Usual Adult Dose for Hepatitis A

Household and institutional hepatitis A contacts: 0.1 mL/kg intramuscularly

Persons traveling to areas where hepatitis A is common:

• Dosing is based on length of stay

Up to 1 month: 0.1 mL/kg intramuscularly
Up to 2 months: 0.2 mL/kg intramuscularly
Longer than 2 months: 0.2 mL/kg intramuscularly every 2 months

Comments:

• Routine passive protection is recommended in persons exposed less than 1 week previously in the following categories: household contacts of an index case who have not had hepatitis A or have no serological evidence of immunity; common sources of exposure such as food or water as an infection source for multiple hepatitis cases; institutional contacts; staff in institutions where hepatitis is endemic.
• Routine prophylaxis is not recommended for school, office, factory, or hospital contacts.
• Prophylactic value is greatest when given before or soon after hepatitis A exposure.
• It is not indicated in patients with clinical manifestations of hepatitis A or in those exposed more than 2 weeks previously.
• Do not use for hepatitis B prophylaxis.

Usual Adult Dose for Measles

0.25 mL/kg intramuscularly

Comments:

• A susceptible person is one who has not been vaccinated and has not had measles previously.
• It may be especially indicated for susceptible household contacts of measles patients, particularly under 1 year of age, for whom complication risk is highest.
• DO NOT give at the same time as the measles vaccine.
• This drug is recommended in immunosuppressed contacts of the index case.

Use(s): To prevent or modify measles in a susceptible person exposed fewer than 6 days previously.

Usual Adult Dose for Rubella

Women who will not consider a therapeutic abortion: 0.55 mL/kg intramuscularly

Comments:

• This drug may be of benefit in women exposed to rubella in the first trimester of pregnancy who will not consider a therapeutic abortion.
• This drug is not indicated for routine prophylaxis or treatment of rubella.
• Although this drug can prevent or modify clinical disease in susceptible contacts if given within 72 hours of exposure, it does not prevent viremia in such patients.
• Do not rely on this drug to prevent congenital malformations from rubella if given to susceptible pregnant women during the first trimester.

Usual Adult Dose for Varicella-Zoster

0.6 to 1.2 mL/kg intramuscularly

Comments:

• This drug may be considered for use in immunocompromised patients for passive immunization against varicella if Varicella-Zoster immune globulin (human) is not available.
• This drug is not indicated for routine prophylaxis or treatment of varicella.
• For patients at risk of thrombosis, administer at the lower range of the recommended dose.

Usual Pediatric Dose for Hepatitis A

Household and institutional hepatitis A contacts: 0.1 mL/kg intramuscularly

Persons traveling to areas where hepatitis A is common:

• Dosing is based on length of stay

Up to 1 month: 0.1 mL/kg intramuscularly
Up to 2 months: 0.2 mL/kg intramuscularly
Longer than 2 months: 0.2 mL/kg intramuscularly every 2 months

Comments:

• Routine passive protection is recommended in persons exposed less than 1 week previously in the following categories: household contacts of an index case who have not had hepatitis A or have no serological evidence of immunity; common sources of exposure such as food or water as an infection source for multiple hepatitis cases; institutional contacts; staff in institutions where hepatitis is endemic.
• Routine prophylaxis is not recommended for school, office, factory, or hospital contacts.
• Prophylactic value is greatest when given before or soon after hepatitis A exposure.
• It is not indicated in patients with clinical manifestations of hepatitis A or in those exposed more than 2 weeks previously.
• Do not use for hepatitis B prophylaxis.

Usual Pediatric Dose for Measles

0.25 mL/kg intramuscularly

Immunocompromised child: 0.5 mL/kg intramuscularly immediately
Maximum dose: 15 mL

Comments:

• A susceptible person is one who has not been vaccinated and has not had measles previously.
• It may be especially indicated for susceptible household contacts of measles patients, particularly under 1 year of age, for whom complication risk is highest.
• DO NOT give at the same time as the measles vaccine.
• If a child older than 12 months is given this drug, s/he should be given measles vaccine about 3 months later when the measles antibody titer will have disappeared.
• If a susceptible child exposed to measles is immunocompromised, give this drug immediately.
• Do not administer measles vaccine or any other live viral vaccine to children who are immunocompromised.
• This drug is recommended in children under 6 months of age whose mothers have not had the disease, in children from 6 months to 3 years who have not been actively immunized, and in immunosuppressed contacts of the index case.

Use(s): To prevent or modify measles in a susceptible person exposed fewer than 6 days previously.

Usual Pediatric Dose for Varicella-Zoster

0.6 to 1.2 mL/kg intramuscularly

Comments:

• This drug may be considered for use in immunocompromised patients for passive immunization against varicella if Varicella-Zoster immune globulin (human) is not available.
• This drug is not indicated for routine prophylaxis or treatment of varicella.
• For patients at risk of thrombosis, administer at the lower range of the recommended dose.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

US BOXED WARNING(S): THROMBOSIS

• Thrombosis may occur with immune globulin products.
• Risk factors include: advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, estrogen use, indwelling central venous catheters, hyperviscosity, and cardiovascular risk factors.
• Thrombosis may occur in the absence of known risk factors.

Recommendations:

• For patients at risk of thrombosis, do not exceed the recommended dose.
• Ensure adequate hydration of patients before administration.
• Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk for hyperviscosity.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• For intramuscular administration only, preferably in the anterolateral aspects of the upper thigh and the deltoid muscle of the upper arm.
• Do not inject into the gluteal region because of the risk of injury to the sciatic nerve.
• Do not administer subcutaneously or intravenously because of a risk for serious reactions (e.g. renal dysfunction/failure/hemolysis, transfusion related lung injury).
• Do not inject into a blood vessel.
• Draw back on the plunger of the syringe before injection to be certain the needle is not in a blood vessel.
• This drug is not standardized with respect to antibody titers against hepatitis B surface antigen; do not use for prophylaxis of hepatitis B.
• This product is not indicated for routine prophylaxis of poliomyelitis or mumps, nor for allergy or asthma in patients with normal immunoglobulin levels.

Storage requirements:

• Refrigerate; do not freeze