Names and pronunciation
WinRho SDF
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Drug reference
WinRho SDF
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Func. class.: Immune globulins
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ACTION: Suppresses immune response of nonsensitized Rho(D or Du)- negative patients who are exposed to Rho(D or Du)-positive blood
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USES: Prevention of isoimmunization in Rh-negative women given Rh-positive blood after abortions, miscarriages, amniocentesis; chronic idiopathic thrombocytopenia purpura (Rhophylac)
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CONTRAINDICATIONS: Previ ous immunization with this product, Rho(O)-positive/Du-positive patient
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Black Box Warning: Intravascular he- molysis Precautions: Pregnancy Black Box Warning: Requires a special- ized setting
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SIDE EFFECTS CNS: Lethargy, dizziness, headache CV: Hypo/hypertension INTEG: Irritation at inj site, fever MISC: Infection, ARDS, anaphylaxis, pul- monary edema, DIC MS: Myalgia, arthralgia HEMA: Anemia, DIC, intravascular hemolysis
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INTERACTIONS Decrease: antibody response—live virus vaccines (measles, mumps, rubella)
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DOSAGE AND ROUTES Rho (D) Immune globulin (for IM Only) • Adult: IM before delivery. Hyper- RHO S/D Full Dose, RhoGam 1 vial standard dose (300 mcg) at 26-28 wk; after delivery 1 vial standard dose (300 mcg) within 72 hr of delivery Pregnancy termination (<13 wk gestation) R • Adult: IM HyperRho Minidose, Mi- croRhoGam 1 vial microdose (50 mcg) within 72 hr of termination Pregnancy termination (>13 wk gestation) • Adult: IM HyperRHO S/D Full Dose, RhoGam 1 vial standard dose (300 mcg) within 72 hr of termination Massive fetomaternal hemorrhage (>15 mL) • Adult: IM RhoGam 20 mcg/mL of Rho(D) positive fetal RBCs Transfusion accident • Adult: IM Hyper Rho Full Dose, RhoGam (Rh+ blood given [volume] × Hct of donor blood)/15 will be the num- ber of vial needed (standard dose), round to next whole vial Rho(D) Immune Globulin IV (for IV/ IM use) • Adult: IM/IV WinRho SDF, 1500 IU (300 mcg) at 28 wk; after delivery 1 vial; after delivery 600 IU (120 mcg) within 72 hr of delivery Termination of pregnancy, amniocentesis • Adult: IM/IV WinRho SDF 600 IU (120 mcg) with 72 hr Amniocentesis, chorionic villus sampling • Adult: IM/IV WinRho SDF (<34 wk gestation) 1500 IU (300 mcg) repeat q12wk during pregnancy Massive fetomaternal hemorrhage (>15 mL)/transfusion accident • Adult: IM WinRho SDF 6000 IU (1200 mcg) repeat q12hr until total dose given by amount of blood loss; IM Win- Rho SDF 3000 IU (600 mcg) repeat q8hr until total dose is given by amount of blood loss Immune thrombocytopenic purpura (ITP) • Adult and child: IV WinRho SDF 250 IU (50 mcg)/kg, if HB <10g/dL use 25-40 mcg (125-200 IU), dosing deter- mined by clinical response
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Available forms: IM MICRhoGAM, HyperRho S/D: Minidose 50 mcg/vial; 300 mcg/vial standard dose; IM/IV 600 IU (120 mcg)/vial, 1500 IU (300 mcg)/ vial 2500 IU (500 mcg)/vial, 5000 IU (1000 mcg)/vial, 15,000 IU (3000 mcg)/vial; prefilled syringe 1500 IU (300 mcg/2 mL)
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Administer: • Store in refrigerator • HyperRHO S/D, MICRhoGAM, RhoGAM given by IM only; do not give IV • Do not confuse different types • Inspect for particulate matter; do not use if particulate matter present • Reconstitute/dilution: no reconstitu- tion or dilution needed for HyperRHO SD; MICRhoGAM, RhoGAM, or liquid for- mulation of WinRho SDF IM route • Use aseptic technique, observe for 20 min after administration • Bring Rhophylac to room temperature before use • Inject into deltoid muscle of upper arm or anterolateral portion of upper thigh; do not inject into gluteal muscle • If dose calculated requires multiple vi- als or syringes, use different sites at same time IV route • Use aseptic technique • WinRho SDF: remove entire contents of vial to obtain calculated dose; if partial vial required for dosage calculation, withdraw entire vial contents to ensure correct calculation; infuse correct calcu- lated dose over 3-5 min; do not infuse with other fluids, products • Rhophylac: bring to room temperature; infuse by slow IV; observe for 20 min
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Assess: • Allergies, reactions to immunizations; previous immunization with product • Intravascular hemolysis: back pain, chills, hemoglobinuria, renal insufficien- cy; usually when WinRho SDF is given in those with immune thrombocytopenia purpura • Type, crossmatch mother and newborn’s cord blood; if mother Rho (D)-negative, Du- negative and newborn Rho (D)-positive, product should be given
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Evaluate: • Rho(D) sensitivity in transfusion error, prevention of erythroblastosis fetalis for normal vision
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • How product works; that product must be given after subsequent deliveries if subsequent babies are Rh-positive • To report immediately: shaking, fever, chills, dark urine, swelling of hands or feet, back pain, SOB (intravascular hemolysis)
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• Adult and child: IV WinRho SDF 250 IU (50 mcg)/kg, if HB <10g/dL use 25-40 mcg (125-200 IU), dosing deter- mined by clinical response
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