Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Hepatitis a (inactivated) and hepatitis b (rdna) (hab) vaccine (adsorbed) may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
for
Ambirix is a vaccine used in infants, children and young people from 1 year up to and including 15 years. It is used to prevent two diseases: hepatitis A and hepatitis B.
1
•
Ambirix helps the body to produce its own protection (antibodies) against these diseases. The vaccine does not contain live virus (see section 6 for the content of the vaccine) and therefore cannot cause hepatitis A or B infections.
•
As with all vaccines, some people respond less well to a vaccine than others.
•
Ambirix may not protect you from being ill if you have already caught the hepatitis A or B virus.
•
Ambirix can only help to protect you against infections with hepatitis A or B viruses. It cannot protect against other infections that can affect the liver – even though these infections might have signs similar to those caused by the hepatitis A or B virus.
2.
e Ambirix
Ambirix should not be given if: • • •
you are allergic to Ambirix, or any of the other ingredients of this vaccine (listed in section 6). Signs of an allergic reaction may include itchy skin rash, shortness of breath and swelling of your face or tongue you have previously had an allergic reaction to any vaccine against hepatitis A or hepatitis B diseases you have a severe infection with a high temperature. The vaccine can be given after you have recovered. A minor infection such as a cold should not be a problem, but talk to your doctor first.
Ambirix should not be given if any of the above apply. If you are not sure, talk to your doctor, nurse or pharmacist before having Ambirix. Warnings and precautions Talk to your doctor, nurse or pharmacist before having Ambirix if: • • •
•
you need to be fully protected against hepatitis A and B infection within the next 6 months – your doctor may recommend a different vaccine you have a bleeding problem or bruise easily – the injection may be given just under the skin instead of into a muscle to reduce the amount of bleeding or bruising you have immune system problems (such as due to an illness, treatment or dialysis) – the vaccine may not work fully. This means you may not be protected against one or both of the hepatitis A and B viruses. Your doctor will run blood tests to see whether more injections are needed to help you be better protected you have fainted before or during a previous injection – in case this happens again. Fainting can occur (mostly in adolescents) following, or even before, any needle injection.
If any of the above apply (or you are not sure), talk to your doctor, nurse or pharmacist before having Ambirix. Other medicines and Ambirix Tell your doctor if you are taking, have recently taken or might take any other medicines or vaccines. This includes medicines obtained without a prescription and herbal medicines. Ask your doctor, nurse or pharmasist if you are not sure. If you are taking medicines that affect your body's immune response, you can still have Ambirix if this is thought to be necessary. However, the vaccine may not work fully. This means that you may
2
not be protected against one or both of the hepatitis A and B viruses. Your doctor will run blood tests to see whether more injections are needed to help you be better protected. Ambirix may need to be given at the same time as other vaccines for measles, mumps, rubella, diphtheria, tetanus, whooping cough (pertussis), poliomyelitis, Haemophilus influenzae type b or some types of treatments for hepatitis infections called "immunoglobulins". Your doctor will make sure that the vaccines are injected into different parts of your body. Pregnancy, breast-feeding and fertility If you are pregnant or breast-feeding, think that you might be pregnant or are planning to have a baby, ask your doctor, nurse or pharmacist for advice before having this vaccine. Ambirix is not usually given to women who are pregnant or breast-feeding. Driving and using machines You may feel sleepy or dizzy after having Ambirix. If this happens, do not drive, cycle or use any tools or machines. Ambirix contains neomycin and sodium This vaccine contains neomycin (an antibiotic). Ambirix should not be given if you are allergic to neomycin. This vaccine contains less than 1 mmol sodium (23 mg) per dose, that is to say essentially 'sodiumfree'.
3.
How Ambirix is given
How the injection is given • • •
The doctor or nurse will give Ambirix as an injection into a muscle. This is usually into the upper arm. They will take care that Ambirix is not given into a vein. In very small children, the injection may be given into the thigh muscle.
• •
You will normally have a total of two injections. Each is given on a separate visit. The injections will be given within 12 months:
Your doctor will advise on the possible need for extra doses, and future booster dosing. Missing a dose •
If you miss the second injection, talk to your doctor and arrange another visit as soon as possible.
•
Make sure you finish the complete course of two injections. If not, you may not be protected against the diseases.
4.
