Drug reference

Antithymocyte immunoglobulin (rabbit)

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 903

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Prophylaxis of organ rejection in heart allograft recipients ▶BY INTRAVENOUS INFUSION ▶Adult: 1–2.5 mg/kg daily for 3–5 days, to be given over at least 6 hours Prophylaxis of organ rejection in renal allograft recipients ▶BY INTRAVENOUS INFUSION ▶Adult: 1–1.5 mg/kg daily for 3–9 days, to be given over at least 6 hours Treatment of corticosteroid-resistant allograft rejection in renal transplantation ▶BY INTRAVENOUS INFUSION ▶Adult: 1.5 mg/kg daily for 7–14 days, to be given over at least 6 hours DOSES AT EXTREMES OF BODY-WEIGHT ▶To avoid excessive dosage in obese patients, calculate dose on the basis of ideal body weight.

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Contra Indications

Infection

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National Funding Access Decisions

NICE decisions ▶Immunosuppressive therapy for kidney transplant in adults (October 2017) NICE TA481 Antithymocyte immunoglobulin (rabbit) is not recommended as an initial treatment to prevent organ rejection in adults having a kidney transplant. Patients Immune system and malignant disease whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding arrangements, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/TA481

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Safety

Interactions

→Appendix 1: immunoglobulins

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Side Effects

▶Common or very common Chills. diarrhoea. dysphagia. dyspnoea. fever. hypotension. infection. lymphopenia. myalgia. nausea. neoplasm malignant. neoplasms. neutropenia. reactivation of infection. secondary malignancy. sepsis. skin reactions. thrombocytopenia. vomiting ▶Uncommon Cytokine release syndrome. hepatic disorders. hypersensitivity. infusion related reaction SIDE-EFFECTS, FURTHER INFORMATION Tolerability is increased by pretreatment with an intravenous corticosteroid and antihistamine; an antipyretic drug such as paracetamol may also be beneﬁcial.

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Pregnancy

Manufacturer advises use only if potential beneﬁt outweighs risk—no information available.

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Breast Feeding

Manufacturer advises avoid—no information available.

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Monitoring Requirements

Monitor blood count.

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Dose and formulations

Directions For Administration

For continuous intravenous infusion (Thymoglobuline ®) in Glucose 5% or Sodium chloride 0.9%; reconstitute each vial with 5 mL water for injections to produce a solution of 5 mg/mL; gently rotate to dissolve. Dilute requisite dose with infusion ﬂuid to a total volume of 50–500 mL (usually 50 mL/vial); begin infusion immediately after dilution; give through an in-line ﬁlter (pore size 0.22 micron); not to be given with unfractionated heparin and hydrocortisone in glucose infusion—precipitation reported.

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Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Powder and solvent for solution for infusion ▶Thymoglobulin (Sanofi) Antithymocyte immunoglobulin (rabbit) 25 mg Thymoglobuline 25mg powder and solvent for solution for infusion vials | 1 vial P £158.77 (Hospital only) IMMUNOSUPPRESSANTS › ANTIMETABOLITES

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Dose text by age group

Adult

1–2.5 mg/kg daily for 3–5 days, to be given over

First-line fragment. Read the complete Indications and Dose section above.

PDF page 903

Adult

1–1.5 mg/kg daily for 3–9 days, to be given over

First-line fragment. Read the complete Indications and Dose section above.

PDF page 903

Adult

1.5 mg/kg daily for 7–14 days, to be given over at

First-line fragment. Read the complete Indications and Dose section above.

PDF page 903

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Antithymocyte immunoglobulin (rabbit)

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 903

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 903

Contra Indications

Infection

PDF page 903

National Funding Access Decisions

PDF page 903

Safety

Interactions

→Appendix 1: immunoglobulins

PDF page 903

Side Effects

PDF page 903

Pregnancy

Manufacturer advises use only if potential beneﬁt outweighs risk—no information available.

PDF page 903

Breast Feeding

Manufacturer advises avoid—no information available.

PDF page 903

Monitoring Requirements

Monitor blood count.

PDF page 903

Dose and formulations

Directions For Administration

PDF page 903

Medicinal Forms

PDF page 903

Dose text by age group

Adult

1–2.5 mg/kg daily for 3–5 days, to be given over

First-line fragment. Read the complete Indications and Dose section above.

PDF page 903

Adult

1–1.5 mg/kg daily for 3–9 days, to be given over

First-line fragment. Read the complete Indications and Dose section above.

PDF page 903

Adult

1.5 mg/kg daily for 7–14 days, to be given over at

First-line fragment. Read the complete Indications and Dose section above.

PDF page 903

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.