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.

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.

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.

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

• Refrigerate

• 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.

• Take vital signs pre-infusion, midway, and post-infusion, as well as before any rate increase.
• Monitor closely during and after each rate change.