Octagam 5% 10gm/200ml Inj, 200ml

• Live virus vaccines (e.g., measles, mumps, rubella, varicella): May interfere with the immune response to these 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 dysfunction, especially in patients with pre-existing renal impairment or risk factors.
• Nephrotoxic drugs: Concomitant use may increase the risk of acute renal failure.

• Headache
• Fever
• Chills
• Nausea
• Vomiting
• Rash
• Hives
• Dyspnea
• Chest tightness
• Back pain
• Muscle cramps
• Dizziness
• Fatigue
• Signs of thrombosis (e.g., pain, swelling, discoloration of limb, shortness of breath, chest pain, neurological deficits)
• Signs of aseptic meningitis (e.g., severe headache, nuchal rigidity, photophobia, fever, nausea, vomiting)
• Signs of acute renal failure (e.g., decreased urine output, swelling, fatigue)

Category C. Octagam 5% should be given to a pregnant woman only if clearly needed. Human IgG is known to cross the placental barrier, particularly during the third trimester. Clinical experience with IVIG in pregnant women suggests no adverse effects on the course of pregnancy, fetus, or neonate.

L2 (Likely Compatible). Human IgG is excreted into breast milk. The effects of orally ingested immunoglobulin on the breast-fed infant have not been evaluated. However, immunoglobulins are proteins and are likely to be digested in the infant's gastrointestinal tract. Benefits of breastfeeding should be weighed against the potential risks.

Dosing is weight-based and indication-specific. Neonates and infants may be at increased risk for acute renal failure and should receive IVIG at the minimum concentration available and the slowest infusion rate practicable. Close monitoring of renal function and fluid status is essential.

Patients >65 years of age are at increased risk for acute renal failure and thrombotic events. Administer at the minimum dose and infusion rate practicable. Ensure adequate hydration. Monitor renal function and for signs/symptoms of thrombosis.

• Always ensure adequate hydration before, during, and after IVIG infusion to minimize the risk of acute renal failure.
• Start infusions at a slow rate and gradually increase if tolerated, especially in patients at high risk for adverse reactions (e.g., first-time users, those with IgA deficiency, renal impairment, or cardiovascular disease).
• Pre-medication (e.g., acetaminophen, antihistamines, corticosteroids) may be considered for patients with a history of infusion-related reactions, but is not routinely required for all patients.
• Monitor vital signs closely throughout the infusion. Headache, chills, and fever are common infusion-related reactions; slowing the infusion rate often helps manage these.
• Be vigilant for signs of serious adverse events such as thrombosis, acute renal failure, aseptic meningitis, and hemolytic anemia.
• Patients with selective IgA deficiency with known antibodies to IgA are at increased risk of severe hypersensitivity reactions, including anaphylaxis. Octagam 5% contains trace amounts of IgA.

• Other IVIG products (e.g., Gammagard S/D, Gamunex-C, Privigen, Flebogamma DIF)
• Subcutaneous Immune Globulin (SCIG) products (e.g., Hizentra, Cuvitru, Xembify) for primary immunodeficiency
• Corticosteroids (e.g., prednisone) for autoimmune conditions like ITP or CIDP
• Other immunosuppressants or immunomodulators depending on the specific indication (e.g., rituximab, azathioprine, cyclophosphamide, plasma exchange)