Octagam 10% 2gm/20ml Inj, 20ml

• Live virus vaccines (e.g., measles, mumps, rubella, varicella): IVIG may interfere with the immune response to live attenuated virus vaccines. Vaccination should be deferred for at least 3 months after IVIG administration. For measles vaccine, deferral may be up to 11 months depending on the IVIG dose.
• Loop diuretics (e.g., furosemide): Increased risk of renal dysfunction, especially in patients with pre-existing renal impairment or risk factors for acute renal failure. Monitor renal function closely.

• ACE inhibitors: Potential for increased risk of angioedema, though evidence is limited.
• Nephrotoxic drugs: Concurrent use may increase the risk of acute renal failure, especially in susceptible patients. Monitor renal function closely.

• Headache
• Chills
• Fever
• Nausea
• Vomiting
• Fatigue
• Dizziness
• Rash
• Hives
• Flushing
• Chest pain or tightness
• Shortness of breath or difficulty breathing
• Swelling (especially face, lips, tongue, throat)
• Signs of thrombosis (e.g., pain, swelling, warmth, redness in a limb; sudden chest pain, shortness of breath, vision changes, slurred speech)
• Signs of renal dysfunction (e.g., decreased urine output, swelling, fatigue)
• Signs of aseptic meningitis (e.g., severe headache, neck stiffness, photophobia, nausea, vomiting)

Category C. Animal reproduction studies have not been conducted. It is not known whether Octagam 10% can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Octagam 10% should be given to a pregnant woman only if clearly needed. IgG antibodies are known to cross the placenta, particularly in the third trimester.

Human IgG is excreted into breast milk and may contribute to the transfer of protective antibodies to the neonate. No adverse effects on the breastfed infant are expected. Use is generally considered compatible with breastfeeding.

Dosing is weight-based and varies by indication. Infusion rates should be initiated slowly, especially in infants and young children, and carefully titrated. Monitor for adverse reactions, particularly renal function and fluid balance, as pediatric patients may be more susceptible to certain side effects.

Use with caution in elderly patients (≥65 years) due to increased risk of acute renal failure and thrombotic events. Ensure adequate hydration and administer at the minimum dose and infusion rate practicable. Monitor renal function and signs of thrombosis closely.

• Always ensure adequate hydration before, during, and after infusion to minimize the risk of renal dysfunction and other adverse events.
• Infusion rate should be started slowly and gradually increased if tolerated. Patients who have not received IVIG before, or who are switching brands, or who have underlying risk factors (e.g., renal impairment, cardiovascular disease) should receive a slower initial infusion rate.
• Pre-medication (e.g., acetaminophen, antihistamines) may be considered for patients with a history of infusion-related reactions, but is not routinely required for all patients.
• Patients with IgA deficiency who have antibodies to IgA are at increased risk of severe hypersensitivity reactions, including anaphylaxis. Octagam 10% contains trace amounts of IgA. Screen for IgA deficiency prior to first infusion.
• Monitor for signs and symptoms of thrombosis (e.g., DVT, PE, stroke, MI) and acute renal failure, especially in high-risk patients. These are serious but rare complications.
• Aseptic meningitis syndrome (AMS) is a known but rare side effect, typically occurring within hours to 2 days post-infusion. Symptoms include severe headache, neck stiffness, photophobia, nausea, and vomiting. It is usually reversible upon discontinuation.
• Octagam 10% is sucrose-free, which may be advantageous for patients at risk of renal dysfunction compared to sucrose-stabilized IVIG products.

• Other IVIG products (e.g., Gammagard, Gamunex-C, Privigen, Flebogamma DIF)
• Subcutaneous Immune Globulin (SCIG) products (e.g., Hizentra, Gammaked, Cuvitru, Xembify) for primary immunodeficiency
• For ITP: Corticosteroids, anti-D immunoglobulin, thrombopoietin receptor agonists (e.g., romiplostim, eltrombopag), splenectomy, rituximab.
• For CIDP: Corticosteroids, plasma exchange (PLEX).
• For PIDD: Prophylactic antibiotics, hematopoietic stem cell transplantation (for severe cases).