Renal Allograft Recipients: 10 to 15 mg/kg daily for 14 days (14 doses) followed by alternate day therapy for further 14 days (7 doses) bringing the total doses to 21 in 28 days.
In children, doses in the range of 5 to 25 mg/kg daily have been administered and in adult renal allograft recipients doses of 10 to 30 mg/kg daily have been administered. When given to delay onset of first rejection episode, start therapy within 24 hours before or after transplant. When given to treat rejection, start therapy at time of diagnosis of the first rejection episode.
Thymogam can also be used concomitantly with azathioprine and corticosteroids which are also used to suppress the immune response.
Aplastic Anaemia Recipients: 10 to 20 mg/kg daily for 8-14 days followed by alternate day therapy for a total of 21 doses. These patients are to be monitored continuously for thrombocytopenia. When administered with a regime of supportive care it may induce partial to complete haematological remission.
Administration: Thymogam should be diluted before use in 0.9% Sodium Chloride Injection, 5% Dextrose and 0.225% Sodium Chloride, or 5% Dextrose and 0.45% Sodium Chloride Injection to a concentration not to exceed 4 mg of Antithymocyte Globulin per mL. The diluted solution should be gently rotated or swirled to effect thorough mixing and allowed to reach room temperature before infusion. Thymogam is appropriately administered into a vascular shunt, arterial venous fistula, or a high-flow central vein through an in-line filter with a pore size of 0.2 to 1.0 micron. Thymogam once diluted has been shown to be physically and chemically stable for up to 24 hours at concentrations of up to 4 mg/mL in the diluents recommended.
Adding Thymogam only to dextrose injection is not recommended, as a low salt concentrations can cause precipitation. Highly acidic infusion solutions can also contribute to physical instability over time. It is recommended that diluted Thymogam be stored in a refrigerator and be used within 24 hours.