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