Rho(D) Immune Globulin

Rho(D) Immune Globulin is a prescription medication administered to Mother to Prevent Hemolytic Disease in Newborn and to treat Obstetric Conditions (Abortion/Miscarriage), Immune Thrombocytopenic Purpura (Nonsplenectomized Rho(D)-Positive Patients), and Incompatible Transfusions.

• Rho(D) Immune Globulin is available under the following different brand names: RhoGAM, Gamulin Rh, HypRho D, MicRhoGAM, Rhesonativ, HyperRHO, Rhophylac, WinRho SDF.

Adult dosage

• 50 mcg
• 300 mcg
• 1,500 Units/2 mL
• 1,500 Units/1.3 mL
• 2,500 Units/2.2 mL
• 5,000 Units/4.4 mL
• 15,000 Units/13 mL

Administer to Mother to Prevent Hemolytic Disease In Newborn

Adult dosage

• Antepartum: 1500 IU`300 mcg IV/IM at 28-30 weeks of gestation
• Postpartum: 1500 IU IV/IM within 72 hours
• If both given risk reduced to 0.1%
• If unable to give within 72 hours, give within 28 days; do not withhold
• If greater than 15 mL of Rho+ fetal RBC is present in the mother’s circulation, multiple 1500 IU doses are required 

Obstetric Conditions (Abortion/Miscarriage)

Adult dosage

• 1500 IU IV/IM x1 within 72 hours 
• HyperRHO/MicRhoGAM: if abortion within 13 weeks given 250 IU/50 mcg (mini-dose)

Immune Thrombocytopenic Purpura (Nonsplenectomized Rho(D)-Positive Patients

Adult dosage

• Initial, Hgb over 10 g/dL: 250 IU/kg IV once
• Initial, Hgb under 10 g/dL: 125-200 IU/kg IV once
• Additional doses: 125-300 IU/kg IV as needed
• Infuse IV over 3-5 minutes
• If unresponsive to initial dose and Hgb under 8 g/dL, use an alternate treatment

Incompatible Transfusions

Adult dosage

WinRho SDF

• Exposure to Rh(D) positive whole blood
• IM: 12 mcg (60 IU)/mL blood
• IV: 9 mcg (45 IU)/mL blood

Rhophylac

• 20 mcg (100 IU)/2mL blood (or 1 mL erythrocyte concentrate) IV/IM 

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”.

Common side effects of Rho(D) Immune Globulin include:

• nausea, 
• diarrhea, 
• vomiting, 
• stomach pain, 
• headache, 
• dizziness, 
• drowsiness, 
• weakness, 
• general ill feeling, 
• joint or muscle pain, 
• flushing (warmth, redness, or tingly feeling), 
• mild itching, 
• skin rash, 
• increased sweating, and
• pain or tenderness where the medicine was injected

Serious side effects of Rho(D) Immune Globulin include:

• rash, 
• hives, 
• lightheadedness, 
• chest tightness, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• fever, 
• chills, 
• shaking, 
• back pain, 
• unusual weakness, 
• red or pink urine, 
• pale or yellowed skin, 
• dark-colored urine, 
• rapid breathing, 
• rapid heart rate, 
• confusion, 
• shortness of breath, 
• little or no urinating, 
• swelling, 
• rapid weight gain, 
• sudden numbness or weakness, 
• slurred speech, 
• problems with vision or balance, 
• chest pain, 
• coughing up blood, and
• swelling with redness and warmth in one or both legs

Rare side effects of Rho(D) Immune Globulin include:

• none 

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.  Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first

• Rho(D) Immune Globulin has severe interactions with no other drugs. 
• Rho(D) Immune Globulin has serious interactions with no other drugs. 
• Rho(D) Immune Globulin has moderate interactions with no other drugs.
• Rho(D) Immune Globulin has minor interactions with the following drugs:
  • adenovirus types 4 and 7 live, oral
  • BCG vaccine live
  • measles (rubeola) vaccine
  • measles mumps and rubella vaccine, live
  • measles, mumps, rubella, and varicella vaccine, live
  • protein a column
  • rubella vaccine
  • smallpox (vaccinia) vaccine, live
  • varicella virus vaccine live

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drugs interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Contraindications

Hemolytic Disease

• Rho(D)+
• Rho(D) negative women who are Rh immunized
• Hypersensitivity to immune globulins

Immune Thrombocytopenic Purpura

• Rho(D) negative individuals
• Splenectomized individuals
• Hypersensitivity to plasma products
• Autoimmune hemolytic anemia
• Pre-existing hemolysis or high risk for hemolysis
• Do not use WinRho SDF in patients with IgA deficiency with antibodies against IgA

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Rho(D) Immune Globulin?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Rho(D) Immune Globulin?”

Cautions

• NEVER GIVE TO NEONATE
• Do not administer IM for ITP
• WinRho SDF: risk of rare but potentially fatal intravascular hemolysis in ITP pts
• Maltose-containing IVIG products (eg WinRho SDF) may give false highs in certain glucose-testing systems
• Avoid live vaccines for 3 months
• IgA deficiency
• Avoid gluteal IM if possible, if not inject only in the upper outer quadrant

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risks during pregnancy. 
• Lactation: Not known if excreted in breast milk, no adverse effects reported.