Twinrix
Twinrix is a vaccine that protects you from getting sick from two types of viral liver infections: hepatitis A and hepatitis B. Twinrix is only for adults who haven't been vaccinated against these two infections yet. It's injected into the shoulder muscle by a healthcare professional (HCP). Twinrix is given as either a standard 3-dose series or a 4-dose series (accelerated schedule). Common side effects include soreness, redness, and swelling at the injection site. Headache and fatigue are common, too.
What is Twinrix?
What is Twinrix used for?
Prevention of hepatitis A and hepatitis B in adults
How Twinrix works
Twinrix is an inactivated vaccine that protects you from the hepatitis A and hepatitis B viruses. The vaccine helps your body's immune system make antibodies that will attack either virus if they ever infect you.
Drug Facts
Get your GoodRx coupon
What are the side effects of Twinrix?
Common Side Effects
- Soreness at injection site (up to 41%)
- Headache (up to 22%)
- Fatigue (up to 14%)
- Redness at injection site (up to 11%)
Other Side Effects
- Swelling at injection site
- Nausea
- Vomiting
- Diarrhea
- Fever
Serious Side Effects
- Serious allergic reaction: hives, rash, itching, shaking, nausea, flushing, dizziness, shortness of breath, chest pain
Source: DailyMed
More on Twinrix side effects
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
Rare
Difficulty with breathing or swallowing
itching, especially of the hands or feet
reddening of the skin, especially around the ears
swelling of the eyes, face, or inside of the nose
unusual tiredness or weakness (sudden and severe)
Incidence not known
Agitation
back pain
being forgetful
black, tarry stools
bleeding gums
blistering, peeling, or loosening of the skin
blood in the urine or stools
bloody nose
blurred vision
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
chills
coma
confusion
convulsions or seizures
dark urine
difficulty controlling your bladder or bowels
difficulty with walking
dizziness
drowsiness
fast, irregular, pounding, or racing heartbeat or pulse
feeling of discomfort
feeling sad or depressed
general feeling of illness
general tiredness and weakness
hallucinations
headache
heavier menstrual periods
inability to move the arms and legs
increased sweating
inflammation of the joints
irritability
joint or muscle pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
light-colored stools
muscle aches or cramps
nausea or vomiting
numbness or tingling in your arms, face, hands, or legs
partial or slight paralysis
pinpoint red spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rash
red, irritated eyes
redness, soreness, or itching skin
severe headache
shortness of breath
slurred speech or problems with swallowing
sores, ulcers, or white spots in the mouth or on the lips
sores, welting, or blisters
stiff neck or back
sudden numbness and weakness in the arms and legs
swollen lymph glands
tightness in the chest
unusual bleeding or bruising
unusual tiredness or weakness
upper right abdominal or stomach pain
yellow eyes and skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Body aches or pain
ear congestion
hard lump, redness, soreness, or swelling at the injection site
loss of voice
Rare
Abdominal or stomach pain
bruising at the injection site
fainting or lightheadedness when getting up suddenly from a lying or sitting position
feeling of constant movement of self or surroundings
feeling of warmth
headache, severe and throbbing
hyperventilation
large, flat, blue or purplish patches in the skin at the injection site
loss of appetite
muscle pain or stiffness
pain, swelling, or redness in the joints
redness of the face, neck, arms, and occasionally, upper chest
restlessness
sensation of spinning
shaking
sleepiness or unusual drowsiness
small, red or purple spots on the skin
sweating
trouble with sleeping
unable to sleep
unusually fast heartbeat
unusually warm skin
weakness
Incidence not known
Acid or sour stomach
belching
continuing ringing or buzzing or other unexplained noise in the ears
disturbed color perception
double vision
hair loss or thinning of the hair
halos around lights
hearing loss
indigestion
night blindness
overbright appearance of lights
painful blisters on the trunk of the body
stomach discomfort or upset
tunnel vision
weakness of the muscles in your face
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Twinrix
Pros
Helps protect against both hepatitis A and hepatitis B in one vaccine
Accelerated dosing schedule available for people who need to get vaccinated quickly
Readily available at local pharmacies
Cons
Only approved for adults
Only given as an injection into the muscle
Must be given by a healthcare professional at a medical office, clinic, or pharmacy
Pharmacist tips for Twinrix
If you're at risk for hepatitis A or at risk for hepatitis B, you should get tested for the viral infection before you get vaccinated with Twinrix. This vaccine might not work as well if you're already infected with hepatitis A or B when you receive your shot.
If you're traveling and haven't been vaccinated against hepatitis A or hepatitis B, ask a healthcare professional (HCP) about any travel vaccines that you need before you leave. Check whether it's recommended for you to get vaccinated with Twinrix for your destination.
Make sure to mark on your calendar the dates for each of your Twinrix injections (usually 3). This makes sure you become fully protected against hepatitis A and hepatitis B. Try to stay on schedule as best as possible. But contact your HCP or pharmacist if you accidentally miss a dose in the series.
The area where you got your Twinrix shot can get sore, red, and a little swollen for a few days. You also might feel tired and have headaches within 4 days of getting your vaccination. Contact an HCP if these side effects last longer and are severe.
