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immune globulin IM (IGIM) (Rx)Brand and Other Names:Gamastan, IM Immune Globulins, more...ISG

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 150-180mg protein/mL
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Hepatitis A Pre-exposure Prophylaxis

Anticipated risk of exposure <3 months: 0.02 mL/kg  

Anticipated risk of exposure 3 months or greater: 0.06 mL/kg

Repeat dose q4-6months if exposure continues

Measles (Rubeola)

Prophylaxis (immunocompetent): 0.25 mL/kg/dose IM; not to exceed 15 mL; administer within 6 days of exposure  

Prophylaxis (immunocompromised): 0.5 mL/kg IM; not to exceed 15 mL; administer immediately following exposure

Rubella

Prophylaxis in pregnancy: 0.55 mL/kg/dose IM within 72 hr of exposure 

Varicella

Prophylaxis: 0.6-1.2 mL/kg IM within 72 hr of exposure if zoster Ig not available 

Immunoglobulin Deficiency

1.3 mL/kg IM initially; follow with 0.66 mL/kg/dose q3-4wk 

Other Indications & Uses

Postexposure prophylaxis

Agammaglobulinemia or hypogammaglobulinemia

Safety and efficacy not established

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Interactions

Interaction Checker

immune globulin IM (IGIM) and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10%

            Chills (8.9%)

            Headache (5.4%)

            Generalized pain (3.6%)

            Pain

            Muscle stiffness at IM injection site

            Urticaria

            Injection site pain

            Nausea/vomiting

            Fever

            Lethargy

            Anaphylaxis

            Angioneurotic edema

            Nephrotic syndrome

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            Warnings

            Black Box Warnings

            Thrombosis

            • Thrombosis may occur regardless of the route of administration
            • Risk factors include: advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, use of estrogens, indwelling central vascular catheters, hyperviscosity and cardiovascular risk factors
            • Thrombosis may occur in the absence of known risk factors
            • For patients at risk of thrombosis, administer at the minimum concentration available and at the minimum rate of infusion practicable
            • Ensure adequate hydration in patients before administration
            • Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk for hyperviscosity

            Contraindications

            Hypersensitivity to gamma globulin, thimerosal

            Isolated IgA deficiency

            Severe thrombocytopenia or coagulation disorders

            Hyperprolinemia (Hizentra contains the stabilizer L-proline)

            Cautions

            Doses >10 mg: use multiple injection sites (pain reduction)

            Thrombocytopenia or other bleeding disorders: bleeding risk

            IgA deficiency, coagulopathies

            Use IV form if higher levels or rapid action is needed

            Subcutaneous administration associated with increased risk of hematoma

            Postpone live virus vaccines for at least 3 months

            Hemolytic anemia reported (monitor)

            Aseptic meningitis syndrome reported

            Renal dysfunction or renal failure has been associated with IG therapy; monitor renal function and urine output

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Not known if excreted in breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Pooled human immune globulins from donors used as replacement therapy for primary and secondary immunodeficiencies, and IgG antibodies against viral, bacteria, parasitic, and mycoplasma antigens; provides passive immunity through an increase in atibody titer and antigen-antibody reaction potential

            Pharmacokinetics

            Half-Life: 23 days (IM); 14-24 days (IV)

            Onset: Immediate

            Duration: 3-4 weeks

            Vd: 0.09-0.13 L/kg

            Peak Plasma Time: 2.9 days

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            Formulary

            FormularyPatient Discounts

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            • View the formulary and any restrictions for each plan.
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            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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