{"id":4409,"date":"2025-03-31T18:12:07","date_gmt":"2025-03-31T18:12:07","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/thymoglobuline-txt\/"},"modified":"2025-03-31T18:12:07","modified_gmt":"2025-03-31T18:12:07","slug":"thymoglobuline-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/thymoglobuline-txt\/","title":{"rendered":"Thymoglobuline.txt"},"content":{"rendered":"<h1>Thymoglobuline<\/h1>\n<p><H3>  CLINICAL USE <\/H3><br \/>\nProphylaxis and treatment of acute or steroid resistant transplant rejection <H3> DOSE IN NORMAL RENAL FUNCTION  <\/H3>Prophylaxis:Kidney 1\u20131.5 mg\/kg\/day Heart 1\u20132.5 mg\/kg\/day for 3\u20139 days Treatment: 1.5 mg\/kg\/day for 7\u201314 days<H3>  PHARMACOKINETICS    <\/H3><LI> Molecular weight &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp :No data<\/li>\n<li>  %Protein binding  &amp;nbsp &amp;nbsp &amp;nbsp  &amp;nbsp  &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp :No data<\/li>\n<li>  %Excreted unchanged in urine &amp;nbsp &amp;nbsp : No data<\/li>\n<p><LI> Volume of distribution (L\/kg) &amp;nbsp &amp;nbsp &amp;nbsp :0.12<\/li>\n<p><LI>half-life \u2013 normal\/ESRD (hrs)&amp;nbsp &amp;nbsp &amp;nbsp :48\u201372\/\u2013<H3>  DOSE IN RENAL IMPAIRMENT <\/H3> <H4>GFR (mL\/MIN)<\/H4><LI> 20 to 50  &amp;nbsp &amp;nbsp : Dose as in normal renal function <LI> 10 to 20  &amp;nbsp &amp;nbsp : Dose as in normal renal function<LI> &lt;10 &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp : Dose as in normal renal function<H3> DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES  <\/H3><LI> CAPD  &amp;nbsp &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp:Not dialysed. Dose as in normal renal function<\/p>\n<li> HD &amp;nbsp  &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp :Not dialysed. Dose as in normal renal function<LI>HDF\/high flux  &amp;nbsp :Unknown dialysability. Dose as in normal renal function<LI>CAV\/VVHD  &amp;nbsp &amp;nbsp &amp;nbsp:Not dialysed. Dose as in normal renal function<H3> IMPORTANT DRUG INTERACTIONS  <\/H3>Potentially hazardous interactions with other drugsRisk of over-immunosuppression with  concomitant prescribing of standard maintenance immunosuppressive regimensSafety of immunisation with attenuated  live vaccines following Thymoglobuline therapy has not been studied; therefore, immunisation with attenuated live vaccines is not recommended for patients who have recently received ATG<H3> ADMINISTRATION  <\/H3><H4> Reconstition<\/H4>\u2013<H4>  Route  <\/H4>IV via central line or via peripheral vein  with good blood flow rates<H4>  Rate of Administration  <\/H4>4\u201316 hours <H4>Comments<\/H4>Dilute dose in 250 mL sodium chloride  0.9%, maximum concentration 5 mg\/mL for peripheral administrationTo minimise risk of adverse effects,  chlorphenamine (10 mg IV) and hydrocortisone (100 mg IV) may be given 15\u201360 minutes before administration of full dose ATGChlorphenamine, hydrocortisone and  adrenaline should be immediately available in case of severe anaphylaxis<H4>  OTHER INFORMATION  <\/H4>Aim to keep total lymphocyte count below  3% of total white cell count or 50 cells\/\u00b5L. Alternatively, keep absolute T cell count below 50 cells\/\u00b5L, and only dose when above thisThe manufacturers advise that overdosage  of Thymoglobulin may result in leucopenia (including lymphopenia and neutropenia) and\/or thrombocytopenia. The dose of ATG should be reduced by  one-half if the WBC count is between 2000 and 3000 cells\/mm3 or if the platelet count is between 50 000 and 75 000 cells\/mm3. Stopping ATG treatment should be  considered if the WBC count falls below 2000 cells\/mm3 or platelets below 50 000 cells\/mm3Avoid simultaneous transfusions of blood  or blood derivatives and infusions of other solutions, particularly lipidsATG (rabbit) (Thymoglobuline)t is not licensed for use by anyone else.Atg (RAbbIt) (tHYMOgLObULINe) 71The recommended route of administration  for ATG is <H4> IV infusion  <\/H4> using a high-flow vein; however, it may be administered through a peripheral vein. In this instance, concomitant use of heparin and hydrocortisone in an infusion solution of 0.9% sodium chloride may minimise the potential for superficial thrombophlebitis and deep vein thrombosis. The combination of ATG, heparin and  hydrocortisone in a dextrose infusion solution has been noted to precipitate and is not recommendedATG should not be administered in  presence of: fluid overload, allergy to rabbit protein, pregnancy or acute viral illnessTotal rabbit IgG remains detectable  in 81% of patients at 60 days. Active ATG (i.e. IgG that is available to bind to human lymphocytes and cause desired immunological effects) disappears from the circulation faster, with only 12% of patients having detectable active ATG levels at day 90<br \/>\n","protected":false},"excerpt":{"rendered":"<p>Thymoglobuline CLINICAL USE Prophylaxis and treatment of acute or steroid<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4409","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4409","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4409"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4409\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4409"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4409"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4409"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}