitis), degenerative brain disease (encephalopathy), nerve inflammation (neuritis), numbness or weakness of the arms and legs (neuropathy), paralysis, seizures, facial, mouth, or throat inflammation (angioneurotic edema), purple or brownish-red skin swelling (lichen planus), severe skin rashes (erythema multiforme), joint inflammation, 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 liver laboratory test results, multiple sclerosis, spinal cord inflammation (myelitis), drooping eyelids and sinking of the muscles on one side of the face (facial paralysis), temporary nerve inflammation, 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, stinging, 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 inflammation, 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 you experience any of these symptoms, you should see a doctor immediately.

Reporting side effects

If you experience any side effects, consult your doctor or pharmacist, even if they are 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 via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. 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

Suspension for injection in pre-filled syringe.

Twinrix Pediatric is a white, slightly milky liquid.

Twinrix Pediatric is available in a pre-filled syringe with or without separate needles, 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 obtain more information on 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.

Τηλ: + 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/).

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This information is intended only for healthcare professionals:

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

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

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

The vaccine should be resuspended by following the steps below.

  1. Hold the syringe upside down with your hand closed.
  2. Shake the syringe by turning it upside down and then right side up.
  3. Repeat this action vigorously for at least 15 seconds.
  4. Inspect the vaccine again:
    1. If the vaccine appears as a white, cloudy, and uniform suspension, it is ready to use (it should not have a translucent appearance).
    2. If the vaccine still does not appear as a white, cloudy, and uniform suspension, turn it upside down and then right side up 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 should be carried out in accordance with local regulations.

Online doctors for TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION

Discuss questions about TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

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Tarek Agami

General medicine 11 years exp.

Dr. Tarek Agami is a general practitioner registered in both Portugal and Israel, with broad experience in family and preventive medicine. He offers online consultations for adults and children, providing personalised support for primary care needs, chronic disease management, and everyday health concerns.

Dr. Agami received clinical training and worked in leading medical institutions in Israel (Kaplan Medical Center, Barzilai Medical Center, Wolfson Medical Center) and Portugal (European Healthcare City, Viscura Internacional, Hospital Dr. José Maria Grande, Hospital Vila Franca de Xira). His approach combines international medical standards with individualised attention to each patient.

Main areas of consultation:

  • Diagnosis and treatment of acute and chronic conditions (high blood pressure, diabetes, respiratory infections, cardiovascular symptoms)
  • Evaluation of symptoms and guidance on further diagnostic testing
  • Preventive check-ups and regular health monitoring
  • Medical support during travel or after relocation
  • Treatment adjustments and lifestyle recommendations based on your personal history
Dr. Agami provides medical support for patients using GLP-1 medications (such as Ozempic or Mounjaro) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Portugal and Israel.

Dr. Agami is committed to evidence-based, patient-centred care, ensuring that each person receives trusted medical support tailored to their health goals.

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Nuno Tavares Lopes

Family medicine 18 years exp.

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
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  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Nuno Tavares Lopes provides medical support for patients using GLP-1 medications (Mounjaro, Wegovy, Ozempic, Rybelsus) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Europe.

Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.

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Anastasiia Shalko

Family medicine 13 years exp.

Dr. Anastasiia Shalko is a general practitioner with a background in both paediatrics and general medicine. She graduated from Bogomolets National Medical University in Kyiv and completed her paediatric internship at the P.L. Shupyk National Medical Academy of Postgraduate Education. After working as a paediatrician in Kyiv, she relocated to Spain, where she has been practising general medicine since 2015, providing care for both adults and children.

Her work focuses on urgent, short-term medical concerns – situations where patients need quick guidance, symptom assessment and clear next steps. She helps people understand whether their symptoms require in-person evaluation, home management or a change in treatment. Common reasons for booking an online consultation include:

  • acute respiratory symptoms (cough, sore throat, runny nose, fever)
  • viral illnesses such as colds and seasonal infections
  • gastrointestinal complaints (nausea, diarrhoea, abdominal pain, gastroenteritis)
  • sudden changes in how a child or adult feels
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  • renewal of prescriptions when clinically appropriate
Dr. Shalko works specifically with urgent and short-term problems, providing practical recommendations and helping patients determine the safest next step. She explains symptoms clearly, guides patients through decision-making and offers straightforward medical advice for everyday acute issues.

She does not provide long-term management of chronic conditions, ongoing follow-up or comprehensive care plans for complex long-term illnesses. Her consultations are designed for acute symptoms, sudden concerns and situations where timely medical input is important.

With clinical experience in both paediatrics and general medicine, Dr. Shalko confidently supports adults and children. Her communication style is clear, simple and reassuring, helping patients feel informed and supported throughout the consultation.

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Tomasz Grzelewski

Dermatology 21 years exp.

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
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  • 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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Frequently Asked Questions

Is a prescription required for TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION?
TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION?
The active ingredient in TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION is combinations. This information helps identify medicines with the same composition but different brand names.
Who manufactures TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION?
TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION is manufactured by Glaxosmithkline Biologicals. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to TWINRIX PEDIATRIC, PRE-FILLED SYRINGE SUSPENSION?
Other medicines with the same active substance (combinations) include AMBIRIX SUSPENSION FOR INJECTION IN PRE-FILLED SYRINGE, AMBIRIX SUSPENSION FOR INJECTION IN PRE-FILLED SYRINGE, TWINRIX ADULTOS, PRE-FILLED SYRINGE SUSPENSION FOR INJECTION. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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