Octagam 5% Inj, 5gm/100ml

• Live virus vaccines (e.g., measles, mumps, rubella, varicella): IVIG may interfere with the immune response to live attenuated virus vaccines. Defer vaccination for at least 3 months after IVIG administration. For measles, defer for up to 11 months.

• Loop diuretics: Increased risk of renal dysfunction, especially in patients with pre-existing renal impairment or risk factors.
• Nephrotoxic drugs: Increased risk of renal dysfunction when co-administered with other nephrotoxic agents.

• Headache
• Fever
• Chills
• Nausea
• Vomiting
• Fatigue
• Rash
• Hives
• Dyspnea
• Chest tightness
• Back pain
• Flank pain
• Signs of thrombosis (e.g., swelling, pain, redness in limb; sudden chest pain, shortness of breath, slurred speech, weakness on one side of body)
• Signs of acute renal failure (e.g., decreased urine output, swelling, fatigue)
• Signs of aseptic meningitis (e.g., severe headache, nuchal rigidity, photophobia, fever, nausea, vomiting)

Category C. Animal reproduction studies have not been conducted. However, immune globulins are known to cross the placental barrier, particularly during the third trimester. Clinical experience with IVIG in pregnant women suggests no harmful effects on the course of pregnancy, the fetus, or the neonate. Use only if clearly needed and the potential benefits outweigh the potential risks.

L3 (Moderately Safe). IgG is naturally present in human milk and is transferred to the infant. Oral absorption of intact IgG is minimal. No adverse effects on the breastfed infant are expected. IVIG is generally considered compatible with breastfeeding.

Dosing for pediatric patients is typically weight-based and similar to adults for approved indications (e.g., ITP, PHI, Kawasaki disease). Safety and efficacy have been established in pediatric patients for these indications. Close monitoring for adverse reactions is important, especially for infusion rate and hydration.

Use with caution in patients aged 65 years and older, especially those with pre-existing renal impairment, diabetes mellitus, volume depletion, or cardiovascular disease, due to increased risk of acute renal dysfunction and thrombotic events. Ensure adequate hydration and use the minimum dose and infusion rate practicable.

• Always ensure adequate hydration before, during, and after IVIG infusion to minimize the risk of renal dysfunction and thrombosis.
• Start infusions at a slow rate and gradually increase if tolerated, especially for the first infusion or in patients at risk for adverse reactions.
• 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.
• Screen patients for IgA deficiency before the first infusion. Patients with severe IgA deficiency may be at higher risk of anaphylactic reactions due to anti-IgA antibodies.
• Monitor for signs of aseptic meningitis (severe headache, neck stiffness, photophobia) which can occur hours to days after infusion.
• Be vigilant for signs and symptoms of thrombosis (e.g., DVT, PE, stroke, MI), particularly in at-risk patients. Octagam is sucrose-free, which may reduce renal risk compared to some other IVIG products, but renal monitoring is still crucial.
• IVIG can interfere with serological tests (e.g., Coombs test, blood typing) due to passive transfer of antibodies.

• Other IVIG brands (e.g., Gammagard, Privigen, Flebogamma, Gamunex)
• Subcutaneous Immune Globulin (SCIG) for primary immunodeficiencies (e.g., Hizentra, Cuvitru, Xembify)
• Corticosteroids (e.g., prednisone) for autoimmune conditions like ITP, CIDP
• Other immunosuppressants (e.g., rituximab, azathioprine, mycophenolate mofetil) depending on the specific autoimmune indication
• Splenectomy for refractory ITP