Drug Detail:Privigen (Immune globulin (igiv) (intravenous) [ im-myoon-glob-yoo-lin ])
Generic Name: Human Immunoglobulin G 5g in 50mL
Dosage Form: injection
Drug Class: Immune globulins
| Indication | Dose | Initial infusion rate | Maintenance infusion rate (as tolerated) |
|---|---|---|---|
| Primary Immunodeficiency | 200-800 mg/kg (2-8 mL/kg) every 3-4 weeks |
0.5 mg/kg/min (0.005 mL/kg/min) |
Increase to 8 mg/kg/min (0.08 mL/kg/min) |
| Chronic Immune Thrombocytopenic Purpura | 1 g/kg (10 mL/kg) for 2 consecutive days | 0.5 mg/kg/min (0.005 mL/kg/min) |
Increase to 4 mg/kg/min (0.04 mL/kg/min) |
| Chronic Inflammatory Demyelinating Polyneuropathy | Loading dose: 2 g/kg (20 mL/kg) in divided doses over 2 to 5 consecutive days Maintenance dose: 1 g/kg (10 mL/kg) administered in 1 to 2 infusions on consecutive days, every 3 weeks |
0.5 mg/kg/min (0.005 mL/kg/min) |
Increase to 8 mg/kg/min (0.08 mL/kg/min) |
Dosage for Primary Humoral Immunodeficiency (PI)
As there are significant differences in the half-life of IgG among patients with PI, the frequency and amount of immunoglobulin therapy may vary from patient to patient. The proper amount can be determined by monitoring clinical response.
The recommended dose of PRIVIGEN for patients with PI is 200 to 800 mg/kg (2 to 8 mL/kg), administered every 3 to 4 weeks. If a patient misses a dose, administer the missed dose as soon as possible, and then resume scheduled treatments every 3 or 4 weeks, as applicable.
Adjust the dosage over time to achieve the desired serum IgG trough levels and clinical responses. No randomized, controlled trial data are available to determine an optimal trough level in patients receiving immune globulin therapy.
Measles Exposure
If a patient has been exposed to measles, it may be prudent to administer an extra dose of Immune Globulin Intravenous as soon as possible and within 6 days of exposure. A dose of 400 mg/kg should provide a serum level > 240 mIU/mL of measles antibodies for at least two weeks.
If a patient is at risk of future measles exposure and receives a dose of less than 530 mg/kg every 3-4 weeks, the dose should be increased to at least 530 mg/kg. This should provide a serum level of 240 mIU/mL of measles antibodies for at least 22 days after infusion.
Dosage for Chronic Immune Thrombocytopenic Purpura (ITP)
The recommended dose of PRIVIGEN for patients with chronic ITP is 1 g/kg (10 mL/kg) administered daily for 2 consecutive days, resulting in a total dosage of 2 g/kg.
Carefully consider the relative risks and benefits before prescribing the high dose regimen (e.g., 1 g/kg/day for 2 days) in patients at increased risk of thrombosis, hemolysis, acute kidney injury, or volume overload [see Warnings and Precautions (5.9)].
Dosage for Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
PRIVIGEN may be initially administered as a total loading dose of 2 g/kg (20 mL/kg) given in divided doses over two to five consecutive days. PRIVIGEN may be administered as a maintenance infusion of 1 g/kg (10 mL/kg) administered in a single infusion given in one day or divided into two doses given on two consecutive days, every 3 weeks. Maintenance therapy beyond 6 months has not been studied.
The recommended initial infusion rate is 0.5 mg/kg/min (0.005 mL/kg/min). If the infusion is well tolerated, the rate may be gradually increased to a maximum of 8 mg/kg/min (0.08 mL/kg/min). For patients judged to be at risk for thrombosis, renal dysfunction, or volume overload, administer PRIVIGEN at the minimum infusion rate practicable [see Warnings and Precautions (5.2, 5.3)].
Preparation and Handling
- PRIVIGEN is a clear or slightly opalescent, colorless to pale yellow solution. Inspect parenteral drug products visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Do not use if the solution is cloudy, turbid, or if it contains particulate matter.
- DO NOT SHAKE.
- Do not freeze. Do not use if PRIVIGEN has been frozen.
- PRIVIGEN should be at room temperature (up to 25ºC [77ºF]) at the time of administration.
- Do not use PRIVIGEN beyond the expiration date on the product label.
- The PRIVIGEN vial is for single-use only. Promptly use any vial that has been entered. PRIVIGEN contains no preservative. Discard partially used vials or unused product in accordance with local requirements.
- Infuse PRIVIGEN using a separate infusion line. Prior to use, the infusion line may be flushed with Dextrose Injection, USP (D5W) or 0.9% Sodium Chloride for Injection, USP.
- Do not mix PRIVIGEN with other IGIV products or other intravenous medications. However, PRIVIGEN may be diluted with Dextrose Injection, USP (D5W).
- An infusion pump may be used to control the rate of administration.
- If large doses of PRIVIGEN are to be administered, several vials may be pooled using aseptic technique. Begin infusion within 8 hours of pooling.
Administration
PRIVIGEN is for intravenous administration only.
Monitor the patient's vital signs throughout the infusion. Slow or stop the infusion if adverse reactions occur. If symptoms subside promptly, the infusion may be resumed at a lower rate that is comfortable for the patient.
Ensure that patients with pre-existing renal insufficiency are not volume depleted. For patients judged to be at risk for renal dysfunction or thrombosis, administer PRIVIGEN at the minimum dose and infusion rate practicable, and discontinue PRIVIGEN administration if renal function deteriorates [see Boxed Warning, Warnings and Precautions (5.2, 5.3)].
The following patients may be at risk of developing systemic reactions (mimicking symptoms of an inflammatory response or infection) on rapid infusion of PRIVIGEN (greater than 4 mg/kg/min [0.04 mL/kg/min]): 1) those who have never received PRIVIGEN or another IgG product or who have not received it within the past 8 weeks, and 2) those who are switching from another IgG product. These patients should be started at a slow rate of infusion (e.g., 0.5 mg/kg/min [0.005 mL/kg/min] or less) and gradually increase as tolerated.