Possible side effects 3
Like all medicines, this vaccine can cause side effects, although not everybody gets them. Serious side effects • Tell your doctor straight away if you notice any of the following serious side effects – you may need urgent medical treatment:allergic and anaphylactic reactions – the signs can include a rash that may be itchy or blistering, swelling of the eyes and face, difficulty in breathing or swallowing, a sudden drop in blood pressure and loss of consciousness. Tell your doctor straight away if you notice any of the serious side effects listed above. Side effects that occurred during clinical trials with Ambirix were as follows: Very common (These may occur with more than 1 in 10 doses of the vaccine) :headache, loss of appetite, feeling tired or irritable, pain and redness where the injection was given. Common (These may occur with up to 1 in 10 doses of the vaccine) :fever, feeling drowsy, stomach and digestive problems, swelling where the injection was given. Additional side effects that have been reported during clinical trials with very similar combined hepatitis A and hepatitis B vaccines, include: Common (These may occur with up to 1 in 10 doses of the vaccine) :generally feeling unwell, diarrhoea, feeling sick (nausea), reaction where the injection was given. Uncommon (These may occur with up to 1 in 100 doses of the vaccine) : feeling dizzy, stomach pain, being sick (vomiting), upper airway infections, aching muscles (myalgia). Rare (These may occur with up to 1 in 1,000 doses of the vaccine) :low blood pressure, joint pain (arthralgia), itching (pruritus), rash, pins and needles (paraesthesia), swollen glands in the neck, armpit or groin (lymphadenopathy), flu-like symptoms, such as high temperature, sore throat, runny nose, cough and chills. Very rare (These may occur with up to 1 in 10,000 doses of the vaccine): hives (urticaria). Please contact your doctor if you have similar side effects.
that occurred during routine use of Ambirix were as follows: fainting, loss of skin sensitivity to pain or touch (hypoaesthesia). Additional side effects that occurred during routine use of very similar combined or individual hepatitis A and hepatitis B vaccines were as follows: multiple sclerosis, swelling of the spinal cord (myelitis), abnormal test results relating to the liver, swelling or infection of the brain (encephalitis), inflammation of some blood vessels (vasculitis), a degenerative disease of the brain (encephalopathy), swelling of the face, mouth and throat (angioneurotic oedema), severe headache with stiff neck and sensitivity to light (meningitis), a temporary inflammation of the nerves, causing pain, weakness and paralysis in the arms and legs and often progressing to the chest and face (Guillain-Barré syndrome). fits or seizures, inflammation of the nerves (neuritis), disease of the nerves of the eyes (optic neuritis), numbness or weakness of the arms and legs (neuropathy), immediate injection site pain, stinging and burning feeling, paralysis, drooping eyelid and sagging muscles on one side of the face (facial palsy), disease mainly affecting the joints with pain and swelling (arthritis), muscular weakness, purple or reddish-purple bumps on the skin (lichen planus), serious skin rashes (erythema multiforme), reduction in blood platelets, which increases risk of bleeding or bruising (thrombocytopenia), purple or red brown spots visible through the skin (thrombocytopenic purpura). Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.You can also report side effects directly via the Yellow Card Scheme Website: 4
www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
5.
Ambirix
Keep this vaccine out of the sight and reach of children. Do not use this vaccine after the expiry date which is stated on the carton. The expiry date refers to the last day of that month. Store in a refrigerator (2°C to 8°C). Do not freeze. Freezing destroys the vaccine. Store in the original package in order to protect from light. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6.
What Ambirix contains
720 ELISA Units 20 micrograms
1
Produced on human diploid (MRC-5) cells Adsorbed on aluminium hydroxide, hydrated 0.05 milligrams Al3+ 3 Produced in yeast cells (Saccharomyces cerevisiae) by recombinant DNA technology 4 Adsorbed on aluminium phosphate, 0.4 milligrams Al3+ 2
5
Other formats: To listen to or request a copy of this leaflet in Braille, large print or audio please call, free of charge: 0800 198 5000 (UK Only) Please be ready to give the following information: Product name Ambirix, suspension for injection in pre-filled syringe
Reference numbers
19494/0259
This is a service provided by the Royal National Institute of Blind People.
This leaflet was last revised in March 2025 Trade marks are owned by or licensed to the GSK group of companies. © 2025 GSK group of companies or its licensor.
