Select a medication above to begin.
Xembify (immune globulin human-klhw)
immune globulin (human)
Black Box Warnings .
Thrombosis
may occur w/ immune globulin products; risk factors incl. advanced age, prolonged immobilization, hypercoagulable conditions, venous or arterial thrombosis hx, estrogen use, indwelling central vascular catheter, hyperviscosity, and cardiovascular dz risk; thrombosis may occur in pts w/o risk factors; use minimum dose and infusion rate practicable in pts at risk; ensure adequate hydration before admin; monitor for s/sx thrombosis and assess blood viscosity in pts w/ hyperviscosity risk
Adult Dosing .
Dosage forms: INJ
Special Note
- [formulation clarification]
- Info: nonproprietary name = immune globulin human-klhw
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing
primary immunodeficiency
- [tx-experienced pts, frequent dosing (2-7x/wk)]
- Dose: frequent SCIG dose = [last IVIG dose (g) x 1.37] divided by last IVIG dosing interval (wk) divided by the desired number of doses per wk; Start: 1wk after receiving last IVIG or SCIG dose; Alt: divide last weekly SCIG dose by the desired number of doses per wk; Info: adjust dose based on trough IgG levels and clinical response
- [tx-experienced pts, weekly dosing]
- Dose: weekly SCIG dose = [last IVIG dose (g) x 1.37] divided by last IVIG dosing interval (wk); Start: 1wk after receiving last IVIG or SCIG dose; Alt: maintain previous weekly SCIG dose; Info: adjust dose based on trough IgG levels and clinical response
- [tx-experienced pts, biweekly dosing (q2wk)]
- Dose: weekly SCIG dose = [last IVIG dose (g) x 1.37] divided by last IVIG dosing interval (wk) x2; Start: 1wk after receiving last IVIG or SCIG dose; Alt: maintain previous weekly SCIG dose x2; Info: adjust dose based on trough IgG levels and clinical response
- [tx-naive pts]
- Dose: 150 mg/kg/dose SC qwk on day 8; Start: 150 mg/kg/dose SC qd x5 consecutive days; Info: adjust dose based on trough IgG levels and clinical response
renal dosing
- [see below]
- renal impairment: not defined, consider lower, more frequent dosing
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: INJ
Special Note
- [formulation clarification]
- Info: nonproprietary name = immune globulin human-klhw
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing
primary immunodeficiency
- [tx-experienced pts, frequent dosing (2-7x/wk), 2 yo and older]
- Dose: frequent SCIG dose = [last IVIG dose (g) x 1.37] divided by last IVIG dosing interval (wk) divided by the desired number of doses per wk; Start: 1wk after receiving last IVIG or SCIG dose; Alt: divide last weekly SCIG dose by the desired number of doses per wk; Info: adjust dose based on trough IgG levels and clinical response
- [tx-experienced pts, weekly dosing, 2 yo and older]
- Dose: weekly SCIG dose = [last IVIG dose (g) x 1.37] divided by last IVIG dosing interval (wk); Start: 1wk after receiving last IVIG or SCIG dose; Alt: maintain previous weekly SCIG dose; Info: adjust dose based on trough IgG levels and clinical response
- [tx-experienced pts, biweekly dosing (q2wk), 2 yo and older]
- Dose: weekly SCIG dose = [last IVIG dose (g) x 1.37] divided by last IVIG dosing interval (wk) x2; Start: 1wk after receiving last IVIG or SCIG dose; Alt: maintain previous weekly SCIG dose x2; Info: adjust dose based on trough IgG levels and clinical response
- [tx-naive pts, 2 yo and older]
- Dose: 150 mg/kg/dose SC qwk on day 8; Start: 150 mg/kg/dose SC qd x5 consecutive days; Info: adjust dose based on trough IgG levels and clinical response
renal dosing
- [see below]
- renal impairment: not defined, consider lower, more frequent dosing
- HD/PD: not defined
hepatic dosing
- [not defined]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- caution: IgA deficiency
- caution: nephrotoxic agent use, concurrent
- caution: pts >65 yo
- caution: renal impairment
- caution: renal impairment risk
- caution: paraproteinemia
- caution: migraine hx
- caution: thrombosis risk
- caution: hyperviscosity
- caution: A blood group
- caution: AB blood group
- caution: B blood group
- caution: inflammatory disorder
- caution: high-dose use
Drug Interactions .
