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Rho (D) Immune Globulin Dosage

Medically reviewed by Drugs.com. Last updated on Jul 31, 2023.

Applies to the following strengths: 300 mcg; 50 mcg; 600 intl units; 1500 intl units; 5000 intl units; 600 intl units/0.5 mL; 1500 intl units/1.3 mL; 5000 intl units/4.4 mL; 2500 intl units/2.2 mL; 15000 intl units/13 mL; 250 intl units; 1500 intl units/2 mL; 120 mcg; 1000 mcg

Usual Adult Dose for Idiopathic (Immune) Thrombocytopenic Purpura

Rhophylac(R): 250 international units (50 mcg) per kg, IV, at 2 mL per 15 to 60 seconds
WinRho(R):


Use: Immune thrombocytopenic purpura (ITP):

Usual Adult Dose for Rh-Isoimmunization

Dose and route varies for each product.

Rh-incompatible pregnancy:
RhoGAM(R): 1500 international units (300 mcg), IM, at gestational week 26 to 28, or within 72 hours of birth of an RHo (D) positive baby.
Rhophylac(R): 1500 international units (300 mcg), IV or IM, at gestational week 29 to 30; repeat dose within 72 hours of birth of an RHo (D) positive baby.
WinRho(R): 1500 international units (300 mcg), IV or IM, at gestational week 28; give an additional 600 international units (120 mcg) dose within 72 hours of birth of an RHo (D) positive baby.

Comments:


Amniocentesis and chorionic villus sampling before 34 weeks gestation:
RhoGAM(R): 1500 international units (300 mcg), IM
WinRho(R): 1500 international units (300 mcg), IV or IM, immediately after the procedure

Abortion or miscarriage of up to 12 weeks gestation:
BayRho-D Mini-Dose(R): 1 syringe, IM, within 3 hours, or as soon as possible (within 72 hours of pregnancy termination).
HyperRHO S/D Mini-Dose(R): 1 syringe, IM, within 3 hours, or as soon as possible (within 72 hours of pregnancy termination).
MICRhoGAM(R) or RhoGAM(R): 250 international units (50 mcg), IM, within 72 hours of actual or threatened pregnancy termination.

Abortion or miscarriage after 12 weeks gestation:
RhoGAM(R): 1500 international units (300 mcg), IM

Abortion, amniocentesis, or any other manipulation after 34 weeks gestation:
WinRho(R): 600 international units (120 mcg), IV or IM, within 72 hours

Ectopic pregnancy:
RhoGAM(R): 1500 international units (300 mcg), IM

Excessive fetomaternal hemorrhage:
Rhophylac(R): 1500 international units (300 mcg), IV or IM, within 72 hours of complication, plus:
OR

Obstetric complications/invasive procedures:
RhoGAM(R): 1500 international units (300 mcg), IM
Rhophylac(R): 1500 international units (300 mcg), IV or IM, within 72 hours of the at-risk event.

Threatened abortion at any time:
WinRho(R): 1500 international units (300 mcg), IV or IM, immediately

Threatened pregnancy loss after 12 weeks gestation with continuation of pregnancy:
RhoGAM(R): 1500 international units (300 mcg), IM

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Incompatible transfusions:
MICRhoGAM(R) or RhoGAM(R):
RhoGAM(R):

Rhophylac(R): 100 international units (20 mcg) per 2 mL transfused blood (or per 1 mL erythrocyte concentrate), IM or IV, within 72 hours of exposure.
WinRho(R):
IV administration:
45 international units (9 mcg) per mL whole blood
90 international units (18 mcg) per mL red blood cells
IM administration:
60 international units (12 mcg) per mL whole blood
120 international units (24 mcg) per mL red blood cells

Uses:
Suppression of Rh isoimmunization in:

Usual Pediatric Dose for Idiopathic (Immune) Thrombocytopenic Purpura

Rhophylac(R): 250 international units (50 mcg) per kg, IV, at 2 mL per 15 to 60 seconds
WinRho(R):


Use: Immune thrombocytopenic purpura (ITP):

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Exposure to over 15 mL of RHo (D)-positive red blood cells (postpartum prophylaxis/obstetric complications/invasive procedures):
Rhophylac(R): Increase the dose based on guidelines for excessive fetomaternal hemorrhage.

Immune thrombocytopenic purpura (ITP):

WinRho(R): Reduce dose to 125 to 200 international units/kg (25 to 40 mcg/kg), IV, over 3 to 5 minutes

If subsequent therapy is needed to elevate platelet counts:
WinRho(R): 125 to 300 international units/kg (25 to 60 mcg/kg), IV, over 3 to 5 minutes
Hgb under 8 g/dL: Use alternative treatment
Hgb 8 to 10 g/dL: 125 to 200 international units/kg (25 to 40 mcg/kg)
Hgb over 10 g/dL: 250 to 300 international units/kg (50 to 60 mcg/kg)

Precautions

US BOXED WARNING(S): INTRAVASCULAR HEMOLYSIS
This warning does NOT apply to Rho(D)-negative patients treated for the suppression of Rh isoimmunization.

Recommendations:


Several Rho (D) immune globulin products are not for IV use. Verify the recommended route of administration for each product prior to dosing.

Rho (D) immune globulin should not be administered to the infant for the suppression of Rh isoimmunization in the mother.

If the dose requires the use of multiple vials, the dose may be injected at different injection sites at the same time or in intervals. The total dosage must be injected within 72 hours postpartum or after the transfusion accident.

The criteria for the administration of Rho (D) immune globulin for a Rh incompatible pregnancy are:
1. Mother must be Rho (D) negative.
2. The mother should not have been previously sensitized to the Rho (D) factor.
3. The infant must be Rho (D) positive and direct antiglobulin negative.

Babies born of women who have been given Rho (D) immune globulin antepartum may have a weakly positive antiglobulin test at birth.

Clinical response to treatment with Rho (D) IGIV by a patient with ITP should be ascertained by monitoring platelet counts, red cell counts, hemoglobin, and reticulocyte levels.

Maltose in IVIG products, such as the liquid formulation of WinRho SDF, has been shown to give false high blood glucose levels in certain types of blood glucose testing systems. Due to the potential for false elevated glucose readings, only testing systems that are glucose-specific should be used to test or monitor blood glucose levels in patients receiving this product.

Hyper RHO S/D Mini-Dose (R) should never be given intravenously.

Hyper RHO S/D Mini-Dose (R) should not be injected into the gluteal region because of the risk of injury to the sciatic nerve.

Dialysis

Data not available

Other Comments

Administration advice:


Monitoring:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.