——————————————————————————————————————–The following information is intended for healthcare professionals only: Upon storage, a fine white deposit with a clear colourless layer above may be observed. The vaccine should be re-suspended before use. When re-suspended, the vaccine will have a uniform hazy white appearance. Re-suspension of the vaccine to obtain a uniform hazy white suspension The vaccine should be re-suspended following the steps below. 1. Hold the syringe upright in a closed hand. 2. Shake the syringe by tipping it upside down and back again. 3. Repeat this action vigorously for at least 15 seconds. 4. Inspect the vaccine again: a. If the vaccine appears as a uniform hazy white suspension, it is ready to use – the appearance should not be clear. b. If the vaccine still does not appear as a uniform hazy white suspension – tip upside down and back again for at least another 15 seconds – then inspect again. The vaccine should be inspected visually for any foreign particulate matter and/or abnormal physical appearance prior to administration. In the event of either being observed, do not administer the vaccine. Instructions for the pre-filled syringe
Luer Lock Adaptor Hold the syringe by the barrel, not by the plunger. Unscrew the syringe cap by twisting it anticlockwise.
Plunger Barrel Cap
6
Needle hub To attach the needle, connect the hub to the Luer Lock Adaptor and rotate a quarter turn clockwise until you feel it lock. Do not pull the syringe plunger out of the barrel. If it happens, do not administer the vaccine.
Disposal Any unused medicinal product or waste material should be disposed of in accordance with local requirements.
7
Ambirix suspension for injection in pre-filled syringe comes as oral solution. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
The active substance in Ambirix suspension for injection in pre-filled syringe is hepatitis a (inactivated) and hepatitis b (rdna) (hab) vaccine (adsorbed).
This leaflet reproduces the patient information leaflet approved for Ambirix suspension for injection in pre-filled syringe, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
Ambirix is indicated in non-immune children and adolescents from 1 year up to and including 15 years of age for protection against hepatitis A and hepatitis B infection.
Protection against hepatitis B infections may not be obtained until after the second dose (see section 5.1).
Therefore:
- Ambirix should be used only when there is a relatively low risk of hepatitis B infection during the vaccination course.
- It is recommended that Ambirix should be administered in settings where completion of the two-dose vaccination course can be assured.
Posology
- Dosage
A dose of 1.0 ml is recommended for subjects from 1 year up to and including 15 years of age.
- Primary vaccination schedule
The standard primary course of vaccination consists of two doses, the first administered at the elected date and the second between 6 and 12 months after the first dose.
The recommended schedule should be adhered to. Once initiated, the primary course of vaccination should be completed with the same vaccine.
- Booster dose
In situations where a booster dose of hepatitis A and/or hepatitis B is desired, a monovalent or combined vaccine can be given. The safety and immunogenicity of Ambirix administered as a booster dose following a two dose primary course have not been evaluated.
Long-term antibody persistence data following vaccination with Ambirix are available up to 15 years after vaccination (see section 5.1).
The anti-hepatitis B surface antigen (anti-HBs) and anti-hepatitis A virus (anti-HAV) antibody titres observed following a primary vaccination course with Ambirix are in the range of what is seen following vaccination with the monovalent hepatitis A and B vaccines. General guidelines for booster vaccination can therefore be drawn from experience with the monovalent vaccines, as follows.
Hepatitis B
The need for a booster dose of hepatitis B vaccine in healthy individuals who have received a full primary vaccination course has not been established. However some official vaccination programmes currently include a recommendation for a booster dose of hepatitis B vaccine and these should be respected.
For some categories of subjects at risk of exposure to HBV (e.g. haemodialysis or immunocompromised patients) a precautionary attitude should be considered to ensure that a protective antibody level ≥ 10 mIU/ml is maintained.
Hepatitis A
It is not yet fully established whether immunocompetent individuals who have responded to hepatitis A vaccination will require booster doses as protection in the absence of detectable antibodies may be ensured by immunological memory. Guidelines for boosting are based on the assumption that antibodies are required for protection.
Paediatric population
The safety and efficacy of Ambirix in children aged less than 1 year have not been established.
No data are available.
Method of administration
Ambirix is for intramuscular injection, usually into the deltoid muscle. However the anterolateral thigh may be used in very young subjects if preferred.
Exceptionally, the vaccine may be administered subcutaneously in patients with thrombocytopenia or bleeding disorders. However, this route of administration may result in suboptimal immune response to the vaccine (see section 4.4).
