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Anti-Thymocyte Globulin is an immunoglobulin G. Doctors use it to prevent and to treat acute rejection in patients who have received a kidney transplant. It must be given together with other immunosuppressive medicines.
Pharmacology
Nobody fully understands how polyclonal antilymphocyte preparations suppress the immune response. For Anti-Thymocyte Globulin, the possible ways it may cause immunosuppression in vivo include clearing T-cells from the circulation and changing how T-cells are activated, how they home to tissues, and how they carry out cytotoxic activity.
Anti-Thymocyte Globulin contains antibodies against T-cell markers such as CD2, CD3, CD4, CD8, CD11a, CD18, CD25, CD44, CD45, HLA-DR, HLA Class I heavy chains, and ß2 micro-globulin. In vitro, at concentrations above 0.1 mg/mL (written in the original as >0.1 mg/mL), it suppresses T-cells by inhibiting their proliferative responses to several mitogens.
In patients, T-cell depletion is usually seen within a day after Anti-Thymocyte Globulin therapy starts. The medicine has not been shown to work for treating antibody-mediated (humoral) rejections.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Give the first dose of Anti-Thymocyte Globulin as an infusion over at least 6 hours. On the following days, each infusion should run over at least 4 hours. Before every infusion, premedication with corticosteroids, acetaminophen and/or an antihistamine is recommended.
The dose of Anti-Thymocyte Globulin should be cut by one half if the white blood cell (WBC) count is between 2,000 and 3,000 cells/mm3, or if the platelet count is between 50,000 and 75,000 cells/mm3. Stopping the treatment should be considered if the WBC count falls below 2,000 cells/mm3 or the platelet count falls below 50,000 cells/mm3.
Prophylaxis of acute rejection: 1.5 mg/kg of body weight given daily for 4 to 7 days.
Treatment of acute rejection: 1.5 mg/kg of body weight given daily for 7 to 14 days.
Side Effects
The most common side effects and lab changes with Anti-Thymocyte Globulin are urinary tract infection, abdominal pain, high blood pressure, nausea, shortness of breath, fever, headache, anxiety and chills. Raised potassium levels in the blood and low counts of platelets and white blood cells are also common. These were the ones seen more than 5% more often than with the comparator treatment.
Cautions & Contraindications
Warnings & Precautions
Anti-Thymocyte Globulin should only be used by physicians who have experience with immunosuppressant therapy in transplantation. Immune-mediated reactions: an Anti-Thymocyte Globulin infusion could cause an anaphylactic reaction. Infusion-associated reactions: sticking closely to the recommended infusion time may reduce how often these reactions happen and how severe they are. Hematologic effects: low counts of platelets and white blood cells have been identified, and they are reversible after dose adjustments. Total white blood cell and platelet counts should be monitored. Infection: infections and reactivation of infections have been reported. Patients should be monitored and given anti-infective prophylaxis. Malignancy: the incidence of malignancies may increase. Immunization with attenuated live vaccines is not recommended for patients who have recently received THYMOGLOBULIN. THYMOGLOBULIN may interfere with rabbit antibody-based immunoassays and with cross-match or panel-reactive antibody cytotoxicity assays.
Contraindications
Anti-Thymocyte Globulin must not be given to anyone with an allergy or anaphylactic reaction to rabbit proteins or to any of the product's excipients. It is also not for people with active acute or chronic infections, where any extra immunosuppression is contraindicated.
Pregnancy & Breastfeeding
Animal reproduction studies haven't been done with Anti-Thymocyte Globulin, and it isn't known whether the medicine can harm an unborn baby. A pregnant woman should be given Anti-Thymocyte Globulin only if the benefit outweighs the risk.
Anti-Thymocyte Globulin has not been studied in nursing women, and it isn't known whether the drug passes into human milk. Other immunoglobulins do pass into human milk, so breastfeeding should be stopped during Anti-Thymocyte Globulin therapy.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Pediatric use: Controlled trials have not established the safety and effectiveness of Anti-Thymocyte Globulin in children. Some limited European studies and U.S. compassionate use do exist, though, and from these the dose, the efficacy and the adverse reaction profile are not thought to differ from those in adults.
Storage
Keep Anti-Thymocyte Globulin in a refrigerator at 2°C to 8°C. Protect it from light, and don't let it freeze.
Common questions about Thymoglobulin 25 mg/10 ml
What is Thymoglobulin 25 mg/10 ml IV Injection?
Thymoglobulin 25 mg/10 ml IV Injection is a medicine that contains Anti-Thymocyte Globulin. It is made by Synovia Pharma PLC. It belongs to the Vaccines group of medicines.
What is Thymoglobulin used for?
Anti-Thymocyte Globulin is an immunoglobulin G. Doctors use it to prevent and to treat acute rejection in patients who have received a kidney transplant.
What are the side effects of Thymoglobulin?
The most common side effects and lab changes with Anti-Thymocyte Globulin are urinary tract infection, abdominal pain, high blood pressure, nausea, shortness of breath, fever, headache, anxiety and chills. Raised potassium levels in the blood and low counts of platelets and white blood cells are also common.
Can I take Thymoglobulin during pregnancy or while breastfeeding?
Animal reproduction studies haven't been done with Anti-Thymocyte Globulin, and it isn't known whether the medicine can harm an unborn baby. A pregnant woman should be given Anti-Thymocyte Globulin only if the benefit outweighs the risk. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
How should I store Thymoglobulin?
Keep Anti-Thymocyte Globulin in a refrigerator at 2°C to 8°C. Protect it from light, and don't let it freeze.
Do I need a prescription for Thymoglobulin?
Thymoglobulin is a prescription (Rx) medicine. Take it as your doctor advises.