Hepatitis B immune globulin (Bayhep B, Hyper Hep B, Nabi-HB, HepaGamB)

OFFICE ADMINISTRATION

Indications for Prior Authorization:

  • Post exposure prophylaxis
    • Acute exposure to blood positive for hepatitis B surface antigen (HBsAg)
    • Perinatal exposure of infants born to HBsAg positive mothers
    • Sexual exposure to an HBsAg positive person
    • Household exposure to people with acute HBV infection
  • Hepatitis B prophylaxis post-liver transplantation

The following indications do not meet the criteria for use established by the Western Health Advantage Pharmacy and Therapeutics Committee:

  • Prophylaxis of household contacts of people with acute hepatitis B is not indicated unless they have had identifiable blood exposure to the infected person. If so they should be treated like those with sexual exposure

Dosing:

Post-exposure prophylaxis

  • 0.06 ml/kg IM immediately after exposure, then repeat in 30 days

Perinatal exposure of infants

  • 0.5 ml IM preferable within 12 hours of birth, then repeat at 3 months of age

Sexual exposure to an HBsAg positive person

  • 0.06 ml/kg IM within 14 days of sexual contact

Household exposure to people with acute HBV infection

  • 0.5 ml IM for infants less then 12 months of age who have been exposed to a primary care giver with acute hepatitis B

HBIG post-liver transplant in Hepatitis B positive patients

  • 10,000 IU, IV pre-operatively, then
  • 10,000 IU, IV for 6 days, then
  • 10,000 IU, IV every 4-6 weeks for life

Approval:

  • Post-exposure prophylaxis: one month
  • Perinatal exposure of infants: up to six months
  • Sexual exposure: 14 days
  • Household exposure: one month
  • HBIG post-liver transplant in Hepatitis B positive patient: indefinitely

 

Last review date: December 2, 2013

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