RhoGAM Disease Interactions

The use of RHo (D) immune globulin is contraindicated in patients with autoimmune hemolytic anemia, with preexisting hemolysis or at high risk for hemolysis. Patients that have lower than normal hemoglobin levels (less than 10 g/dL), a reduced dose of 125 to 200 international unit/kg (25 to 40 mcg/kg) should be given to minimize the risk of increasing the severity of anemia. Alternative treatments should be used in patients with hemoglobin levels that are less than 8 g/dL due to the risk of increasing the severity of the anemia. Patients should be monitored to determine clinical response by assessing platelet counts, RBCs, hemoglobin, and reticulocyte levels.

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The use of RHo (D) immune globulin should be used with caution in diabetic patients as immune globulin intravenous products containing maltose, such as the liquid formulation of WinRho SDF, have been shown to give falsely high blood glucose in certain types of blood glucose testing system. It is recommended to use only test systems that are glucose-specific to test or monitor blood glucose levels in patients receiving maltose-containing parenteral products.

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The use of RHo (D) immune globulin should be used with caution in volume-depleted patients as these agents may cause acute renal dysfunction/failure, osmotic nephropathy, and death. Ensure that patients are not volume depleted before administering this agent. It is advisable to administer RHo (D) immune globulin at the minimum infusion rate practicable in patients at risk of renal dysfunction or failure, including those with any degree of preexisting renal insufficiency. Also, in patients with diabetes mellitus, advanced age (above 65 years of age), volume depletion, sepsis, paraproteinemia, or receiving known nephrotoxic drugs. It is recommended to assess renal function, including measurement of blood urea nitrogen (BUN) and serum creatinine, before the initial infusion.

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The use of immune globulin intravenous products, including RHo (D) immune globulin may cause thromboembolism. Care should be taken when using these agents in patients with a history of atherosclerosis, multiple cardiovascular risk factors, advanced age, impaired cardiac output, coagulation disorders, prolonged periods of immobilization, and/or known/suspected hyperviscosity. It is recommended to assess blood viscosity in patients at risk of hyperviscosity and in those at risk of developing thromboembolic events, these agents should be administered at the minimum rate of infusion practicable.

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