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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, 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.

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 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 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

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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 discomfort, fatigue, fever of 37.5°C or higher, 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): reduced platelet count, 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 muscle sagging 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, 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 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 through wastewater or household waste. Ask your pharmacist how to dispose of the packaging and any unused medicines. 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 cloudy 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 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.

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, colorless layer above may be observed.

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

Resuspension of the vaccine to obtain a uniform, cloudy, white 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, cloudy, white suspension, it is ready to use (it should not have a clear appearance).
    2. If the vaccine still does not appear as a uniform, cloudy, white suspension, turn it upside down and then back upright for at least another 15 seconds and then inspect it 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 done 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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Doctor

Anna Biriukova

General medicine 6 years exp.

Dr Anna Biriukova is an internal medicine doctor with clinical experience in cardiology, endocrinology, and gastroenterology. She provides online consultations for adults, offering expert medical support for heart health, hormonal balance, digestive issues, and general internal medicine.

Cardiology – Diagnosis and treatment of:

  • High blood pressure, blood pressure fluctuations, and cardiovascular risk prevention.
  • Chest pain, shortness of breath, arrhythmias (tachycardia, bradycardia, palpitations).
  • Leg swelling, chronic fatigue, reduced exercise tolerance.
  • EKG interpretation, lipid profile evaluation, cardiovascular risk assessment (heart attack, stroke).
  • Post-COVID-19 cardiac monitoring and care.
Endocrinology – Diabetes, thyroid, metabolism:
  • Diagnosis and management of type 1 and type 2 diabetes, and prediabetes.
  • Individual treatment plans including oral medications and insulin therapy.
  • GLP-1 therapy– modern pharmacological treatment for weight management and diabetes control, including drug selection, monitoring, and safety follow-up.
  • Thyroid disorders – hypothyroidism, hyperthyroidism, autoimmune thyroid diseases (Hashimoto’s, Graves’ disease).
  • Metabolic syndrome – obesity, lipid disorders, insulin resistance.
Gastroenterology – Digestive health:
  • Abdominal pain, nausea, heartburn, gastroesophageal reflux (GERD).
  • Stomach and intestinal conditions: gastritis, irritable bowel syndrome (IBS), indigestion.
  • Management of chronic digestive disorders and interpretation of tests (endoscopy, ultrasound, labs).
General internal medicine and preventive care:
  • Respiratory infections – cough, colds, bronchitis.
  • Lab test analysis, therapy adjustments, medication management.
  • Adult vaccinations – planning, contraindications assessment.
  • Cancer prevention – screening strategies and risk assessment.
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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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Dmytro Horobets

Family medicine 7 years exp.

Dr. Dmytro Horobets is a licensed family medicine physician in Poland, specialising in endocrinology, diabetology, obesity management, gastroenterology, pediatrics, general surgery, and pain medicine. He offers online consultations for adults and children, providing personalised medical support for a wide range of acute and chronic health concerns.

Areas of expertise:

  • Endocrinology: diabetes type 1 and type 2, prediabetes, thyroid disorders, metabolic syndrome, hormonal imbalance.
  • Obesity medicine: structured weight management plans, nutritional counselling, obesity-related health risks.
  • Gastroenterology: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), liver and biliary conditions.
  • Pediatric care: infections, respiratory symptoms, digestive issues, growth and development monitoring.
  • General surgery support: pre- and post-surgical consultations, wound care, rehabilitation.
  • Pain management: chronic and acute pain, back pain, joint pain, post-traumatic pain syndromes.
  • Cardiovascular health: hypertension, cholesterol control, risk assessment for heart disease.
  • Preventive medicine: regular check-ups, health screenings, long-term management of chronic conditions.

Dr. Horobets combines evidence-based medicine with a patient-centred approach. He carefully evaluates each patient’s medical history and symptoms, offering clear explanations and structured treatment plans adapted to individual needs.

Whether you need help managing diabetes, tackling weight-related health issues, interpreting lab results, or receiving general family medicine support, Dr. Horobets provides professional online care tailored to your specific health goals.

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Svetlana Kolomeeva

Cardiology 18 years exp.

