Classes
DEA Class; Rx
Common Brand Names; Atgam, ATG equine
- Immunosuppressants;
- Polyclonal Antibodies
Description
Immunosuppressant, polyclonal IgG against human T-lymphocytes derived from horses (Atgam) or rabbits (Thymoglobulin)
Used for kidney organ transplant rejection, organ transplant rejection prophylaxis, and moderate to severe aplastic anemia
Risk of serious hypersensitivity reactions, including anaphylaxis or cytokine release syndrome (CRS)
Indications
Indicated for the treatment of acute kidney transplant rejection.
Contraindications
Hypersensitivity to antithymocyte globulin, other equine gamma globulins
Adverse Effects
- Fever (33-51%)
- Thrombocytopenia (11-30%)
- Rash (27%)
- Chills (14-16%)
- Leukopenia (14%)
- Systemic infection (13%)
- Dermatologic rxns (12%)
- Arthralgia, clotted AV fistula, hypotension, peripheral thrombophlebitis
- Headache
- Diarrhea, nausea or vomiting, stomatitis
- Chest or back pain
- Night sweats
- Pain at the infusion site
- Dyspnea
- Edema, hypertension, pulmonary edema, tachycardia
- Dizziness, malaise, paresthesia, seizures, weakness or faintness
- Toxic epidermal necrosis, wound dehiscence
- Epigastric pain, hiccoughs, iliac vein obstruction
- Myalgia
- Renal artery thrombosis
- Herpes simplex reactivation, localized infection, systemic infection, serum sickness
- Anaphylaxis, hyperglycemia, laryngospasm
Warnings
Test for allergic response by intradermal injection before start of treatment
Discontinue if anaphylaxis, unremitting thrombocytopenia, or unremitting leukopenia occur
Aplastic anemia patients may need prophylactic platelet transfusion
Observe patients carefully for previously masked reactions when reducing dose of corticosteroids, other immunosuppressants
Pregnancy and Lactation
Pregnancy Category: C
Lactation: not known if excreted in breast milk, use caution
Maximum Dosage
1.5 mg/kg/day IV for Thymoglobulin; 30 mg/kg/day IV for Atgam.
1.5 mg/kg/day IV for Thymoglobulin; 30 mg/kg/day IV for Atgam.
Safe and effective use has not been established for Thymoglobulin; 25 mg/kg/day IV for Atgam.
Safe and effective use has not been established for Thymoglobulin; 25 mg/kg/day IV for Atgam.
How supplied
Antithymocyte globulin equine
Lymphocyte immune globulin, anti-thymocyte globulin equine
injectable solution
- 50mg/mL