Rho(D) immune globulin: Difference between revisions
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*Type: Immune Globulin | *Type: Immune Globulin | ||
*Routes of Administration: IM, IV | *Routes of Administration: IM, IV | ||
*Common Trade Names: RhoGAM, WinRho | *Common Trade Names: RhoGAM, WinRho | ||
==Adult Dosing== | ==Adult Dosing== | ||
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==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
**Animal studies have not been conducted, though available evidence suggest that administration of RhIG during pregnancy does not harm fetus | **Animal studies have not been conducted, though available evidence suggest that administration of RhIG during pregnancy does not harm fetus<ref>ACOG practice bulletin. Prevention of Rh D alloimmunization. Number 4, May 1999 (replaces educational bulletin Number 147, October 1990). Clinical management guidelines for obstetrician-gynecologists. American College of Obstetrics and Gynecology. Int J Gynaecol Obstet. 1999; 66(1):63-70. [PubMed 10458556]</ref> | ||
*[[Lactation risk categories|Lactation risk]]: | *[[Lactation risk categories|Lactation risk]]: | ||
**Caution advised while breastfeeding, however no adverse events observed | **Caution advised while breastfeeding, however no adverse events observed | ||
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==See Also== | ==See Also== | ||
*[[Vaginal Bleeding (Main)]] | *[[Vaginal Bleeding (Main)]] | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:OBGYN]] | [[Category:OBGYN]] | ||
Revision as of 21:31, 3 February 2021
General
- Type: Immune Globulin
- Routes of Administration: IM, IV
- Common Trade Names: RhoGAM, WinRho
Adult Dosing
1st Trimester (<13weeks) Vaginal Bleeding
- 150 microgm IM
- There is no harm in giving the standard 300 microgram dose, which is more readily available
2nd & 3rd Trimester Vaginal Bleeding
- 300 microgm IM once and send Kleihauer-Betke test
- Within 72hrs give additional 300 microgm/15 ml Rh-positive blood
Pediatric Dosing
- Same as adult dosing above
Special Populations
- Pregnancy Rating: C
- Animal studies have not been conducted, though available evidence suggest that administration of RhIG during pregnancy does not harm fetus[1]
- Lactation risk:
- Caution advised while breastfeeding, however no adverse events observed
- Renal Dosing
- No dosage adjustments
- Hepatic Dosing
- No dosage adjustments
Indications
- For fetal maternal hemorrhage
- Risk = >4-12wks
- Duration effect: 12wks
- Also given to Rh- male trauma patients who receive O+ blood to prevent future reaction with O+ transfusions[2]
Contraindications
- Allergy to class/drug
- Prior sensitization of mother
- Known Rh-negative father
- Known Rh-negative fetus (from cord blood)
Adverse Reactions
Serious
- Anaphylaxis
- Viral transmission risk
- Acute intravascular hemolysis in patients with ITP
- Acute transfusion reaction
Common
- Fever
- Injection site reaction
- Headache
- Myalgias
- Fatigue
Pharmacology
- Half-life: Approximately 30 days
- Metabolism: Unknown
- Excretion: Unknown
- Mechanism of Action:
- Exact mechanism unknown
- Prevents isoimmunization by suppressing immune response by Rh negative individuals against Rh positive blood cells
Comments
See Also
References
- ↑ ACOG practice bulletin. Prevention of Rh D alloimmunization. Number 4, May 1999 (replaces educational bulletin Number 147, October 1990). Clinical management guidelines for obstetrician-gynecologists. American College of Obstetrics and Gynecology. Int J Gynaecol Obstet. 1999; 66(1):63-70. [PubMed 10458556]
- ↑ Miraflor, E, et al. Emergency uncrossmatched transfusion effect on blood type alloantibodies. J Trauma. 2012; 72:48-53.