Anti-Rho(D) Immunoglobulin
Indications
Anti-Rho(D) Immunoglobulin is used for:
Hemolytic disease of newborn, Idiopathic thrombocytopenic purpura
Adult Dose
Intramuscular
Transfusion of D-positive blood components to rhesus-negative women of child-bearing potential
Adult: 125 units/ml of transferred cells.
Prevent formation of antibodies against fetal rhesus-positive RBCs in a rhesus-negative mother during childbirth, abortion or certain other sensitising events
Adult: 500 units as soon as possible after birth. An additional dose may be required depending on the amount of transplacental bleeding as assessed by the Kleihauer test; for bleeds >4 ml, an additional 125 units for each ml of RBCs will be required.
Routine antenatal prophylaxis
Adult: 2 doses of 500 units to be given at wk 28th and 34th of gestation.
Intravenous
Idiopathic thrombocytopenic purpura
Adult: Initially, 250 units/kg, may be given in 2 divided doses on separate days. Maintenance doses: 125-300 units/kg depending on the clinical response.
Child Dose
Renal Dose
Administration
Contra Indications
Contraindicated in Rh-positive individuals.
Precautions
For intramuscular use only, do not inject intravenously.
In the case of postpartum use, the product is intended for maternal administration.
Do not inject the newborn infant.
Patients should be observed for at least 20 minutes after administration.
Administer with caution to patients who have had prior severe systemic allergic reactions to human immune globulin.
RhoGAM / MICRhoGAM contain a small quantity og IgA. There is a potential risk of hypersensitivity in IgA deficient individuals.
Patients treated for Rh-incompatible transfusion should be monitored by clinical and laboratory means for signs and symptoms of a hemolytic reaction.
Lactation: not known if excreted in breast milk, no adverse effects reported
Pregnancy-Lactation
Interactions
Live vaccines should only be admin at least 3 mth after the last dose of immunoglobulin admin.
Adverse Effects
Side effects of Anti-Rho(D) Immunoglobulin :
The most frequently reported AEs are anti-D formation and injection site reactions, such as swelling, induration, redness and mild pain or warmth. Possible systemic reactions are skin rash, body aches or a slight elevation in temperature. Severe systemic allergic reactions are extremely rare. Patients should be observed for at least 20 minutes after administration.
Patients who are Rh-positive or have received Rh-positive red blood cells may result in signs and symptoms of a hemolytic reaction, including fever, back pain, nausea and vomiting, hypo- or hypertension, hemoglobinuria/emia, elevated bilirubin and creatinine and decreased haptoglobin.
Potentially Fatal: Intravascular haemolysis. Anaphylaxis reactions.
Mechanism of Action
Anti-D immunoglobulin prevents a rhesus-negative mother from actively forming antibodies to foetal rhesus-positive RBCs that may pass into the maternal circulation during childbirth, abortion, or certain other sensitising events. It is also used in idiopathic thrombocytopenic purpura to prevent excessive bleeding.