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Hepatitis A Medication

  • Author: Richard K Gilroy, MBBS, FRACP; Chief Editor: BS Anand, MD  more...
 
Updated: Jan 28, 2016
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications. Agents used include analgesics, antiemetics, vaccines, and immunoglobulins.

Although acetaminophen may be safely used to treat some of the symptoms associated with hepatitis A virus (HAV) infection, the dosage should be no higher than 4 g/day.

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Analgesic agents

Class Summary

Pain control is essential to quality patient care. Acetaminophen is useful for pain and/or fever.

Acetaminophen (Tylenol, Tempra, Feverall)

 

Acetaminophen reduces fever by acting directly on the hypothalamic heat-regulating centers, thereby increasing dissipation of body heat via vasodilation and sweating. It relieves mild to moderate pain.

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Antiemetics

Class Summary

Antiemetic agents are used to treat nausea and vomiting.

Metoclopramide (Reglan)

 

Metoclopramide is a dopamine antagonist that stimulates acetylcholine release in the myenteric plexus. It acts centrally on chemoreceptor triggers in the floor of the fourth ventricle, and this action provides important antiemetic activity.

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Vaccines, viral, prevention

Class Summary

Hepatitis A vaccine is used for active immunization against disease caused by HAV.

Hepatitis A vaccine, inactivated, and hepatitis B vaccine (Twinrix)

 

This combined hepatitis A–hepatitis B vaccine is used for active immunization of persons older than 18 years against disease caused by HAV and infection by all known subtypes of hepatitis B virus (HBV).

Hepatitis A vaccine, inactivated (Havrix, Vaqta)

 

Hepatitis A vaccine may be administered with immunoglobulin injections without affecting efficacy.

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Immune globulins

Class Summary

Hepatitis A vaccine may be administered with immunoglobulin injections without affecting efficacy.

Immune globulin IM (Gamunex, Octagam, Gammaplex)

 

Immune globulin IM neutralizes circulating myelin antibodies through anti-idiotypic antibodies; down-regulates proinflammatory cytokines, including interferon-gamma; blocks Fc receptors on macrophages; suppresses inducer T and B cells and augments suppressor T cells; blocks the complement cascade; promotes remyelination; and may increase cerebrospinal fluid immunoglobulin G (10%). It is effective when administered within 14 days of exposure.

If the patient is likely to be returning to areas of high endemicity, concurrent vaccination is recommended. For situations in which exposure is likely to occur before vaccination would be effective, both agents may be administered without reducing the efficacy of the HAV vaccine.

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Contributor Information and Disclosures
Author

Richard K Gilroy, MBBS, FRACP Associate Professor, Medical Director of Liver Transplantation and Hepatology, Department of Internal Medicine, Kansas University Medical Center

Disclosure: Received salary from gilead, NPS pharmaceuticals, salix pharmaceuticals, AbbVie for speaking and teaching.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

BS Anand, MD Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

BS Anand, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Additional Contributors

George Y Wu, MD, PhD Professor, Department of Medicine, Director, Hepatology Section, Herman Lopata Chair in Hepatitis Research, University of Connecticut School of Medicine

George Y Wu, MD, PhD is a member of the following medical societies: American Association for the Study of Liver Diseases, American Gastroenterological Association, American Medical Association, American Society for Clinical Investigation, Association of American Physicians

Disclosure: Received consulting fee from Springer for consulting; Received consulting fee from Gilead for review panel membership; Received honoraria from Vertex for speaking and teaching; Received honoraria from Bristol-Myers Squibb for speaking and teaching; Received royalty from Springer for review panel membership; Received honoraria from Merck for speaking and teaching.

Acknowledgements

Sandeep Mukherjee, MB, BCh, MPH, FRCPC Associate Professor, Department of Internal Medicine, Section of Gastroenterology and Hepatology, University of Nebraska Medical Center; Consulting Staff, Section of Gastroenterology and Hepatology, Veteran Affairs Medical Center

Sandeep Mukherjee, MB, BCh, MPH, FRCPC is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada

Disclosure: Merck Honoraria Speaking and teaching; Ikaria Pharmaceuticals Honoraria Board membership

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