Dr. Svetlana Kolomeeva is a general practitioner and internal medicine doctor providing online consultations for adults. She helps patients manage acute symptoms, chronic conditions, and preventive care. Her clinical focus includes cardiovascular health, hypertension control, and managing symptoms like fatigue, weakness, sleep issues, and overall low energy.

Patients commonly seek her help for:

  • High blood pressure, headaches, dizziness, swelling, palpitations.
  • Diagnosis and management of hypertension, arrhythmias, and tachycardia.
  • Metabolic syndrome, excess weight, high cholesterol.
  • Chronic fatigue, insomnia, poor concentration, anxiety.
  • Respiratory symptoms: colds, flu, sore throat, cough, fever.
  • Digestive issues: heartburn, bloating, constipation, IBS symptoms.
  • Chronic conditions: diabetes, thyroid disorders.
  • Interpretation of lab tests and medical reports, therapy adjustment.
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  • Cardiovascular disease prevention and metabolic risk reduction.
  • Long-term follow-up and dynamic health monitoring.

Dr Kolomeeva combines clinical expertise with personalised care. She clearly explains diagnoses, guides patients through symptoms and treatment options, and provides actionable plans. Her consultations are designed not only to address current complaints but also to stabilise chronic conditions and prevent future complications. She supports patients through every stage of care – from first symptoms to ongoing health management.

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Doctor

Alexander Nazarchuk

Allergology 7 years exp.

Dr. Alexander Nazarchuk is a physician specialising in allergology and internal medicine. He provides online consultations for adults, following the principles of evidence-based medicine — no outdated treatments or unnecessary tests, with clear explanations and a personalised approach. He helps patients with a wide range of allergic and therapeutic conditions, from common day-to-day complaints to complex cases involving allergies, gastrointestinal issues, cardiovascular concerns, respiratory symptoms, and more.

You can consult Dr. Nazarchuk for:

  • Test interpretation and guidance on diagnostic plans.
  • Allergic rhinitis, hay fever, bronchial asthma (including severe cases).
  • Food and drug allergies, skin rashes, angioedema.
  • Atopic dermatitis, urticaria, contact allergies.
  • Allergen-specific immunotherapy (AIT) – initiation and ongoing management.
  • Abdominal pain, bloating, changes in bowel habits, nausea, heartburn.
  • High blood pressure and adjustment of baseline antihypertensive therapy.
  • Hyperlipidaemia and elevated cholesterol.
  • Cough, nasal congestion, fever, sore throat.
  • Anaemia, including iron deficiency and related conditions.
  • Other issues related to allergology and internal medicine.

During consultations, Dr. Nazarchuk takes a thorough, structured approach — analysing symptoms, identifying potential causes, and helping patients make informed decisions. Whether treatment, further investigation, or monitoring is needed, he explains each step clearly so you understand your health and how best to manage it.

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Marta Reguero Capilla

Allergology 8 years exp.

Dr Marta Reguero Capilla is an allergist and immunologist who works with both adults and children. She specialises in the diagnosis, treatment, and ongoing management of allergic and immune-related conditions through online consultations.

In her practice, Dr Reguero Capilla helps patients understand the causes of their symptoms, review test results, and choose appropriate treatment or monitoring strategies. Her consultations are suitable both for first-time assessments and for follow-up care over time.

Patients commonly consult Dr Marta Reguero Capilla for:

  • allergic rhinitis, seasonal allergies, and perennial allergy symptoms;
  • allergic conditions in adults and children;
  • bronchial asthma and allergy-related respiratory symptoms;
  • urticaria (acute and chronic) and angioedema;
  • food allergies and reactions to foods, additives, or medications;
  • atopic dermatitis, allergic rashes, and persistent itching;
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  • interpretation of laboratory tests, allergy testing, and immunology results;
  • immune system concerns, frequent infections, and reduced immune response;
  • ongoing medical follow-up and treatment adjustment.
Dr Reguero Capilla works in a structured and attentive manner, explaining medical decisions clearly and helping patients make informed choices about their own health or their child’s care.

When clinically appropriate, she may provide recommendations for further tests or referrals that patients can use within Spanish medical networks, including Sanitas and DKV, in accordance with the terms and conditions of those services.

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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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