Human Cytomegalovirus Immunoglobulin
Synonym :
Cytomegalovirus Immunoglobulin
Mechanism :
Human cytomegalovirus immunoglobulin contains IgG antibodies representative of the large number of normal persons who contributed to the plasma pools from which the product was derived. The globulin contains a relatively high concentration of antibodies directed against Cytomegalovirus (CMV). In the case of persons who may be exposed to CMV, it can raise the relevant antibodies to levels sufficient to attenuate or reduce the incidence of serious CMV disease.
Indication :
- Acute CMV infection
- CMV prophylaxis in AIDS, transplants
- Congenital CMV
Contraindications :
Contraindicated in individuals with a history of a prior severe reaction associated with the administration of this or other human immunoglobulin preparations. Persons with selective immunoglobulin A deficiency have the potential for developing antibodies to immunoglobulin A and could have anaphylactic reactions.
Dosing :
Doses need to be individualized to suit the patient.
Prophylaxis:
Renal Transplant:
150 mg/kg IV infusion within 72 hours of transplant; 100 mg/kg after 2, 4, 6, 8 weeks post-transplant and then 50 mg/kg after 12 and 16 weeks post-transplant.
Liver, Pancreas, Heart or Lung Transplant:
150 mg/kg IV infusion within 72 hours of transplant; 150 mg/kg after 2, 4, 6, 8 weeks post-transplant and then 100 mg/kg after 12 and 16 weeks post-transplant.
Acute CMV infection:
200 mg/kg IV infusion on days 1 and 7, given with appropriate antiviral therapy.
Adverse Effect :
Flushing, nausea and vomiting, fever with chills, muscle cramps, back pain, arthralgia, and wheezing, anaphylaxis, aseptic meningitis.
Interaction :
Live Virus Vaccines: Antibodies present in immune globulin preparation may interfere with the immune response to live virus vaccines such as measles, mumps, and rubella, therefore, vaccination with live virus vaccines should be deferred until approximately three months after administration.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in normal renal function |
| HD | Not dialysed. Dose as normal renal function |
| HDF/High flux | Unknown dialysability. Dose as in normal renal function |
| CAV/VVHD | Not dialysed. Dose as in normal renal function |
Hepatic Dose :
No dosage adjustments are recommended.