Precautions and warnings

There is a higher risk of sudden kidney failure in patients who already have kidney problems, diabetes, low blood volume, are overweight, take other medicines that can harm the kidneys, or are over 65 years old. Giving immunoglobulin too quickly by IV can increase the chance of side effects. Make sure the patient is well-hydrated before starting treatment. During treatment, check urine output and blood creatinine levels regularly. Do not use loop diuretics at the same time as IV immunoglobulin. Live vaccines should usually be given either 3 weeks before or 3 months after giving normal immunoglobulin. Different brands or types of immunoglobulin may not be the same, so check the specific information for each product. Use with caution in pregnancy and breastfeeding.

Drug Interactions

This medicine can affect how well live vaccines for measles, mumps, rubella, and chickenpox (varicella) work. To avoid problems, these vaccines should be given at least 3 weeks before or 3 months after receiving immunoglobulins.

Contraindications

People who have selective immunoglobulin A (IgA) deficiency, or who have had serious allergic reactions (anaphylaxis) to immunoglobulin, blood, or blood products in the past.

Mode of actions

Human normal immunoglobulin is made from the combined plasma of many donors. It has antibodies, mostly immunoglobulin G (IgG), that protect against common bacteria and viruses found in the general population, like hepatitis A, measles, mumps, rubella, and chickenpox (varicella). The mix of IgG types in it is almost the same as in normal human plasma. That’s why it can be used to give people temporary protection (passive immunisation) against these diseases.

Dosage & Administration

Adult: IV Prevention of infections after bone marrow transplantation 500 mg/kg/wk. Increase platelet count in patients w/ idiopathic thrombocytopenic purpura 400 mg/kg/day for 2-5 consecutive days.

Kawasaki disease 1.6-2 g/kg in divided doses over 2-5 days. Guillain-Barre syndrome 400 mg/kg/day for 5 consecutive days, repeat 4 wkly if needed. Allogenic bone marrow transplantation 500 mg/kg/wk, starting 7 days before transplantation and for up to 3 mth after transplantation.

Primary antibodies deficiency Initial: 400-800 mg/kg, then 200 mg/kg 3 wkly. Maintenance: 200-800 mg/kg/mth. For secondary immunodeficiency syndromes: 200-400 mg/kg 3-4 wkly.

IM Hepatits A 500 mg. Measles attack in immunocompromised patients Prevention: 750 mg w/in 6 days after exposure. To modify an attack: 250 mg. Primary rubella in pregnant women 750 mg.

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

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