Octagam 10% 20g/200ml Inj, 1 Vial

• Live virus vaccines (e.g., measles, mumps, rubella, varicella): Antibodies in IVIG may interfere with the immune response to live virus vaccines. Vaccination should be deferred for at least 3 months after IVIG administration. For measles, deferral may be up to 11 months depending on the IVIG dose.

• Loop diuretics: Increased risk of acute renal failure, especially in patients with pre-existing renal impairment or risk factors.
• Nephrotoxic drugs (e.g., aminoglycosides, NSAIDs): Concomitant use may increase the risk of acute renal failure.
• ACE inhibitors/ARBs: Potential for increased risk of renal dysfunction in susceptible patients.

• Headache
• Fever
• Chills
• Nausea
• Vomiting
• Flushing
• Rash
• Hives
• Dyspnea
• Chest tightness
• Back pain
• Muscle cramps
• Dizziness
• Signs of thrombosis (e.g., swelling, pain, redness in an extremity; sudden chest pain; shortness of breath; sudden vision changes)
• Signs of renal dysfunction (e.g., decreased urine output, swelling, fatigue)
• Signs of aseptic meningitis (e.g., severe headache, nuchal rigidity, photophobia, fever, nausea, vomiting)

Category C. Use only if clearly needed and the potential benefits outweigh the potential risks to the fetus. Human IgG is known to cross the placental barrier, particularly during the third trimester.

Human IgG is excreted into breast milk. However, antibodies in breast milk are generally considered beneficial to the infant. Oral absorption of intact IgG by the infant is unlikely. Use is generally considered compatible with breastfeeding, but caution is advised.

Dosing is weight-based and indication-specific. Pediatric patients, especially neonates and infants, may be at increased risk for acute renal failure and fluid overload. Use lower concentrations and slower infusion rates. Monitor closely for adverse reactions.

Elderly patients (≥65 years) are at increased risk for acute renal failure and thrombotic events. Administer at the minimum concentration available and at the slowest infusion rate practicable. Ensure adequate hydration. Monitor renal function and for signs/symptoms of thrombosis closely.

• Always ensure adequate hydration before, during, and after IVIG infusion to minimize the risk of renal dysfunction and thrombosis.
• Infusion rate should be started slowly and gradually increased if tolerated. Patients at high risk for adverse events (e.g., renal impairment, cardiovascular disease, elderly) should receive the slowest possible infusion rate and lowest concentration.
• Pre-medication with antihistamines, acetaminophen, or corticosteroids may be considered for patients with a history of infusion-related reactions.
• Screen for IgA deficiency before the first infusion. Patients with severe IgA deficiency and known antibodies to IgA are at increased risk of severe hypersensitivity reactions, including anaphylaxis.
• Monitor for signs of aseptic meningitis syndrome (AMS), which can occur hours to days after infusion and typically resolves spontaneously within several days.
• Be vigilant for signs and symptoms of thrombosis, especially in patients with risk factors. Consider prophylactic anticoagulation in high-risk patients if appropriate.
• IVIG can interfere with serological tests (e.g., Coombs test) due to passive transfer of antibodies.

• Corticosteroids (e.g., prednisone, methylprednisolone) for autoimmune conditions like ITP, CIDP.
• Other immunomodulators (e.g., rituximab, azathioprine, mycophenolate mofetil, cyclophosphamide) depending on the specific autoimmune indication.
• Plasma exchange (plasmapheresis) for certain neurological or autoimmune conditions.
• Specific disease-modifying therapies for primary immunodeficiencies (e.g., subcutaneous immune globulin for maintenance therapy).