rho(d) immune globulin

IM:

REMS

IV: Administered to Rh_o(D)-negative patients who have been exposed to Rh_o(D)-positive blood by:
- Pregnancy or delivery of a Rh_o(D)-positive infant,
- Abortion of a Rh_o(D)-positive fetus,
- Fetal-maternal hemorrhage due to amniocentesis, other obstetrical manipulative procedure, or intra-abdominal trauma while carrying a Rh_o(D)-positive fetus,
- Transfusion of Rh_o(D)-positive blood or blood products to a Rh_o(D)-negative patient.
IV: Management of immune thrombocytopenic purpura (ITP).

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Prior hypersensitivity reaction to human immune globulin;
Rh_o(D)- or Du-positive patients.

Use Cautiously in:

ITP patients with pre-existing anemia (decrease dose if Hgb <10 g/dL). May also cause disseminated intravascular coagulation in ITP patients.

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypertension, hypotension

Derm: rash

GI: diarrhea, nausea, vomiting

GU: acute renal failure

Hemat: anemia, ITPDISSEMINATED INTRAVASCULAR COAGULATION, INTRAVASCULAR HEMOLYSIS

Local: pain at injection site

MS: arthralgia, myalgia

Neuro: dizziness, headache

Misc: fever

Interactions ⬆ ⬇

Drug-drug:

May ↓ antibody response to some live-virus vaccines (measles, mumps, rubella).

Availability ⬆ ⬇

Rho(D) Immune Globulin (for IM Use)

Solution for injection (prefilled syringes): 50 mcg (microdose—MICRhoGAM, HyperRHO S/D Mini-Dose); 300 mcg (standard dose—RhoGAM, HyperRHO S/D Full Dose)

Rho(D) Immune Globulin Intravenous (for IM or IV Use)

Injection: 300 mcg/vial; 500 mcg/vial; 3000 mcg/vial
Prefilled syringes: 300 mcg/2 mL

Route/Dosage ⬆ ⬇

Rho(D) Immune Globulin (for IM use only)

Following Delivery
IM (Adults ): HyperRHO S/D Full Dose, RhoGAM: 1 vial standard dose (300 mcg) within 72 hr of delivery.
Before Delivery
IM (Adults ): HyperRHO S/D Full Dose, RhoGAM: 1 vial standard dose (300 mcg) at 26–28 wk.
Termination of Pregnancy (<13 wk Gestation)
IM (Adults ): HyperRHO S/D Mini-Dose, MICRhoGAM: 1 vial of microdose (50 mcg) within 72 hr.
Termination of Pregnancy (>13 wk Gestation)
IM (Adults ): RhoGAM: 1 vial standard dose (300 mcg) within 72 hr.
Large Fetal-Maternal Hemorrhage (>15 mL)
IM (Adults ): RhoGAM: 20 mcg/mL of Rh_o(D)-positive fetal RBCs.
Transfusion Accident
IM (Adults ): HyperRHO S/D Full Dose, RhoGAM: (Volume of Rh-positive blood administered × Hct of donor blood)/15 = number of vials of standard dose (300 mcg) preparation (round to next whole number of vials).

Rho(D) Immune Globulin IV (for IM or IV Use)

Following Delivery
IM IV (Adults ): WinRho SDF: 120 mcg within 72 hr of delivery. Rhophylac: 300 mcg within 72 hr of delivery.
Prior to Delivery
IM IV (Adults ): WinRho SDF, Rhophylac: 300 mcg at 28 wk; if initiated earlier in pregnancy, repeat every 12 wk.
Following Amniocentesis or Chorionic Villus Sampling
IM IV (Adults ): WinRho SDF (before 34 wk gestation): 300 mcg immediately; repeat every 12 wk during pregnancy. Rhophylac: 300 mcg within 72 hr of procedure.
Termination of Pregnancy, Amniocentesis, or Any Other Manipulation
IM IV (Adults ): WinRho SDF: 120 mcg within 72 hr after event.
Large Fetal-Maternal Hemorrhage/Transfusion Accident
IM (Adults ): WinRho SDF: 1200 mcg every 12 hr until total dose is given (total dose determined by amount of blood loss/hemorrhage).
IV (Adults ): WinRho SDF: 600 mcg every 8 hr until total dose is given (total dose determined by amount of blood loss/hemorrhage).
Immune Thrombocytopenic Purpura
IV (Adults and Children ): WinRho SDF, Rhophylac: 50 mcg/kg initially (if Hgb <10 g/dL, ↓ dose to 25–40 mcg/kg); further dosing/frequency determined by clinical response (range 25–60 mcg/kg). Each dose may be given as a single dose or in 2 divided doses on separate days.

US Brand Names ⬆ ⬇

Rho(D) immune globulin standard dose IM: HyperRHO S/D Full Dose, RhoGAM,

Rho(D) immune globulin microdose IM: HyperRHO S/D Mini-Dose, MICRhoGAM,

Rho(D) immune globulin IV: WinRho SDF,

Rho(D) immune globulin microdose IM, IV: Rhophylac

Action ⬆ ⬇

Prevent production of anti-Rh_o(D) antibodies in Rh_o(D)-negative patients who were exposed to Rh_o(D)-positive blood.
Increase platelet counts in patients with ITP.

Therapeutic effects:

Prevention of antibody response and hemolytic disease of the newborn (erythroblastosis fetalis) in future pregnancies of women who have conceived a Rh_o(D)-positive fetus.
Prevention of Rh_o(D) sensitization following transfusion accident.
Decreased bleeding in patients with ITP.

ROUTE	ONSET	PEAK	DURATION
IM	rapid	5–10 days	unknown
IV‡	unknown	2 hr	unknown

section name header

Indications ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇

Availability ⬆ ⬇

Route/Dosage ⬆ ⬇

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Classifications ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Pronunciation ⬆