Human Normal Immunoglobulin
Synonyms :
IGIM, Immune globulin IM
Mechanism :
HNIG is a solvent/detergent treated sterile solution of immune globulin for intramuscular administration and contains no preservative. It is prepared by cold ethanol fractionation from human plasma.
Indication :
- Passive immunisation for
- Measles
- Hepatitis A
- Varicella-zoster
- Poliomyelitis
- Rubella
- Agammaglobulinemia
Contraindications :
Contraindicated in persons with isolated immunoglobulin A (IgA) deficiency. Such persons have the potential for developing antibodies to IgA and could have anaphylactic reactions to subsequent administration of blood products that contain IgA. Should not be administered to patients who have severe thrombocytopenia or any coagulation disorder that would contraindicate intramuscular injections.
Dosing :
Available as 16.5% protein/ml.
Hepatitis A:
Anticipated risk of exposure upon travel to endemic countries:
<1 month of stay: 0.1 ml/kg IM.
1-2 months of stay: 0.2 ml/kg IM. Repeat dose every 2 months for longer stays.
Post exposure prophylaxis:
0.1 ml/kg IM within 14 days of exposure for Hepatitis A exposure.
0.25 ml/kg/dose IM (not to exceed 15 ml) within 6 days of exposure for measles.
0.6-1.2 ml/kg IM within 72 hours of exposure to varicella zoster virus.
Adverse Effect :
Local pain and tenderness at the injection site, angioedema, urticaria, anaphylactic reactions.
Interaction :
MMR: Measles, mumps and rubella vaccines should not be given within 3 weeks before or 3 months after HNIG as their efficacy may be reduced.
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 in normal renal function |
| HDF/High flux | Probably not dialysed. Dose as in normal renal function |
| CAV/VVHD | Probably not dialysed. Dose as in normal renal function |
Hepatic Dose :
No dosage adjustments are recommended.