Formulary
Anti-D (Rh0) immunoglobulin: Indications, Dosing, Side Effects and Interactions
Anti-D (Rh0) immunoglobulin clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 4 min read
Anti-D (Rh0) immunoglobulin: Indications, Dosing, Side Effects and Interactions
Anti-D (Rh0) immunoglobulin clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**To rhesus-negative woman for prevention of Rh(D) sensitisation, following birth of rhesus-positive infant for anti-D (Rh0) immunoglobulin**
- **Females of childbearing potential** (By deep intramuscular injection): 500 units, dose to be administered immediately or within 72 hours; for transplacental bleed of over 4 mL fetal red cells, extra 100-125 units per mL fetal red cells, subcutaneous route used for patients with bleeding disorders.
**To rhesus-negative woman for prevention of Rh(D) sensitisation, following any potentially sensitising episode (e.g. stillbirth, abortion, amniocentesis) up to 20 weeks' gestation for anti-D (Rh0) immunoglobulin**
- **Females of childbearing potential** (By deep intramuscular injection): 250 units per episode, dose to be administered immediately or within 72 hours, subcutaneous route used for patients with bleeding disorders.
**To rhesus-negative woman for prevention of Rh(D) sensitisation, following any potentially sensitising episode (e.g. stillbirth, abortion, amniocentesis) after 20 weeks' gestation for anti-D (Rh0) immunoglobulin**
- **Females of childbearing potential** (By deep intramuscular injection): 500 units per episode, dose to be administered immediately or within 72 hours, subcutaneous route used for patients with bleeding disorders.
**To rhesus-negative woman for prevention of Rh(D) sensitisation, antenatal prophylaxis for anti-D (Rh0) immunoglobulin**
- **Females of childbearing potential** (By deep intramuscular injection): 500 units, dose to be given at weeks 28 and 34 of pregnancy, if infant rhesus-positive, a further dose is still needed immediately or within 72 hours of delivery, subcutaneous route used for patients with bleeding disorders.
**To rhesus-negative woman for prevention of Rh(D) sensitisation, antenatal prophylaxis (alternative NICE recommendation) for anti-D (Rh0) immunoglobulin**
- **Females of childbearing potential** (By deep intramuscular injection): 1000-1650 units, dose to be given at weeks 28 and 34 of pregnancy, alternatively 1500 units for 1 dose, dose to be given between 28 and 30 weeks gestation.
**To rhesus-negative woman for prevention of Rh(D) sensitisation, following Rh(D) incompatible blood transfusion for anti-D (Rh0) immunoglobulin**
- **Females of childbearing potential** (By deep intramuscular injection): 100-125 units per mL of transfused rhesus-positive red cells, subcutaneous route used for patients with bleeding disorders.
**To rhesus-negative woman for prevention of Rh0(D) sensitisation, following birth of rhesus-positive infant for Rhophylac**
- **Females of childbearing potential** (By intramuscular injection, or by intravenous injection): 1000-1500 units, dose to administered immediately or within 72 hours; for large transplacental bleed, extra 100 units per mL fetal red cells (preferably by intravenous injection), intravenous route recommended for patients with bleeding disorders.
**To rhesus-negative woman for prevention of Rh0(D) sensitisation, following any potentially sensitising episode (e.g. abortion, amniocentesis, chorionic villous sampling) up to 12 weeks' gestation for Rhophylac**
- **Females of childbearing potential** (By intramuscular injection, or by intravenous injection): 1000 units per episode, dose to be administered immediately or within 72 hours, intravenous route recommended for patients with bleeding disorders, higher doses may be required after 12 weeks gestation.
**To rhesus-negative woman for prevention of Rh0(D) sensitisation, antenatal prophylaxis for Rhophylac**
- **Females of childbearing potential** (By intramuscular injection, or by intravenous injection): 1500 units, dose to be given between weeks 28-30 of pregnancy; if infant rhesus-positive, a further dose is still needed immediately or within 72 hours of delivery, intravenous route recommended for patients with bleeding disorders.
**To rhesus-negative woman for prevention of Rh0(D) sensitisation, following Rh0(D) incompatible blood transfusion for Rhophylac**
- **Females of childbearing potential** (By intravenous injection): 50 units per mL of transfused rhesus-positive blood, alternatively 100 units per of mL of erythrocyte concentrate, intravenous route recommended for patients with bleeding disorders.
Cautions
For anti-D (Rh 0 ) immunoglobulin Immunoglobulin A deficiency; possible interference with live virus vaccines Cautions, further information MMR vaccine MMR vaccine may be given in the postpartum period with anti-D (Rh 0 ) immunoglobulin injection provided that separate syringes are used and the products are administered into different limbs. If blood is transfused, the antibody response to the vaccine may be inhibited-measure rubella antibodies after 6-8 weeks and revaccinate if necessary.
Side effects
For anti-D (Rh 0 ) immunoglobulin Uncommon Chills; fever; headache; malaise; skin reactions Rare or very rare Arthralgia; dyspnoea; hypersensitivity; hypotension; nausea; tachycardia; vomiting Frequency not known Intravascular haemolysis
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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