Make sure you're feeling well when you get Twinrix. This will help make sure your immune system protects you as best as it can. You can still get your shot if you have a mild sickness, such as a cold or low-grade fever. But wait until you recover if you feel very sick. Ask your HCP if you're not sure whether or not you should get this vaccine when you're feeling under the weather.
It's recommended to wait at least 4 weeks after you've gotten your Twinrix dose to donate blood. You might have some of the vaccine still in your system. This can be mistaken as the virus when your donated blood gets screened for blood-borne diseases later. Your blood could get rejected from blood donation organizations.
Receiving Twinrix doesn't guarantee that you won't get infected with the hepatitis virus. In addition to the vaccine, take all necessary precautions while traveling to areas where hepatitis A is common to avoid getting sick from unclean food and beverages. For example, avoid raw foods, street food, bushmeat (animals not typically eaten in the United States), tap water, ice, and freshly squeezed juice.
Report any severe reactions to Twinrix to the vaccine adverse event reporting system (VAERS) website or by calling 1-800-822-7967.
Frequently asked questions about Twinrix
How to save using GoodRx
What are the risks and warnings for Twinrix?
Twinrix can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe allergic reaction
Risk factors: Allergic reaction to other vaccines
As with any vaccine, there's a rare chance that you might have a severe allergic reaction to Twinrix. Tell your HCP if you've had an allergic reaction to any vaccines in the past before you get Twinrix. Your HCP might ask you to stay a little longer at the pharmacy or clinic after you've received your vaccination. They can make sure you can get proper care in case of a serious allergic reaction.
Sometimes, allergic reactions can happen after you've already left the clinic. Get medical help right away if you notice symptoms of a severe allergic reaction, such as swelling of the face, closing of the throat, difficulty breathing, hives or rash, dizziness, or chest pain.
Fainting
Risk factors: Fainting after vaccines in the past
Fainting can happen while or after receiving injectable vaccines, including Twinrix. Fainting can come along with changes in vision, burning or tingling sensation, and stiffening or twitching of your arms and legs. Let your HCP know if you've ever fainted after you've gotten vaccinated in the past so they can look after you more carefully.
Lower response to Twinrix in people with a weakened immune system
Risk factors: Medical conditions that weaken the immune system | Taking medications that lower your immune system
Twinrix might not work as well in people with a weakened immune system. This can put them at higher risk of hepatitis A or B, even after they've received the vaccine.
Talk with your HCP first before you get Twinrix if you have any medical conditions that weaken your immune system, like human immunodeficiency virus (HIV) or cancer. Also make sure your HCP knows about the medications you take so they can check whether you're taking any medications that affect your immune system, such as high-dose corticosteroids and transplant medications.
More on Twinrix warnings
Twinrix dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 1ml | 1 syringe | $135.99 | $135.99 |
Typical dosing for Twinrix
Each Twinrix dose is 1 injection (1 mL) given into the shoulder muscle by a healthcare professional (HCP).
Typical 3-dose series: Typically, you'll get 3 injections of Twinrix over a 6-month period. After your first shot, you can get your second shot 1 month later. Then, your third shot should be about 5 months after your second shot.
Accelerated schedule (4-dose series): You'll receive the 3 injections of Twinrix over 1 month with a booster dose 1 year later. After your first dose, you can get your second dose 1 week later. You should get your third dose about 2 to 3 weeks after your second dose. Then, you'll need to get a booster dose of Twinrix about 1 year from the first shot you received.
Interactions between Twinrix and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
How much does Twinrix cost?
Twinrix contraindications
Allergic reaction to a previous hepatitis A or hepatitis B vaccine
Allergic reaction to yeast or neomycin
What are alternatives to Twinrix?
Prevention of hepatitis A and hepatitis B in adults
Prevention of hepatitis B in adults 18 years of age and older
What is the latest news about Twinrix?
Twinrix images
Get savings updates for Twinrix
Receive price alerts, news, and other messages from GoodRx about Twinrix and other healthcare topics and relevant savings offers.By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx.
References
Best studies we foundCenters for Disease Control and Prevention. (n.d.). Destinations.
Centers for Disease Control and Prevention. (2023). Food and drink considerations when traveling.
Centers for Disease Control and Prevention. (2024). Adult immunization schedule notes.
Centers for Disease Control and Prevention. (2025). Hepatitis A prevention and control.
GlaxoSmithKline Biologicals SA. (2024). Twinrix (hepatitis a and hepatitis b- recombinant vaccine injection, suspension [package insert]. DailyMed.
Immunize.org. (2025). Ask the experts: Hepatitis B.
MedlinePlus. (2022). Hepatitis virus panel.
Nelson, N., et al. (2024). Hepatitis A. CDC Yellow Book 2024.
Van Damme, P., et al. (2017). Persistence of antibodies 20 y after vaccination with a combined hepatitis A and B vaccine. Human Vaccines & Immunotherapeutics.
World Health Organization. (2020). How do vaccines work?
Browse medications
View AllResearch prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.