Hypersensitivity to the active substances or to any of the excipients listed in section 6.1, or neomycin.
Hypersensitivity after previous administration of hepatitis A and/or hepatitis B vaccines.
As with other vaccines, the administration of Ambirix should be postponed in subjects suffering from acute severe febrile illness.
As with all injectable vaccines, appropriate medical treatment and supervision should always be readily available in case of a rare anaphylactic reactions following the administration of the vaccine.
Syncope (fainting) can occur following, or even before, any vaccination especially in adolescents as a psychogenic response to the needle injection. This can be accompanied by several neurological signs such as transient visual disturbance, paraesthesia and tonic-clonic limb movements during recovery. It is important that procedures are in place to avoid injury from faints.
It is possible that subjects may be in the incubation period of a hepatitis A or hepatitis B infection at the time of vaccination. It is not known whether Ambirix will prevent hepatitis A and hepatitis B in such cases.
The vaccine will not prevent infection caused by other agents such as hepatitis C and hepatitis E and other pathogens known to infect the liver.
Ambirix is not recommended for postexposure prophylaxis (e.g. needle stick injury).
If rapid protection against hepatitis B is required, the standard three-dose regimen of the combined vaccine containing 360 ELISA Units of formalin inactivated hepatitis A virus and 10 micrograms of recombinant hepatitis B surface antigen is recommended. This is because, a higher proportion of subjects are protected in the interval between the second and third dose of the three-dose combined vaccine, than after a single dose of Ambirix. This difference is no longer present after the second dose of Ambirix (see section 5.1 for seroprotection rates).
It is recommended that the two-dose regimen of Ambirix be completed prior to start of sexual activity.
The vaccine has not been tested in patients with an impaired immune system. In haemodialysis patients and persons with an impaired immune system, adequate anti-HAV and anti-HBs antibody titers may not be obtained after the primary immunisation course.
Since intradermal injection or intramuscular administration into the gluteal muscle could lead to a suboptimal response to the vaccine, these routes should be avoided. However, exceptionally Ambirix can be administered subcutaneously to subjects with thrombocytopenia or bleeding disorders since bleeding may occur following an intramuscular administration to these subjects.
Ambirix should under no circumstances be administered intravascularly.
This vaccine contains less than 1 mmol sodium (23 mg) per dose, that is to say essentially 'sodium-free'.
Traceability
In order to improve the traceability of biological medicinal products, the name and the batch number of the administered product should be clearly recorded.
No data on concomitant administration of Ambirix with specific hepatitis A immunoglobulin or hepatitis B immunoglobulin have been generated. However, when the monovalent hepatitis A and hepatitis B vaccines were administered concomitantly with specific immunoglobulins there was no effect on seroconversion rates. Concomitant immunoglobulin administration may result in lower antibody titres.
When Ambirix was administered concomitantly with, but as a separate injection to a combined diphtheria, tetanus, acellular pertussis, inactivated poliomyelitis and Haemophilus influenzae type b vaccine (DTPa-IPV+Hib) or with a combined Measles-Mumps-Rubella vaccine in the second year of life, immune responses to all antigens were satisfactory (see section 5.1).
Concomitant administration of Ambirix and other vaccines than those listed above has not been studied. It is advised that Ambirix should not be administered at the same time as other vaccines unless absolutely necessary.
Concomitant vaccines should always be administered at separate injection sites and preferably into different limbs.
It may be expected that in patients receiving immunosuppressive treatment or patients with immunodeficiency, an adequate response may not be achieved.
Pregnancy
Ambirix can be used during pregnancy only when clearly needed, and the possible advantages outweigh the potential risks for the foetus.
Breast-feeding
Ambirix should only be used during breast-feeding when the possible advantages outweigh the potential risks.
Fertility
No fertility data are available.
Ambirix has no or negligible influence on the ability to drive and use machines.
Summary of safety profile
Clinical trials involved the administration of 2029 doses of Ambirix to 1027 subjects from 1 year up to and including 15 years of age.
In 2 comparative trials in subjects aged 1-15 years, the incidences of local and general solicited symptoms after a two-dose regimen of Ambirix was overall similar to that seen with the three-dose combined vaccine containing 360 ELISA Units of HAV and 10 µg of HBsAg.
