Drug Class: Immune globulins
Usual Adult Dose for CMV Prophylaxis
Kidney transplant:
Within 72 hours of transplant: 150 mg/kg
2 weeks post transplant: 100 mg/kg
4 weeks post transplant: 100 mg/kg
6 weeks post transplant: 100 mg/kg
8 weeks post transplant: 100 mg/kg
12 weeks post transplant: 50 mg/kg
16 weeks post transplant: 50 mg/kg
Maximum dose: 150 mg immunoglobulin/kg
Liver, pancreas, lung, or heart transplant:
Within 72 hours of transplant: 150 mg/kg
2 weeks post transplant: 150 mg/kg
4 weeks post transplant: 150 mg/kg
6 weeks post transplant: 150 mg/kg
8 weeks post transplant: 150 mg/kg
12 weeks post transplant: 100 mg/kg
16 weeks post transplant: 100 mg/kg
Maximum dose: 150 mg immunoglobulin/kg
Comments:
- In organ transplants other than kidney from cytomegalovirus seropositive donors into seronegative recipients, consider using prophylactically in combination with ganciclovir.
Use: Prophylaxis of cytomegalovirus disease associated with transplantation of kidney, lung, liver, pancreas, and heart
Usual Pediatric Dose for CMV Prophylaxis
Kidney transplant:
Within 72 hours of transplant: 150 mg/kg
2 weeks post transplant: 100 mg/kg
4 weeks post transplant: 100 mg/kg
6 weeks post transplant: 100 mg/kg
8 weeks post transplant: 100 mg/kg
12 weeks post transplant: 50 mg/kg
16 weeks post transplant: 50 mg/kg
Maximum dose: 150 mg immunoglobulin/kg
Liver, pancreas, lung, or heart transplant:
Within 72 hours of transplant: 150 mg/kg
2 weeks post transplant: 150 mg/kg
4 weeks post transplant: 150 mg/kg
6 weeks post transplant: 150 mg/kg
8 weeks post transplant: 150 mg/kg
12 weeks post transplant: 100 mg/kg
16 weeks post transplant: 100 mg/kg
Maximum dose: 150 mg immunoglobulin/kg
Comments:
- In organ transplants other than kidney from cytomegalovirus seropositive donors into seronegative recipients, consider using prophylactically in combination with ganciclovir.
Use: Prophylaxis of cytomegalovirus disease associated with transplantation of kidney, lung, liver, pancreas, and heart
Renal Dose Adjustments
Use with caution.
- Administer at the minimum concentration and minimum infusion rate practicable.
- Consider discontinuation if renal function deteriorates.
- Make sure patients are not volume depleted prior to infusion.
Liver Dose Adjustments
Data not available
Dose Adjustments
Minor side effects: Slow the administration rate immediately; consider temporary interruption of the infusion.
Precautions
CONTRAINDICATIONS:
- History of severe reactions to this or other human immunoglobulin preparations
- Selective immunoglobulin A deficiency patients have the potential for developing antibodies and could have an anaphylactic reaction to subsequent doses of immunoglobulin A containing products.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Only for intravenous administration.
- Initial dose should be administered at 15 mg/kg/hour; if no adverse reactions after 30 minutes, may increase to 30 mg/kg/hour; if no adverse reactions after another 30 minutes, may increase to 60 mg/kg/hour.
- Subsequent doses should be administered at 15 mg/kg/hour; if no adverse reactions after 15 minutes, may increase to 60 mg/kg/hour.
- Maximum administration rate: 75 mL/hour
Storage requirements:
- Refrigerate
Reconstitution/preparation techniques:
- Do not shake vial; avoid foaming
- Infusion should start within 6 hours of entering the vial and should be completed within 12 hours of entering the vial.
Monitoring:
- Take vital signs pre-infusion, midway, and post-infusion, as well as before any rate increase.
- Monitor closely during and after each rate change.
