No

Immune Globulin

Household and sexual contacts of persons with hepatitis A, measles, varicella, and possibly rubella; travelers to high-risk areas outside tourist routes; staff, attendees, and parents of diapered attendees in day-care center outbreaks

C

Thrombocytopenia, hypersensitivity to immune globulin, thimerosal, IgA deficiency

Skin testing should not be performed as local irritation can occur and be misinterpreted as a positive reaction; do not administer I.V.; IG should not be used to control outbreaks of measles; epidemiologic and laboratory data indicate current IMIG products do not have a discernible risk of transmitting HIV

>10%: Local: Pain, tenderness, muscle stiffness at I.M. site

1% to 10%:

Cardiovascular: Flushing

Central nervous system: Chills

Gastrointestinal: Nausea

<1%: Lethargy, fever, urticaria, angioedema, erythema, vomiting, myalgia, hypersensitivity reactions

Increased toxicity: Live virus, vaccines (measles, mumps, rubella); do not administer within 3 months after administration of these vaccines

Keep in refrigerator; do not freeze

Provides passive immunity by increasing the antibody titer and antigen-antibody reaction potential

Duration of immune effect: Usually 3-4 weeks

Half-life: 23 days

Time to peak serum concentration: I.M.: Within 24-48 hours

I.M.:

Pre-exposure prophylaxis upon travel into endemic areas (hepatitis A vaccine preferred):

0.02 mL/kg for anticipated risk 1-3 months

0.06 mL/kg for anticipated risk >3 months

Repeat approximate dose every 4-6 months if exposure continues

Postexposure prophylaxis: 0.02 mL/kg given within 2 weeks of exposure

Measles:

Prophylaxis: 0.25 mL/kg/dose (maximum dose: 15 mL) given within 6 days of exposure followed by live attenuated measles vaccine in 3 months or at 15 months of age (whichever is later)

For patients with leukemia, lymphoma, immunodeficiency disorders, generalized malignancy, or receiving immunosuppressive therapy: 0.5 mL/kg (maximum dose: 15 mL)

Poliomyelitis: Prophylaxis: 0.3 mL/kg/dose as a single dose

Rubella: Prophylaxis: 0.55 mL/kg/dose within 72 hours of exposure

Varicella:: Prophylaxis: 0.6-1.2 mL/kg (varicella zoster immune globulin preferred) within 72 hours of exposure

IgG deficiency: 1.3 mL/kg, then 0.66 mL/kg in 3-4 weeks

Hepatitis B: Prophylaxis: 0.06 mL/kg/dose (HBIG preferred)

Intramuscular injection only

Skin tests should not be done

No information available to require special precautions

No effects or complications reported

Do not mix with other medications; skin testing should not be performed as local irritation can occur and be misinterpreted as a positive reaction

Injection: I.M.: 165±15 mg (of protein)/mL (2 mL, 10 mL)

ASHP Commission on Therapeutics, "ASHP Therapeutic Guidelines for Intravenous Immune Globulin," Clin Pharm, 1992, 11(2):117-36.

Berkman SA, Lee ML, and Gale RP, "Clinical Uses of Intravenous Immunoglobulins," Ann Intern Med, 1990, 112(4):278-92.