Zoster Immunoglobulin

Presentation

Single vials containing 200IU varicella-zoster antibody.

Indications for Use

Zoster Immunoglobulin is indicated for prophaylaxis against varicella in patients who meet all four of the criteria list below:

• One of the following underlying illnesses or conditions
• Neoplastic disease (leukaemia or lymphoma)
• Congenital or acquired immunodeficiency
• Immunosuppressive therapy with steroids or antimetabolites
• One of the following types of exposure to chickenpox or shingles
  
  • Household contact
  • Playmate contact (one hour play indoors)
  • Hospital contact (in same room 2 to 4 bedroom or adjacent beds ina large ward)
  • Newborn contact ( Newborn of mother who had onset of chickenpox , 5 days before delivery or within 48 hours after delivery)
  • Premature infant (≥28weeks gestation) whose mother lacks a prior history of chickenpox
  • Premature infoant (< 28 weeks gestation or ≤1000g) regardless of amternal history.
• Negative or unknown prior history of chickenpox
• If Zoster Immunoglobulin can be administered with 96 hours after exposure.

Note: Zoster Immunoglobulin is of no value in the treatment of established varicella or zoster infection. High levels of circulating antibody do not prevent dissemination of infection.

There is no indication for the prophylactic use of Zoster Immunoglobulin in immunodeficient children or adults when there is a history of varicella, unless the patient’s immunosuppressed status is that which is associated with bone marrow transplantation.

Contraindications

Individuals with:

• IgA deficiency – unless they have no circulating anti IgA antibodies.
• Severe thrombycytopenia or coagulation disorder that would contraindicate IM injections.

Precautions

MUST NOT be administered intravenously.

Care should be taken to draw back plunger of syringe before injection to be certain needle is not in a vessel.

Give with caution to patients with a history of prior systemic allergic reactions to human immunoglobulin preparations.

Availability

Requests to ARCBS.

Dosage and Administration

Zoster Immunoglobulin should be given slowly by intramuscular injection.

Administer by slow intramuscular injection using large gauge needle (20g). If a large dose (more than 5 mls) is required, it is advisable to administer it in divided doses at different sites. Suitable local anaesthetic may be added if desired.

The product s does not contain antimicrobial preservative; it must be used immediately after opening the vial.

Dose is based on weight according to the following schedule:

Refer to the current product information sheet for further information.