vaccinia immune globulin intravenous (Rx)

Brand and Other Names:VIGIV
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 50mg/mL

Vaccinia Infection

6000 Units/kg IV; may require additional dose of 9000 Units/kg if patient unresponsive to lower dose

Renal Impairment

Use caution; administer at minimum rate of infusion; discontinue if renal deterioration worsens

Safety and efficacy not established

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Interactions

Interaction Checker

and vaccinia immune globulin intravenous

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%

            Abdominal pain

            Arthalgia

            Dizziness

            Headache

            Inj site reactions

            Nausea

            Dyspnea

            URI

            Contact dermatitis

            Erythema

            Flushing

            Skin lacerations

            Urticaria

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            Warnings

            Black Box Warnings

            Associated with renal dysfunction, acute renal failure, osmotic nephrosis, and death

            Administer IV at minimum concentration available and minimum rate of infusion in patients predisposed to acute renal failure; IVIG products containing sucrose as a stabilizer or at daily doses >400 mg/kg account for a disproportionate share of case reports involving renal failure

            Maltose in vaccinia immune globulin can interact with glucose monitoring and cause unncessary use of insulin

            Patients predisposed to acute renal failure

            • Any degree of preexisting renal insufficiency
            • Diabetes mellitus
            • Age >65 years
            • Volume depletion
            • Sepsis
            • Paraproteinemia
            • Currently taking nephrotoxic drugs

            Contraindications

            Hypersensitivity to immunoglobulins

            Presence of isolated vaccinia keratitis

            IGA deficiency

            Cautions

            Contains 5% sucrose as preservative. Immunoglobulins with sucrose preservative have been associated with ARF, renal dysfunction, osmotic nephrosis, proximal tubular nephropathy, & death

            Not effective against postvaccinial encephalitis

            Renal impairment & conditions that incr risk of renal impairment

            Vaccination with live viruses should be deferred for at least 6 mth postadministration

            Maltose in vaccinia immune globulin can cause false readings in glucose monitoring systems

            Derived from human plasma, small risk of viral transmission through admin

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: use caution

            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

            Human immune globulins from donors who received booster shots of vaccinia virus (Dryvax)

            Pharmacokinetics

            Half-Life: 13-67 days

            Peak plasma time: ≤ 2 hr

            Vd: 6630 L

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            Administration

            IV Administration

            Begin infusion within 6 hr of entering vial & complete within 12 hr of entering vial

            Infuse at 1 mL/kg/hr for first 30 min, THEN 2 mL/kg/hr for next 30 min, THEN 3 mL/kg/hr for the remainder

            Predilution not recommended

            Through dedicated IV catheter with in-line 0.22 micron filter OR

            IVPB into preexisting catheter if the catheter contains NS, D2.5W, D5W, D10W or D20W

            If using preexisting catheter flush catheter before use, and do not dilute VIGIV more than 1:2

            Adverse Event Management

            Reduce infusion rate or interrupt if minor

            In case of anaphylactoid reactions, may use epinephrine with or without diphenhydramine

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            Images

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • 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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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.