Formulary
Normal immunoglobulin: Indications, Dosing, Side Effects and Interactions
Normal immunoglobulin clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 4 min read
Normal immunoglobulin: Indications, Dosing, Side Effects and Interactions
Normal immunoglobulin clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Post-exposure prophylaxis against hepatitis A infection [using Subgam]**
- **Adult** (By Deep Intramuscular Injection): 1000 mg for 1 dose.
**Post-exposure prophylaxis of varicella-zoster infection [if antivirals are contra-indicated or otherwise unsuitable]**
- **Adult** (By Intravenous Infusion): 200 mg/kg for 1 dose, dose to be administered within 10 days after exposure (preferably within 7 days if patient is immunosuppressed), but can be later if necessary.
**Replacement therapy in primary immunodeficiency disorders (specialist use only),Replacement therapy in secondary immunodeficiency disorders (specialist use only)**
- **Adult** (By Subcutaneous Infusion, Or By Intravenous Infusion): (consult product literature).
**Post-exposure prophylaxis against hepatitis A infection [using Subgam] for normal immunoglobulin**
- **Neonate** (By deep intramuscular injection): 500 mg for 1 dose.
- **Child 1 month-9 years** (By deep intramuscular injection): 500 mg for 1 dose.
- **Child 10-17 years** (By deep intramuscular injection): 1000 mg for 1 dose.
**Rubella in pregnancy [post-exposure prophylaxis to prevent or attenuate clinical attack; only when termination of pregnancy is unacceptable] for normal immunoglobulin**
- **Females of childbearing potential** (By deep intramuscular injection): 750 mg for 1 dose.
**Post-exposure prophylaxis of varicella-zoster infection [neonates exposed to maternal chickenpox 7 days before or after delivery, if varicella-zoster immunoglobulin is unavailable] for normal immunoglobulin**
- **Neonate** (By intravenous infusion): 200 mg/kg for 1 dose, dose to be administered as soon as possible-preferably within 96 hours after exposure.
**Post-exposure prophylaxis of varicella-zoster infection [if antivirals are contra-indicated or otherwise unsuitable] for normal immunoglobulin**
- **Neonate** (By intravenous infusion): 200 mg/kg for 1 dose, dose to be administered within 10 days after exposure (preferably within 7 days), but can be later if necessary.
- **Child** (By intravenous infusion): 200 mg/kg for 1 dose, dose to be administered within 10 days after exposure (preferably within 7 days if patient is immunosuppressed), but can be later if necessary.
**Replacement therapy in primary immunodeficiency disorders (specialist use only), Replacement therapy in secondary immunodeficiency disorders (specialist use only) for normal immunoglobulin**
- **Neonate** (By subcutaneous infusion, or by intravenous infusion): (consult product literature).
- **Child** (By subcutaneous infusion, or by intravenous infusion): (consult product literature).
**Immune-mediated disorders (specialist use only) for normal immunoglobulin**
- **Neonate** (By intravenous infusion): For some indications, subcutaneous infusion may be used for maintenance treatment (consult product literature).
- **Child** (By intravenous infusion): For some indications, subcutaneous infusion may be used for maintenance treatment (consult product literature).
**Kawasaki disease [with concomitant aspirin] for normal immunoglobulin**
- **Child** (By intravenous infusion): 2 g/kg for 1 dose, treatment should be given within 10 days of onset of symptom (but children with a delayed diagnosis may also benefit).
Cautions
General cautions: Agammaglobulinaemia with or without IgA deficiency; hypogammaglobulinaemia with or without IgA deficiency Specific cautions: With intravenous use Ensure adequate hydration; obesity; renal insufficiency; risk factors for arterial or venous thromboembolic events; thrombophilic disorders Cautions, further information For full details on cautions, consult product literature.
Contraindications
Patients with selective IgA deficiency who have known antibodies against IgA Contra-indications, further information For full details on contra-indications, consult product literature.
Side effects
General side-effects: Common or very common Diarrhoea; dizziness; fatigue; gastrointestinal discomfort; myalgia; nausea; pain; skin reactions Specific side-effects: Common or very common With intravenous use Arthralgia; chills; embolism and thrombosis; feeling hot; fever; haemolysis; headache; hyperaemia; hypersensitivity; hypertension; infusion related reaction; palpitations; sensory disorder; taste altered; vomiting With subcutaneous use Drowsiness; headaches; hypotension; local reaction Uncommon With intravenous use Hypothermia With subcutaneous use Paraesthesia Frequency not known With intravenous use Acute kidney injury; angina pectoris; cutaneous lupus erythematosus; dyspnoea; leucopenia; meningitis aseptic; neutropenia; shock; transfusion-related acute lung injury Side-effects, further information Adverse reactions are more likely to occur in patients receiving normal immunoglobulin for the first time, or following a prolonged period between treatments, or when a different brand of normal immunoglobulin is administered.
Pregnancy
Rubella in pregnancy [post-exposure prophylaxis to prevent or attenuate clinical attack; only when termination of pregnancy is unacceptable] for normal immunoglobulin By deep intramuscular injection Females of childbearing potential 750 mg for 1 dose.
Medicinal forms
Solution,Solution,Solution
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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