Human normal Immunoglobulin

Human normal Immunoglobulin is used for: Immunocompromised patients or patients with primary antibodies deficiency, Prophylaxis of infections after bone marrow transplantation, Allogenic bone marrow transplantation.

Intramuscular Control outbreaks of hepatitis A; Prophylaxis against hepatitis A in immunocompromised patients Adult: Recommended dose: 500 mg via deep IM inj. Prevent or modify measles attack in immunocompromised patients Adult: For prevention of an attack: 750 mg as an IM inj; to be given within 6 days after exposure (better efficacy if given within 72 hr). To modify an attack: 250 mg as an IM inj. Primary rubella in pregnant women whereby pregnancy termination is unacceptable Adult: 750 mg as an IM inj. Parenteral Immunocompromised patients or patients with primary antibodies deficiency Adult: IV admin: Initially, 400-800 mg/kg, then 200 mg/kg every 3 wk, adjust according to trough-immunoglobulin levels; maintenance dose: 200-800 mg/kg/mth. In patients with secondary immunodeficiency syndromes: 200-400 mg/kg every 3-4 wk may be used. Alternatively, dose may be given via SC admin: Initial loading dose of 200-500 mg/kg (divided over several days), followed by maintenance doses at repeated intervals to achieve a cumulative mthly dose of 400-800 mg/kg. Intravenous Prophylaxis of infections after bone marrow transplantation Adult: 500 mg/kg/wk, adjust dose according to response. Raise platelet count in patients with idiopathic thrombocytopenic purpura Adult: 400 mg/kg/day for 2-5 consecutive days. Alternatively, a dose of 800-1000 mg/kg may be given on day 1 and repeated on day 3 if needed. Doses to be given via IV infusion. Treatment may be repeated if relapse occurs. Kawasaki disease Adult: 1.6-2 g/kg in divided doses over 2-5 days, or 2 g/kg given as a single dose. To be used in conjunction with acetylsalicylic acid. Guillain-Barre syndrome Adult: 400 mg/kg daily for 5 consecutive days, may repeat every 4 wk if needed. Allogenic bone marrow transplantation Adult: As part of the conditioning regimen and after transplantation: 500 mg/kg/wk, starting 7 days before transplantation and for up to 3 mth after transplantation. In cases of persistent lack of antibody production, 500 mg/kg/mth may be used to normalise the antibody level.

Intramuscular Control outbreaks of hepatitis A; Prophylaxis against hepatitis A in immunocompromised patients Child: Recommended dose: <10 yr: 250 mg; >10 yr: 500 mg, to be given as deep IM inj. Prevent or modify measles attack in immunocompromised patients Child: For prevention of an attack: <1 yr: 250 mg; 1-2 yr: 500 mg; ?3 yr: 750 mg, as a single IM inj. Dose should be given within 6 days after exposure (better efficacy if given within 72 hr). To modify an attack: <1 yr: 100 mg and >1 yr: 250 mg, as a single IM inj.

Hypersensitivity to human Ig, circulating Abs to IgA.

For IV use only. Pregnancy, lactation.

May interfere with the immune response to live measles vaccine, live mumps vaccine, live rubella vaccine and live varicella vaccine, therefore these vaccines should be given at least 3 wk before or 3 mth after the admin of the immunoglobulins.

Side effects of Human normal Immunoglobulin : Occasionally, chills, headache, fever, allergic reactions, nausea, arthralgia & mild back pain. In particular cases & esp after high IV doses, reversible aseptic meningitis & impaired renal function (dose-dependent) may occur. Rarely, fall in BP. In isolated cases, anaphylactic shock.

Human normal immunoglobulin is derived from donations of pooled human plasma. It contains antibodies, mainly immunoglobulin G (IgG), to various bacteria and viruses present in the general population such as hepatitis A, measles, mumps, rubella and varicella. It has a distribution of IgG subclasses that is very close to that of the normal human plasma. It is therefore, used to provide passive immunisation against such diseases.