Tetanus Immune Globulin

( TIG ) Pronouncation: (TET-ah-nus ih-MYOON GLAH-byoo-lin)
Class: Immune globulin

Trade Names:
Baytet
- Solution 250 units/syringe

Pharmacology

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Directly neutralizes toxin excreted by Clostridium tetani , cause of tetanus.

Pharmacokinetics

Absorption

Tetanus immune globulin T _max is approximately 2 days after IM injection.

Elimination

Tetanus immune globulin T _½ is 23ߙdays.

Indications and Usage

Passive, transient protection against tetanus in any person that may be contaminated with tetanus spores when: (1) patient's personal history of immunization with tetanus toxoid is unknown or uncertain, (2) person received less than 2ߙprior doses of tetanus toxoid, or (3) person received 2 prior doses of tetanus toxoid, but delay of more than 24ߙh occurred between time of injury and initiation of tetanus prophylaxis.

Unlabeled Uses

Treatment of clinical tetanus.

Contraindications

Hypersensitivity to human antibody product, thimerosal, or other components; circulating anti-IgA antibodies.

Dosage and Administration

Adults Prophylactic dose

IM 250 units. Give 500 units if wounds are severe or treatment is delayed. Dosage may be increased to 1,000 to 2,000 units. For therapy of tetanus, give 500 to 3,000 or 6,000 units. Give deep IM, preferably in upper outer quadrant of gluteal muscle.

Children

IM Dose is calculated on basis of body weight (4 units/kg); however, it may be advisable to administer 250 units regardless of the size of the child. The same amount of toxin is produced by the bacteria in adults and children.

General Advice

Refer to appropriate immunization schedule or CDC wound management guideline for correct dosing.
Use different syringe and injection site for the tetanus toxoid.

Storage/Stability

Store in the refrigerator.

Drug Interactions

There is no significant interaction between TIG and tetanus toxoid if given at different injection sites. To avoid inactivating vaccines containing live viruses or bacteria, give live vaccines 2 to 4 wk before or 12ߙwk after TIG.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Local and systemic reactions following TIG are infrequent and usually mild. Expect some pain, tenderness, and muscle stiffness at injection site, persisting for several hours. Hives, angioedema, nephrotic syndrome, and local inflammation occur occasionally. Anaphylactic reactions are very infrequent.

Precautions

Pregnancy

Category C .

Lactation

Undetermined. Use TIG as soon as possible after tetanus-prone injuries. Do not inject IV.

Patient Information

Alert patient that pain, soreness, inflammation, or stiffness at site of injection may be experienced.
Advise patient who is also receiving tetanus toxoid series to complete pending immunizations since TIG protection is only temporary.