Pharm

Lymphocyte Immune Globulin

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Lymphocyte Immune Globulin, Anti-thymocyte Globulin, Lymphocyte Immunoglobulin, Horse Antihuman Thymocyte Gamma Globulin, Atgam

  • Indications
  1. Aplastic Anemia
  2. Transplant Rejection (prevention and treatment)
    1. Renal Transplant
  • Contraindications
  1. Active Infection (e.g. EBV, CMV, HSV, VZV)
  • Mechanism
  1. Horse serum IgG extract
  2. Suppresses both T Cell and Humoral Immunity
  • Dosing
  1. See other references
  2. Precautions
    1. Although only FDA approved in adults, has been used in children safely (at same weight-based dose)
    2. Infuse over at least 4 hours
    3. Must be infused with intravenous line filter (contains insoluble components)
    4. Consider coadministration of Corticosteroids to prevent Anaphylaxis
  3. Renal Allograft rejection
    1. Infuse 10 to 15 mg/kg daily IV over 4 hours for 14 days
  4. Aplastic Anemia
    1. Infuse 10 to 20 mg/kg daily IV over 4 hours for 8 to 14 days
  • Adverse Effects
  1. Anaphylaxis (<1% of patients within first 24 hours, black box warning)
  2. Serum Sickness
  3. Cytokine Release Syndrome
  4. Hematologic
    1. Leukopenia
    2. Thrombocytopenia
  5. Common
    1. Fever and chills
    2. Rash
  6. Uncommon
    1. Nausea and Vomiting
    2. Chest Pain
    3. Back Pain
    4. Arthralgias
    5. Night Sweats
    6. Headache
  • Safety
  1. Unknown safety in Lactation
  2. Pregnancy Category C
    1. May use in pregnancy if benefit outweighs risk
    2. Men and women should prevent pregnancy with reliable Contraception for 10 weeks after dose
  • Drug Interactions
  1. Live Attenuated Vaccine
    1. Avoid with Lymphocyte Immune Globulin
  • Resources
  1. Horse Antihuman Thymocyte Gamma Globulin (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=bd545ba1-2366-4df1-bd67-10dfd7632b54