Anti-D (Rh) Immunoglobulin

Registered South African indications: 

• Rhesus incompatibility

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Rhesus positive individuals

Cautions

• Renal impairment 
• Elderly
• Diabetes mellitus
• Volume depletion
• Cardiovascular disorders
• Atherosclerosis 
• Risk factors for thrombosis
• IgA deficiency 
• Sepsis
• Paraproteinaemia
• Anaemia 
• Thrombocytopaenia
• Coagulation disorders
• Asplenia
• Children

Forms avail. in SA and covered in this monograph: inj

Antenatal prophylaxis in rhesus negative women

• IM: 500 IU, given at 28 and/or 34 weeks gestation

Prophylaxis following potentially sensitising events in rhesus negative women
- amniocentesis
- antepartum haemorrhage
- abdominal trauma
- external cephalic version
- ectopic pregnancy
- chorionic villus sampling
- still birth
- foetal blood sampling
- abortions

• <20 weeks gestational age: IM: 250 IU, as a single dose
• >20 weeks gestational age: IM: 500 IU, as a single dose

Postnatal prophylaxis in rhesus negative women

• IM: 500 IU, to be given within 7 days of delivery

Transfusion of rhesus incompatible blood

• IM: 125 IU for each 1ml of red cells

Transfusion of rhesus positive platelets in rhesus negative women of child bearing age

• IM: 250 IU for each dose of platelets; Max: 500 IU 

Administer within 72hrs of a sensitising event 

No information available

Pregnancy

• Safe; no evidence of risk in studies
• Human anti-d immunoglobulin is used in pregnancy. No study drug-related adverse events were reported in children delivered of 432 women who received antepartum administration of human anti-d immunoglobulin 300 micrograms

Breastfeeding

• Compatible
• This medicinal product can be used during breastfeeding. Immunoglobulins are excreted in human milk. No study drug-related adverse events were reported in children delivered of 256 women who received postpartum administration of human anti-d immunoglobulin 300 micrograms, nor in children delivered of 139 women who received postpartum administration of human anti-d immunoglobulin 200 micrograms

Renal Impairment

• Caution; no dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• Caution; no dose adjustment recommended

Porphyria Information

• Not porphyrinogenic (NP)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Headache
• Lightheadedness

Cardiovascular Disorders

• Hypotension
• Tachycardia
• Shock
• Flushing

Gastrointestinal Disorders

• Nausea and vomiting

Skin and Subcutaneous Disorders

• Injection site reactions
• Chills
• Allergic reactions

• Measles, mumps and rubella vaccine
• Measles, mumps, rubella and varicella vaccine
• Live vaccines
• Varicella vaccine

None routine

Anti-D immunoglobulin prevents isoimmunization by suppressing the immune response and antibody formation by Rh(D)-negative individuals to Rh(D)-positive red blood cells. When administered within 72 hours of a full term delivery, the incidence of Rh isoimmunization decreases.

Injection (per 2ml) 500 IU

• Rhesugam (National Bioproducts)