Thymoglobulin
Generic Name
Anti-thymocyte globulin (rabbit)
Manufacturer
Sanofi
Country
France
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| thymoglobulin 25 mg injection | ৳ 29,800.00 | N/A |
Description
Overview of the medicine
Anti-thymocyte globulin (rabbit) is an immunosuppressive agent composed of purified immunoglobulins from rabbits immunized with human thymocytes. It is used to prevent and treat acute organ rejection in transplant recipients and for the treatment of aplastic anemia.
Uses & Indications
Dosage
Adults
For acute rejection: 1.5 mg/kg daily for 7-14 days. For induction: 1-1.5 mg/kg daily for 2-5 days. For aplastic anemia: 2.5-3.5 mg/kg daily for 5 days.
Elderly
No specific dosage adjustment required, but monitor carefully.
Renal_impairment
No specific dosage adjustment required, but monitor for side effects.
How to Take
Administered intravenously after dilution in 0.9% sodium chloride or 5% dextrose solution, over at least 6 hours via a central vein or high-flow peripheral vein. Premedication is often given to reduce infusion-related reactions.
Mechanism of Action
Thymoglobulin depletes T-lymphocytes through multiple mechanisms, including complement-dependent lysis, antibody-dependent cell-mediated cytotoxicity, and induction of apoptosis. It also modulates T-cell function and adhesion molecule expression.
Pharmacokinetics
Onset
Rapid (within hours to days for T-cell depletion).
Excretion
Primarily via catabolism; minimal renal excretion of intact globulin.
Half life
Varies widely, typically 2-3 days, but can be up to 30 days depending on dose and patient.
Absorption
Administered intravenously, so 100% bioavailability.
Metabolism
Catabolized by the reticuloendothelial system.
Side Effects
Contraindications
- History of severe anaphylactic reaction to rabbit proteins or to any excipients.
- Active acute or chronic infections that would be worsened by immunosuppression.
- Severe thrombocytopenia or uncontrolled leukopenia.
Drug Interactions
Vaccines (live)
Avoid, due to risk of disseminated infection.
Anticoagulants/Antiplatelets
Increased risk of bleeding if thrombocytopenia occurs.
Other immunosuppressants (e.g., cyclosporine, tacrolimus, corticosteroids)
Increased risk of profound immunosuppression and infection.
Storage
Store refrigerated between 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light.
Overdose
Overdose may lead to severe leukopenia, thrombocytopenia, and increased risk of infection. Management is supportive, including discontinuing the drug, monitoring blood counts, and administering anti-infective therapy as needed.
Pregnancy & Lactation
Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Not known if excreted in human milk; use with caution in nursing mothers.
Side Effects
Contraindications
- History of severe anaphylactic reaction to rabbit proteins or to any excipients.
- Active acute or chronic infections that would be worsened by immunosuppression.
- Severe thrombocytopenia or uncontrolled leukopenia.
Drug Interactions
Vaccines (live)
Avoid, due to risk of disseminated infection.
Anticoagulants/Antiplatelets
Increased risk of bleeding if thrombocytopenia occurs.
Other immunosuppressants (e.g., cyclosporine, tacrolimus, corticosteroids)
Increased risk of profound immunosuppression and infection.
Storage
Store refrigerated between 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light.
Overdose
Overdose may lead to severe leukopenia, thrombocytopenia, and increased risk of infection. Management is supportive, including discontinuing the drug, monitoring blood counts, and administering anti-infective therapy as needed.
Pregnancy & Lactation
Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Not known if excreted in human milk; use with caution in nursing mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 36 months when stored as recommended.
Availability
Hospitals, Specialty Pharmacies
Approval Status
FDA Approved
Patent Status
Expired / Off-patent
Clinical Trials
Numerous clinical trials have established its efficacy in transplant rejection and aplastic anemia, demonstrating improved outcomes compared to placebo or other immunosuppressants in specific settings.
Lab Monitoring
- Complete blood count (CBC) with differential (daily during initial treatment, then regularly).
- Renal and liver function tests.
- Monitoring for signs/symptoms of infection.
- Thymoglobulin levels (if required by protocol).
Doctor Notes
- Monitor CBC closely, especially lymphocyte counts, to guide dosing and duration.
- Prophylaxis for PTLD and CMV infection may be indicated.
- Ensure adequate hydration and premedication to minimize infusion reactions.
Patient Guidelines
- Report any signs of infection (fever, chills, sore throat) immediately.
- Report any unusual bruising or bleeding.
- Avoid live vaccines during treatment.
- Follow all instructions regarding premedication.
Missed Dose Advice
Contact your doctor or nurse immediately if a dose is missed. They will advise on the next steps. Do not double the dose.
Driving Precautions
May cause dizziness or fatigue. Patients should be advised not to drive or operate machinery if they experience these symptoms.
Lifestyle Advice
- Practice good hygiene to minimize infection risk.
- Avoid crowded places or contact with sick individuals.
- Discuss any planned travel with your doctor.
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