Immune Globulin
Class: Antitoxins and Immune Globulins
VA Class: IM500
CAS Number: 9007-83-4
Brands: Asceniv, Bivigam, Carimune, Cutaquig, Cuvitru, Flebogamma, Gammagard, GamaSTAN, Gammaked, Gammaplex, Gamunex-C, Hizentra, Hyqvia, Octagam, Panzyga, Privigen, Xembify
Warning
- Thrombosis
Thrombosis may occur with immune globulin preparations. (See Thrombosis under Cautions.)
Risk factors for thrombosis may include advanced age, prolonged immobilization, hypercoagulable disorders, history of venous or arterial thrombosis, use of estrogen-containing preparations, indwelling central vascular catheters, hyperviscosity, and other cardiovascular risk factors. Thrombosis may occur in the absence of known risk factors.
In patients at risk of thrombosis, administer immune globulin using minimum dose and minimum infusion rate practicable and ensure adequate hydration before administration of the drug. Monitor for signs and symptoms of thrombosis; assess blood viscosity in those at risk for hyperviscosity.
- Renal Dysfunction and Acute Renal Failure
Renal dysfunction, acute renal failure, osmotic nephrosis, and death may occur with immune globulin preparations. (See Renal Effects under Cautions.)
Patients predisposed or at increased risk of renal dysfunction include those with any degree of preexisting renal insufficiency, diabetes mellitus, age >65 years, volume depletion, sepsis, paraproteinemia, or concomitant therapy with nephrotoxic drugs.
Renal dysfunction and acute renal failure occur more commonly in patients receiving IGIV preparations containing sucrose.
In patients at risk of renal dysfunction or failure, administer immune globulin using minimum dose and minimum infusion rate practicable.
Introduction
Immune globulin IM (IGIM), immune globulin IV (IGIV), and immune globulin subcutaneous; sterile, nonpyrogenic preparations of globulins containing many antibodies normally present in adult human blood.
Uses for Immune Globulin
Hepatitis A Virus (HAV) Infection (Preexposure Prophylaxis)
IGIM (GamaSTAN) is used to provide short-term passive immunity to HAV infection for preexposure prophylaxis in certain susceptible individuals at risk of exposure to the virus.
Primary immunization with an age-appropriate schedule of hepatitis A vaccine is preferred for HAV preexposure prophylaxis in most adults, adolescents, children, and infants ≥12 months of age, unless contraindicated, since active immunization provides long-term protection.
IGIM can be used alone for HAV preexposure prophylaxis when the vaccine is unavailable or cannot be used (e.g., infants <12 months of age, individuals hypersensitive to vaccine components).
Combined passive immunization with IGIM and active immunization with hepatitis A vaccine should be used in those who require both immediate and long-term protection against HAV.
Travelers to areas with intermediate or high levels of endemic HAV are at substantial risk of acquiring the disease. Risk is highest for those who live in or visit rural areas, trek in back country areas, or frequently eat or drink in setting.