Overview
immune globulin
immunoglobulin
- immunomodulatory effects (immune globulin)
- nephrotoxicity
- thrombogenic effects
- monitor renal fxn; nephrotoxicity risk may be higher w/ sucrose-containing immune globulins, may vary depending on route of admin.
Contraindicated
- cidofovir
Avoid/Use Alternative
- aldesleukin
- amikacin
- amikacin inhaled
- bumetanide
- clofarabine
- efgartigimod alfa
- ethacrynic acid
- foscarnet
- furosemide
- ganciclovir
- gentamicin
- immune globulin
- mannitol
- methotrexate
- oxaliplatin
- pentamidine
- polymyxin B
- pozelimab
- rozanolixizumab
- streptomycin
- streptozocin
- tenofovir disoproxil
- tobramycin
- tobramycin inhaled
- torsemide
- tranexamic acid
- vaccinia immune globulin
- valganciclovir
Monitor/Modify Tx
- abemaciclib
- abrocitinib
- acyclovir
- adefovir dipivoxil
- adenovirus vaccine, live
- aflibercept
- alectinib
- aliskiren
- amiloride
- aminocaproic acid
- amphotericin
- angiotensin II
- anthrax immune globulin
- anti-inhibitor coagulant complex
- antihemophilic factor (factor VIII)/von Willebrand factor complex
- asciminib
- asparaginase
- aspirin
- atidarsagene autotemcel
- auranofin
- avatrombopag
- axitinib
- azilsartan medoxomil
- balsalazide
- baricitinib
- bazedoxifene
- benazepril
- bevacizumab
- binimetinib
- bleomycin
- botulism immune globulin
- brolucizumab
- C1 esterase inhibitor
- cabozantinib
- calaspargase
- candesartan cilexetil
- capecitabine
- captopril
- carboplatin
- carfilzomib
- celecoxib
- chlorothiazide
- chlorthalidone
- chorionic gonadotropin
- cisplatin
- clindamycin
- clozapine
- coagulation factor IX
- coagulation factor VIIa
- coagulation factor XIII A-subunit
- colistimethate
- concizumab
- creatine
- cyclophosphamide
- cyclosporine
- cytomegalovirus immune globulin
- danazol
- darbepoetin alfa
- deferasirox
- deferoxamine
- deflazacort
- dengue vaccine, live
- desogestrel (contraceptive)
- deuruxolitinib
- dexamethasone
- diclofenac
- diclofenac topical
- dienogest (contraceptive)
- diflunisal
- drospirenone (contraceptive)
- drospirenone (hormone replacement)
- eltrombopag
- enalapril
- enalaprilat
- epirubicin
- epoetin alfa
- estetrol (contraceptive)
- estradiol (contraceptive)
- estradiol (hormone replacement)
- estrogens, conjugated (hormone replacement)
- estrogens, esterified (hormone replacement)
- ethinyl estradiol (contraceptive)
- ethinyl estradiol (hormone replacement)
- ethynodiol (contraceptive)
- etodolac
- etonogestrel (contraceptive)
- everolimus
- exenatide
- factor XIII concentrate
- faricimab
- fedratinib
- fenofibrate
- fenofibric acid
- fenoprofen
- fitusiran
- flucytosine
- flurbiprofen
- follitropin
- fosinopril
- fruquintinib
- hepatitis B immune globulin
- hydrochlorothiazide
- ibuprofen
- ibuprofen lysine
- ifosfamide
- indapamide
- indomethacin
- iohexol
- iopamidol
- irbesartan
- ketoprofen
- ketorolac
- lazertinib
- lenalidomide
- lenvatinib
- levonorgestrel (contraceptive)
- levonorgestrel (hormone replacement)
- lifileucel
- liraglutide
- lisinopril
- lithium
- losartan
- luspatercept
- lusutrombopag
- lutetium Lu 177 vipivotide tetraxetan
- magnesium citrate
- magnesium salicylate
- measles/mumps/rubella vaccine, live
