DRUG SUPPLIED DOSE COMMENTS
ANTI-THYMOCYTE GLOBULIN (rabbit) (Paeds)
(Thymoglobulin = antithymocyte globulin = lymphocyte immune globulin [rabbit source])

Mechanism of action:

Immunosuppressant; purified, pasteurized, rabbit immune globulin


Ref: 44, 124, 125, 558


Last update: 2022-06-08
Injection: 25 mg vial lyophilized powder, reconstitute to 5 mg per mL

See separate monograph for equine anti-thymocyte globulin; brand name Atgam
 Kidney and Heart Transplant:
Induction: 1-2 mg/kg/dose once daily for 4-5 days. Maximum: 150mg/dose.
Cumulative maximum dose : 8 mg/kg.

Kidney Allograft Acute Rejection:
1.5 mg/kg/day once daily for up to 5 doses.

Hematopoietic Stem Cell Transplant:
1.5-5 mg/kg/dose IV once daily x 3-4 days per protocol (usual total dose: 4.5-15 mg/kg).

See separate monograph for equine anti-thymocyte globulin; brand name Atgam.

 Not to be confused with equine anti-thymocyte globulin, brand name ATGAM.

Anaphylaxis has been reported: rescuscitation equipment, oxygen, and epinephrine must be readily available.

Rapid infusion has been associated with cytokine release syndrome (CRS) which can be fatal – follow parenteral monograph infusion guidelines.

Fever and chills may occur. Pre-treatment with acetaminophen, diphenydramine, and methylprednisolone may reduce incidence.

May cause neutropenia and thrombocytopenia – monitor CBC and differential.



Standard Prescription:

Thymoglobulin __ mg IV  Q24H (__ mg/kg/24hrs) x __ days