Postnatal prophylaxis of RhD immunisation in RhD negative women
Adult: In Rhesus (Rh)-negative mothers who have just delivered Rh(D)-positive infants: 500 IU (100 mcg) as soon as possible after delivery. Recommended dose range: 500-1,500 IU (100-300 mcg). Testing of the amount of fetomaternal haemorrhage (FMH) must be performed when lower dose is administered. Postnatal dose should still be administered even when antenatal prophylaxis has been given and residual activity can be demonstrated in maternal serum. If large FMH (>4 mL) is suspected, extent must be determined by suitable method (e.g. Kleihauer-Betke acid elution test or flow cytometry) and additional doses of 50 IU (10 mcg) per 0.5 mL foetal RBC may be administered.
Routine antenatal prophylaxis of RhD immunisation in RhD negative women
Adult: Recommended dose: 500 IU given at both 28 and 34 weeks of gestation. Alternatively, 1,500 IU as single dose may be given between 28-30 weeks of gestation. Recommended dose range: 250-1,650 IU (50-330 mcg). Dosage may vary depending on the preparation used (refer to detailed product guideline).
Antenatal prophylaxis of RhD immunisation following complications of pregnancy in RhD negative women
Adult: Following any potential sensitising episode (e.g. stillbirth, abortion, amniocentesis) up to 20 weeks gestation: 250 IU as single dose to be given as soon as possible and within 72 hours. Following any potential sensitising episode (e.g. stillbirth, abortion, amniocentesis) after 20 weeks gestation: 500 IU as single dose to be given as soon as possible and within 72 hours. Doses may be repeated at 6- to 12-week intervals throughout pregnancy, if necessary. A test for the FMH size must be performed when administered after 20 weeks of gestation and additional doses may be administered as indicated. Doses may vary among countries, refer to specific product guideline.
Suppression of RhD immunisation following incompatible transfusions
Adult: In Rh(D)-negative individuals who undergone transfusions with Rh(D)-positive blood components: Recommended dose: 100 IU (20 mcg) per 2 mL of transfused Rh(D) positive blood or per 1 mL of RBC concentrate. Max: 15,000 units (3,000 mcg). Clinical evaluation is recommended to determine the dosage requirement. Dosage may vary depending on the preparation used (refer to detailed product guideline).
Idiopathic thrombocytopenic purpura
Adult: In Rh(D)-positive, non-splenectomised patients: Initially, 250 IU/kg (50 mcg/kg) as single dose or may be given in 2 divided doses on separate days. Maintenance dose: 125-300 IU/kg (25-60 mcg/kg) depending on clinical response. Patient with pre-existing anaemia (Hb <10 g/dL): Initially, 125-200 IU/kg (25-40 mcg/kg) as single dose or may be given in 2 divided doses on separate days.