Hepamerz Dosing Information
I cannot provide dosing information for "Hepamerz" as this product does not appear in the provided evidence, which exclusively addresses Hepatitis B Immunoglobulin (HBIG) for post-exposure prophylaxis.
Clarification Needed
The term "Hepamerz" may refer to:
- L-ornithine L-aspartate (LOLA): A hepatic encephalopathy treatment, not covered in the provided evidence
- Hepatitis B Immunoglobulin (HBIG): If this is what you're asking about, dosing is detailed below
Hepatitis B Immunoglobulin (HBIG) Dosing - If This Is Your Question
Standard Post-Exposure Prophylaxis Dose
For adults and children exposed to HBsAg-positive blood, administer 0.06 mL/kg body weight intramuscularly as soon as possible after exposure, preferably within 24 hours. 1
Specific Clinical Scenarios
Needlestick/Percutaneous Exposure:
- Unvaccinated persons: 0.06 mL/kg IM immediately (within 24 hours preferred) plus initiate hepatitis B vaccine series at separate site 2, 1
- Effectiveness decreases markedly if delayed beyond 7 days 2
Perinatal Prophylaxis (Newborns):
- 0.5 mL IM administered within 12 hours of birth (preferably) to infants born to HBsAg-positive mothers 1
- Efficacy decreases markedly if delayed beyond 48 hours 1
- Must be given at separate site from hepatitis B vaccine 1
Sexual Exposure:
- 0.06 mL/kg IM as single dose within 14 days of last sexual contact with HBsAg-positive person 1
- Should be combined with hepatitis B vaccine series 1
Vaccine Non-Responders:
- After two complete vaccine series with persistent anti-HBs <10 mIU/mL: Give 2 doses of HBIG 1 month apart if source is HBsAg-positive 2
Critical Timing Considerations
- Optimal window: Within 24 hours of exposure 2, 1
- Acceptable window: Up to 7 days (though efficacy beyond 7 days is unclear) 2
- Recent evidence suggests HBIG given between 24 hours and 7 days may be as effective as administration within 24 hours 3
Common Pitfalls to Avoid
- Delaying administration while awaiting serologic results—give immediately if indicated 4
- Administering HBIG and vaccine at the same injection site—always use separate anatomic sites 2, 1
- Failing to complete the full hepatitis B vaccine series after HBIG administration 4
- Testing for anti-HBs too early after HBIG—wait 4-6 months to avoid detecting passively acquired antibodies 2, 4
If you were asking about a different medication called "Hepamerz," please clarify the specific indication (e.g., hepatic encephalopathy, ammonia reduction) so I can provide appropriate guidance.