Human Anti-D Immunoglobulin

Introduction: Human 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.

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.

• 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

Intramuscular (IM) injection - deep IM 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

Contraindications:

• History of anaphylactic or severe systemic reaction to human immune globulin
• IgA-deficient patients with antibodies to IgA and history of hypersensitivity

Drug Interactions:

• May interfere with immune response to live measles, mumps, rubella and varicella vaccines
• These vaccines should be given at least 3 weeks before or 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 Immunoglobulin