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Tetanus Immune Globulin (Human)

Pronunciation: TET-a-nus i-MUNE GLOB-ue-lin
Class: Immune Globulin

Trade Names

HyperTET S/D
- Injection, solution 250 units/mL

Pharmacology

Neutralizes toxin produced by Clostridium tetani , the cause of tetanus.

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Pharmacokinetics

Absorption

Peak blood levels are obtained in approximately 2 days.

Elimination

Half-life is approximately 23 days.

Indications and Usage

Prophylaxis against tetanus following injury in patients whose immunization is incomplete or uncertain; in the regimen of active tetanus, however, evidence of effectiveness is limited.

Contraindications

None well documented.

Dosage and Administration

Tetanus Prophylaxis
Adults and Children 7 y and older

IM 250 units. Administer at the same time, but in a different extremity and with a separate syringe, Tetanus and Diphtheria Toxoids Adsorbed (For Adult Use) (Td).

Children Younger Than 7 y

IM 4 units/kg; however, it may be advisable to administer the entire contents of the syringe (250 units) regardless of child's size. Administer at the same time, but in a different extremity and with a different syringe, diphtheria and tetanus toxoids and pertussis vaccine adsorbed (DTP) or diphtheria and tetanus toxoids adsorbed (for pediatric use) (DT), if pertussis vaccine is contraindicated.

Tetanus Treatment
Adults and Children

IM Some studies recommend single doses of 3,000 to 6,000 units IM. The manufacturer states that standard therapy for the treatment of active tetanus, including the use of tetanus immune globulin, must be implemented immediately. Adjust the dosage according to the severity of infection.

General Advice

  • For IM administration only; not for IV administration.
  • Administer IM, preferably in the deltoid muscle of the upper arm or lateral thigh muscle. The gluteal region should not be used routinely as an injection site.
  • Adults with uncertain histories of a complete primary vaccination series should receive a primary series using the combined Td toxoid.
  • To ensure continued protection, booster doses of Td should be given every 10 y.

Storage/Stability

Store between 36° and 46°F. Do not freeze.

Drug Interactions

Live virus vaccines (eg, measles, mumps, polio, rubella)

Antibodies in immunoglobulin preparations may interfere with the response to live viral vaccines. Defer use of such vaccines until approximately 3 mo after tetanus immune globulin (human) administration.

Adverse Reactions

Local

Slight soreness at the injection site.

Miscellaneous

Slight temperature elevation; isolated occurrences of angioneurotic edema, nephrotic syndrome, and anaphylactic shock after injection.

Precautions

Pregnancy

Category C . No risk to the fetus has been reported. The American Congress of Obstetricians and Gynecologists recommends the use of tetanus immune globulin in pregnancy for postexposure prophylaxis.

Lactation

No data are available.

Hypersensitivity

Use with caution in patients with a history of system allergic reactions following the administration of human immunoglobulin preparations.

Administration

Do not administer IV.

Bleeding disorders

Use with caution in patients with severe thrombocytopenia or any coagulation disorder that would contraindicate IM injection.

Chemoprophylaxis

Chemoprophylaxis against tetanus is neither practical nor useful in managing wounds.

Skin tests

Skin testing should not be performed because local irritation can occur and be misinterpreted as a positive reaction.

Transmission of infectious agents

Because tetanus immune globulin is made from human plasma, it may contain infectious agents, such as viruses, and theoretically, the Creutzfeldt-Jacob disease agent that can cause disease.

Overdosage

Symptoms

No data are available; however, pain and tenderness at the injection site would be expected.

Patient Information

  • Inform patient that slight soreness at injection site or slight temperature elevations may occur after administration of this medication.
  • Advise patients to complete the tetanus toxoid immunization series as required.

Copyright © 2009 Wolters Kluwer Health.

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