Antithymocyte immunoglobulin, rabbit


Generic Medicine Info
Indications and Dosage
Intravenous
Prophylaxis of rejection in kidney graft transplant
Adult: In combination with other immunosuppressants: 1-1.5 mg/kg daily for 3-9 days via infusion over at least 6 hours for the 1st dose and at least 4 hours on subsequent doses, using an in-line 0.22 micron filter. Pre-medicate with antihistamine, antipyretic, and/or corticosteroid.
Child: Same as adult.

Intravenous
Prophylaxis of rejection in cardiac graft transplant
Adult: In combination with other immunosuppressants: 1-2.5 mg/kg daily for 3-5 days via infusion over at least 6 hours for the 1st dose and at least 4 hours on subsequent doses, using an in-line 0.22 micron filter. Pre-medicate with antihistamine, antipyretic, and/or corticosteroid.
Child: Same as adult.

Intravenous
Treatment of kidney transplant rejection
Adult: In corticosteroid-resistant cases (in combination with other immunosuppressants): 1.5 mg/kg daily for 7-14 days via infusion over at least 6 hours for the 1st dose and at least 4 hours on subsequent doses, using an in-line 0.22 micron filter. Pre-medicate with antihistamine, antipyretic, and/or corticosteroid.
Child: Same as adult.
Reconstitution
Reconstitute powder with 5 mL of sterile water for injection and further dilute with NaCl 0.9% or glucose 5% to a total volume of 50-500 mL.
Incompatibility
Incompatible with heparin and hydrocortisone in dextrose infusion solution.
Contraindications
Hypersensitivity to rabbit proteins. Active, acute or chronic infections which contraindicate additional immunosuppression. Lactation. Concurrent vaccination with live viral vaccines.
Special Precautions
Patient with severe neutropenic aplastic anaemia. Hepatic impairment. Children. Pregnancy.
Adverse Reactions
Significant: Haematologic effects (e.g. thrombocytopenia, leucopenia, neutropenia, lymphopaenia), severe infections, risk of transmission of infectious agents.
Blood and lymphatic system disorders: Anaemia, leukocytosis.
Cardiac disorders: Tachycardia.
Gastrointestinal disorders: Abdominal pain, nausea, diarrhoea, vomiting, constipation, dyspepsia.
General disorders and administration site conditions: Pain, malaise, fever.
Infections and infestations: Cytomegalovirus disease, sepsis, intestinal candidiasis, herpes simplex.
Metabolism and nutrition disorders: Peripheral oedema, hyper/hypokalaemia, acidosis, hypophosphataemia, anorexia.
Musculoskeletal and connective tissue disorders: Chills.
Nervous system disorders: Headache.
Psychiatric disorders: Insomnia, anxiety.
Respiratory, thoracic and mediastinal disorders: Dyspnoea, pulmonary disease, chest pain, cough.
Skin and subcutaneous tissue disorders: Rash, diaphoresis, acne vulgaris, pruritus.
Vascular disorders: Hypo/hypertension.
Potentially Fatal: Anaphylactic reactions, infusion related reactions (e.g. severe cytokine release syndrome (CRS) associated with cardiopulmonary events), malignancies (e.g. lymphoma, lymphoproliferative disorders).
Patient Counseling Information
This drug may cause adverse events which may impair ability to drive or operate machinery.
Monitoring Parameters
Monitor lymphocyte count, complete blood count with differential, platelet count, coagulation parameters; vital signs and symptoms of anaphylaxis during and after infusion; signs and symptoms of infection.
Drug Interactions
Potentially Fatal: May diminish the therapeutic effect and enhance the toxic effect of live vaccines.
Lab Interference
May interfere with rabbit antibody-based immunoassays and with cross-match or panel-reactive antibody cytotoxicity assays.
Action
Description: Antithymocyte immunoglobulin is a polyclonal preparation derived from rabbit antibodies. It causes immunosuppression, mostly acting on T-lymphocytes, leading to T-cell depletion and down modulation of adhesion molecules resulting in interference of rejection pathways.
Synonym: antilymphocyte immunoglobulin, rabbit.
Onset: T-cell depletion: Within 24 hours.
Duration: Lymphopaenia: Up to 1 year.
Pharmacokinetics:
Excretion: Elimination half-life: 2-3 days.
Storage
Store between 2-8°C. Do not freeze. Protect from light.
MIMS Class
ATC Classification
L04AA04 - antithymocyte immunoglobulin (rabbit) ; Belongs to the class of selective immunosuppressive agents. Used to induce immunosuppression.
References
Anon. Antithymocyte Globulin (Rabbit). AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 05/06/2018.

Anon. Antithymocyte Globulin (Rabbit). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 05/06/2018.

Buckingham R (ed). Antilymphocyte Immunoglobulins. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/06/2018.

Joint Formulary Committee. Antithymocyte Immunoglobulin (Rabbit). British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/06/2018.

Thymoglobulin Injection, Powder, Lyophilized, for Solution (Genzyme Corporation). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 05/06/2018.

Disclaimer: This information is independently developed by MIMS based on Antithymocyte immunoglobulin, rabbit from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 MIMS. All rights reserved. Powered by MIMS.com
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in