Hepatitis A Medication

Updated: May 08, 2019
  • Author: Richard K Gilroy, MBBS, FRACP; Chief Editor: BS Anand, MD  more...
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Medication

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 relief and/or fever.

Acetaminophen (Tylenol, Tempra, Feverall)

Acetaminophen reduces fever by acting directly on the hypothalamic heat-regulating centers, thereby increasing the 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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