Human Anti-D Immunoglobulins

Introduction: Human Anti-D Immunoglobulins prevent a rhesus-negative mother from actively forming antibodies to foetal rhesus-positive RBCs that may pass into the maternal circulation during childbirth, abortion, or certain other sensitising events. It is also used in idiopathic thrombocytopenic purpura to prevent excessive bleeding.

How it works: Anti-D immunoglobulin coats Rh-positive RBCs and prevents their recognition by the maternal immune system, thereby preventing anti-D antibody formation and preventing Rh disease in future pregnancies.

Important Information: 250 mcg IM dose should be given immediately or as soon as possible after delivery or abortion of an Rh-positive child, preferably within 48 hours, but not later than 72 hours. Deep intramuscular injection only.

• Pregnancy and Other Obstetrical Conditions in Rh-Negative Women: unless the father or baby are conclusively Rh negative
• Pregnancy/delivery of an Rh-positive baby
• Abortion/threatened abortion - at any stage of gestation
• Ectopic pregnancy
• Antepartum fetal-maternal hemorrhage
• Transfusion of Rh incompatible blood or blood products

Vaccines, Anti-sera & Immunoglobulin

Passive Immunisation

Anti-D immunoglobulin prevents a rhesus-negative mother from actively forming antibodies to foetal rhesus-positive RBCs that may pass into the maternal circulation during childbirth, abortion, or certain other sensitising events. It is also used in idiopathic thrombocytopenic purpura to prevent excessive bleeding.

Anti-D immunoglobulin coats Rh-positive RBCs and prevents their recognition by the maternal immune system, thereby preventing anti-D antibody formation.

Adult Dose (IM):

• After delivery/abortion: 250 mcg immediately or as soon as possible (within 48 hours, not >72 hours)

Antenatal Prophylaxis:

• 250 mcg at week 28 & week 34 of pregnancy

Sensitising episode (up to 20 weeks):

• 125 mcg per episode

Sensitising episode (after 20 weeks):

• 250 mcg immediately or within 72 hours

* Use as directed by the registered physician

Deep intramuscular (IM) injection only. Do not inject intravenously. Observe patients for 20 minutes after administration.

If you miss a dose, consult your doctor.

Common Side Effects:

• Nausea
• Dizziness
• Headache
• Injection-site pain and tenderness
• Malaise
• Fever, chills
• Flushing
• Hypersensitivity reactions (hives, wheezing, urticaria)

Serious (in ITP treatment): Intravascular hemolysis, anemia, acute renal insufficiency, DIC, death

Precautions:

• For maternal administration only (postpartum use)
• Not for rhesus-positive individuals
• IgA deficient patients with antibodies to IgA are at greater risk of severe hypersensitivity and anaphylactic reactions
• Made from human blood - may contain infectious agents
• Caution in splenectomised patients

Contraindications:

• History of anaphylactic or severe systemic reaction to human immune globulin
• IgA-deficient patients with antibodies to IgA and history of hypersensitivity
• Splenectomised or rhesus-negative patients (hemolysis may exacerbate pre-existing anaemia)

Drug Interactions:

• May interfere with immune response to live measles, mumps, rubella and varicella vaccines
• These vaccines should be given at least 3 months after immunoglobulin administration

Food Interactions: No interaction found/established.

Use in Pregnancy: Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus.

Use in Lactation: Limited information available. Use with caution.

Pediatric Use: Indicated for hemolytic disease of newborn (Rh disease).

Geriatric Use: Use as per doctor's advice for elderly patients.

Renal & Hepatic Impairment: No known restrictions. However, consult your doctor.

Overdose: Limited information available on overdose. Employ usual supportive measures.

Storage: Store in a cool and dry place.

Human Anti-D Immunoglobulins