Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes 20mcg/mL (Hepatitis-b-vaccine). If you are concerned about side effects, discuss the risks and benefits of 20mcg/mL (Hepatitis-b-vaccine) with your doctor.

The following side effects have been reported by at least 1% of people taking 20mcg/mL (Hepatitis-b-vaccine). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• Diarrhea
• dizziness
• drowsiness
• Fever of 37.7°C (100°F) or higher
• hard lump, redness, swelling, pain, itching, purple spot, tenderness, or warmth at the place of injection
• headache
• loss of appetite
• muscle aches
• nausea
• soreness where the vaccine was injected
• unusual tiredness or weakness
• vomiting

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• aches or pain in joints
• fever
• flu-like symptoms (sudden lack of energy, fever, cough, sore throat)
• irritability
• muscle weakness or numbness or tingling of arms and legs
• skin rash or welts (may occur days or weeks after receiving the vaccine)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• difficulty breathing or swallowing
• Hives
• itching, especially hands or feet
• reddening of skin, especially around ears
• swelling of eyes, face, or inside of nose
• unusual tiredness or weakness (sudden and severe)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking 20mcg/mL (Hepatitis-b-vaccine).

Engerix®-B
Each 1 mL adult dose contains 20 µg of hepatitis B surface antigen adsorbed onto 0.5 mg of aluminum hydroxide. Nonmedicinal ingredients: aluminum hydroxide. The vaccine is a slightly opaque, white, sterile suspension. A slow settling of the white aluminum hydroxide may occur during storage leaving a clear, colourless, supernatant liquid. Thimerosal-free

Engerix®-B Pediatric Dose
Each 0.5 mL pediatric dose contains 10 µg of hepatitis B surface antigen adsorbed onto 0.25 mg of aluminum hydroxide. Nonmedicinal ingredients: aluminum hydroxide. The vaccine is a slightly opaque, white, sterile suspension. A slow settling of the white aluminum hydroxide may occur during storage leaving a clear, colourless, supernatant liquid. Thimerosal-free.

Hepatitis B vaccine should not be used by anyone who is allergic to hepatitis B vaccine or to any of the ingredients of the medication.

• Acetaminophen
• Abatacept
• Azathioprine
• Baricitinib
• Belimumab
• cancer medications (e.g., Carboplatin, Cyclophosphamide, Doxorubicin, Ifosfamide, Vincristine)
• corticosteroids (e.g., budesonide, Dexamethasone, Hydrocortisone, fluticasone, Prednisone)
• Cyclosporine
• eculizumab
• Etanercept
• Fingolimod
• Golimumab
• Hydroxyurea
• Infliximab
• Ixekizumab
• Leflunomide
• mycophenolate
• Rituximab
• Romidepsin
• Secukinumab
• siltuximab
• Sirolimus
• Tacrolimus
• teriflumomide
• Tocilizumab
• Tofacitinib
• Vedolizumab
• vaccines
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with 20mcg/mL (Hepatitis-b-vaccine). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you receive 20mcg/mL (Hepatitis-b-vaccine), be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use 20mcg/mL (Hepatitis-b-vaccine).

Hemodialysis: People undergoing hemodialysis have a reduced immune response to the hepatitis B vaccine. Additional and higher doses of the vaccine may be required.  Discuss any concerns you have with your doctor.

Immune deficiency or suppression: People with immunodeficiency or those receiving immunosuppressive therapy (e.g., some medications used for the treatment of cancer or for transplant recipients) may require higher doses and may not respond as well as healthy individuals.

Infection: The vaccine should be delayed for people with serious infections, unless in the opinion of the doctor there is a greater risk associated with not giving the vaccine.

Vaccine protection: As with any vaccine, this vaccine may not protect 100% of people who receive it. (NOTE: Hepatitis B vaccine may not prevent hepatitis in people who were infected with the virus prior to receiving the vaccine.)

Pregnancy: 20mcg/mL (Hepatitis-b-vaccine) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while receiving 20mcg/mL (Hepatitis-b-vaccine), contact your doctor immediately.

Breast-feeding: It is not known if the vaccine passes into breast milk. If you are a breast-feeding mother and are receiving this vaccine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: This vaccine can be used in babies and children.