- meclofenamate
- medroxyprogesterone (contraceptive)
- medroxyprogesterone (hormone replacement)
- mefenamic acid
- megestrol
- meloxicam
- menotropins
- mesalamine
- mesalamine rectal
- methoxy polyethylene glycol-epoetin beta
- methyltestosterone
- metolazone
- mitomycin
- moexipril
- momelotinib
- nabumetone
- naproxen
- necitumumab
- neomycin
- nintedanib
- norelgestromin (contraceptive)
- norethindrone (contraceptive)
- norethindrone acetate (hormone replacement)
- norgestimate (contraceptive)
- norgestimate (hormone replacement)
- norgestrel (contraceptive)
- nusinersen
- olaparib
- olmesartan medoxomil
- olsalazine
- ospemifene
- oxaprozin
- pacritinib
- pamidronate
- paromomycin
- pazopanib
- pegaspargase
- pemetrexed
- penicillamine
- pentostatin
- perindopril
- piroxicam
- plazomicin
- polyethylene glycol
- polyethylene glycol/electrolytes
- pomalidomide
- ponatinib
- porfimer
- progesterone (hormone replacement)
- progesterone vaginal (hormone replacement)
- prothrombin complex concentrate (human)
- quinapril
- raloxifene
- ramipril
- ramucirumab
- ranibizumab
- ravulizumab
- Rho(D) immune globulin
- ritlecitinib
- rituximab
- romiplostim
- ropeginterferon alfa-2b
- ruxolitinib
- ruxolitinib topical
- salsalate
- segesterone (contraceptive)
- sipuleucel-T
- sirolimus
- sitagliptin
- sodium tetradecyl sulfate
- sotatercept
- sparsentan
- spironolactone
- sulfate bowel prep
- sulindac
- sunitinib
- tacrolimus
- tamoxifen
- telavancin
- telmisartan
- temsirolimus
- tenofovir alafenamide
- testosterone
- thalidomide
- tiopronin
- tivozanib
- tofacitinib
- tolmetin
- toremifene
- trametinib
- trandolapril
- tretinoin
- triamterene
- upadacitinib
- vadadustat
- valacyclovir
- valoctocogene roxaparvovec
- valsartan
- vamorolone
- vancomycin
- varicella vaccine, live
- varicella zoster immune globulin
- voclosporin
- von Willebrand factor
- vorinostat
- ziv-aflibercept
- zoledronic acid
- zonisamide
Caution Advised
- eculizumab
Adverse Reactions .
Serious Reactions
- hypersensitivity rxn, severe
- anaphylaxis
- nephrotoxicity
- hyperviscosity
- thromboembolism
- aseptic meningitis
- hemolytic anemia
- transfusion-related acute lung injury
- viral transmission risk
Common Reactions
- infusion site rxn
- cough
- diarrhea
- skin papules
- arthralgia
- myalgia
Safety/Monitoring .
Monitoring Parameters
BUN/Cr at baseline, then periodically; urine output if acute renal failure risk; vital signs during infusion; blood viscosity at baseline, s/sx thrombosis if hyperviscosity risk; consider Hgb or Hct at baseline, then w/in 36-96h post-infusion if hemolysis risk
Pregnancy/Lactation .
Pregnancy
Clinical Summary
may use during pregnancy; no known risk of fetal harm based on human data
Lactation
Clinical Summary
may use while breastfeeding; no known risk of infant harm based on human data; no human data available to assess effects on milk production
Pharmacology .
Metabolism: other; CYP450: unknown
Excretion: other; Half-life: 40.6 days; Info: half-life varies among pts
Subclass: Immunoglobulins
Mechanism of Action
exact mechanism of action unknown; reestablishes normal immunoregulatory pathways
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.