cytomegalovirus immune globulin

REMS

Prevention of cytomegalovirus (CMV) disease associated with transplantation of kidney, lung, liver, pancreas, or heart (if transplant is other than kidney from CMV-positive donors to CMV-negative recipient, then concurrent ganciclovir should be considered).

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to immune globulins or albumin;
Selective IgA deficiency.

Use Cautiously in:

OB: Lactation: Pregnancy or lactation (safety not established);
Renal insufficiency or predisposition to acute renal failure.

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypotension, thromboembolism

Derm: flushing, rash

GI: hepatic dysfunction, nausea, vomiting

GU: acute renal failure, anuria, oliguria

Hemat: hemolysis, leukopenia, pancytopenia

MS: back pain, muscle cramps

Neuro: anxiety, headache, seizures, tremor

Resp: dyspnea, pulmonary edema, wheezing

Misc: allergic reactions including chills, ANAPHYLAXIS, fever

Interactions ⬆ ⬇

Drug-drug:

May interfere with immune response to some live-virus vaccines including measles, mumps, and rubella (MMR; do not administer within 3 mo of immune globulin).

Availability ⬆ ⬇

Powder for injection: 1000-mg vial; 2500-mg vial

Route/Dosage ⬆ ⬇

Kidney Transplant

IV (Adults ): 150 mg/kg within 72 hr of transplantation, followed by 100 mg/kg at 2, 4, 6, and 8 wk, then 50 mg/kg at 12 and 16 wk post-transplantation.

Liver, Pancreas, Lung, or Heart Transplant

IV (Adults ): 150 mg/kg within 72 hr of transplantation, and at 2, 4, 6, and 8 wk, then 100 mg/kg after at 12 and 16 wk post-transplantation.
IV (Children ): Safety and efficacy has not been established in pediatrics, however adult doses have been used in children.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Consists of IgG antibodies capable of providing passive immunity against CMV disease.

Therapeutic effects:

Prevention of serious sequelae of CMV disease in transplant patients.

Classifications ⬆ ⬇

Therapeutic Classification: vaccines/immunizing agents

Pharmacologic Classification: immune globulins

Pharmacokinetics ⬆ ⬇

Absorption: Administered IV only, resulting in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: 7 days.

Time/Action Profile ⬆ ⬇

(CMV antibody titers)

ROUTE	ONSET	PEAK	DURATION
IV	rapid	unknown	unknown

Patient/Family Teaching ⬆ ⬇

Instruct patient to notify health care professional if any adverse reactions occur.
If live virus vaccines were administered within 14 days of immune globulin, vaccination should be repeated 3 mo after the last dose of immune globulin.

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Indications ⬇