Anti-d Immunoglobulin

What it is and how it works

Plasma-derived IgG containing high titres of antibodies against the RhD antigen. It binds RhD-positive fetal red cells in the maternal circulation, leading to their clearance before the mother's immune system becomes sensitised, thereby preventing formation of maternal anti-D antibodies.

Indications

Prevention of RhD sensitisation in RhD-negative women during pregnancy (routine antenatal prophylaxis and after potentially sensitising events), after delivery of an RhD-positive infant, and after miscarriage, termination or ectopic pregnancy; after incompatible transfusion of RhD-positive blood.

Dosage and administration (summary)

Dosing is individualised according to protocol, gestational age and the estimated volume of fetomaternal haemorrhage (Kleihauer test); given by intramuscular injection, usually within 72 hours of the sensitising event.

Contraindications

RhD-positive individuals; RhD-negative women already sensitised with anti-D antibodies; hypersensitivity to human immunoglobulins; intramuscular route in severe thrombocytopenia or coagulation disorders.

Warnings and precautions

Hypersensitivity reactions including anaphylaxis may occur, particularly in IgA-deficient patients with anti-IgA antibodies. As a plasma-derived product, transmission of infectious agents cannot be totally excluded. May interfere with live viral vaccines (e.g. measles, rubella) for up to 3 months.

Pregnancy

Intended for use in pregnancy; no adverse effects on the fetus are expected.

Storage and supply

Store at 2–8 °C refrigerated; do not freeze; protect from light.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.