The most commonly reported adverse reactions following Ambirix administration are pain and fatigue occurring in an approximated per dose frequency of 50% and 30% respectively.
List of adverse reactions
Local and general adverse reactions reported following primary vaccination with Ambirix were categorised by frequency.
Adverse reactions reported are listed according to the following frequency:
Very common:
≥ 1/10
Common:
≥ 1/100 to < 1/10
Uncommon:
≥ 1/1,000 to < 1/100
Rare:
≥ 1/10,000 to < 1/1,000
Very rare:
< 1/10,000
The following adverse reactions were reported during clinical trials with Ambirix.
• Clinical trial data
Metabolism and nutrition disorders
Very common: appetite lost
Psychiatric disorders
Very common: irritability
Nervous system disorders
Very common: headache
Common: drowsiness
Gastrointestinal disorders
Common: gastrointestinal symptoms
General disorders and administration site conditions
Very common: fatigue, pain and redness at the injection site
Common: fever, swelling at the injection site
In addition, the following adverse reactions were reported during clinical trials with GlaxoSmithKline's other combined hepatitis A and hepatitis B vaccines (given as a 3 or 4 dose schedule).
Infections and infestations
Uncommon: upper respiratory tract infection
Blood and lymphatic system disorders
Rare: lymphadenopathy
Nervous system disorders
Uncommon: dizziness
Rare: paraesthesia
Vascular disorders
Rare: hypotension
Gastrointestinal disorders
Common: diarrhoea, nausea
Uncommon: vomiting, abdominal pain*
Skin and subcutaneous tissue disorders
Rare: pruritus, rash
Very rare: urticaria
Musculoskeletal and connective tissue disorders
Uncommon: myalgia
Rare: arthralgia
General disorders and administration site conditions
Common: malaise, injection site reaction
Rare: chills, influenza like illness
* refers to adverse reactions observed in clinical trials performed with the paediatric formulation
• Post-marketing data
Because these events were reported spontaneously, it is not possible to reliably estimate their frequency.
The following adverse reactions were reported during post-marketing surveillance following vaccination with Ambirix.
Immune system disorders
Allergic reactions including anaphylactic and anaphylactoid reactions
Nervous system disorders
Syncope or vasovagal responses to injection, localised hypoaesthesia
Following widespread use of either GlaxoSmithKline's combined hepatitis A and hepatitis B vaccines or the monovalent hepatitis A and/or hepatitis B vaccines, the following adverse reactions have additionally been reported.
Infections and infestations
Meningitis
Blood and lymphatic system disorders
Thrombocytopenic purpura, thrombocytopenia
Immune system disorders
Allergic reactions including mimicking serum sickness, angioneurotic oedema
Nervous system disorders
Multiple sclerosis, encephalitis, encephalopathy, polyneuritis such as Guillain-Barré syndrome (with ascending paralysis), myelitis, convulsions, paralysis, facial palsy, neuritis, optic neuritis, neuropathy
Vascular disorders
Vasculitis
Hepatobiliary disorders
Abnormal liver function tests
Skin and subcutaneous tissue disorders
Erythema multiforme, lichen planus
Musculoskeletal and connective tissue disorders
Arthritis, muscular weakness
General disorders and administration site conditions
Immediate injection site pain, stinging and burning sensation
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
Cases of overdose with GlaxoSmithKline's combined hepatitis A and hepatitis B vaccine have been reported during post-marketing surveillance. Adverse reactions reported following overdosage were similar to those reported with normal vaccine administration.
Medicines sold in Romania with the same active substance: Cunoscut în România ca
⚠ Not the same combination. This medicine contains Hepatitis a (inactivated) and hepatitis b (rdna) (hab) vaccine (adsorbed). The products below do not contain exactly the same set of active substances — they are not direct substitutes.
Some of these do not contain exactly the same active substances — check each one. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Romanian medicines in the UK →
Medicines sold in Poland with the same active substance: W Polsce znany jako
⚠ Same active substance, but a different pharmaceutical form (for example a gel instead of a tablet). Not interchangeable — ask a pharmacist.
Same active substance. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Polish medicines in the UK →
Ask anything about Ambirix suspension for injection in pre-filled syringe. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.
We use essential cookies to make the site work. We would also like to set optional cookies to understand how the site is used, so we can improve it. We will not set optional cookies unless you accept. See our cookie policy and privacy policy.