How to administer Zoster Immunoglobulin-VF - Quick Guide

Presentation

  • Zoster Immunoglobulin-VF (200 IU) in 2mL vial with variable volume in the bottle. The actual volume of liquid is written on the top of the box (e.g. 1.73mL in the image on the right).
Zoster Immunoglobulin-VF

ABO Compatibility

  • Compatibility is not relevant for manufactured (fractionated) plasma product transfusion

Storage and Infusion

  • Inject promptly. Do not give intravenously. If any delay store at 2-8°C in an appropriately monitored refrigerator.

Precautions

  • Read manufacturer's instructions carefully
  • Always observe for turbidity, floating material and sediment
  • Intra-muscular products - follow recommended best practice.
  • Specific information about the administration of each product is given in the manufacturer's product information

Intravenous Alternatives

  • Intragam®P is an intravenous alternative (eg for a thrombocytopenic patient) to Zoster Immunoglobulin-VF. Please contact Blood Bank to find out the dose for the current batch of Intragam®P.

Vaccination

  • Inactivated vaccines:
    • Inactivated vaccines may be administered concurrently with passive antibody (although in separate syringes injected into separate limbs) to induce active immunity.
  • Live attenuated virus vaccines:
    • Passively acquired antibody can interfere with the response to live, attenuated virus vaccines. Therefore, administration of such vaccines, e.g. poliomyelitis or measles, should be deferred until approximately three months after passive immunisation.
    • If Zoster Immunoglobulin-VF is administered within two weeks of vaccination with a live attenuated virus vaccine, the efficacy of the vaccine may be compromised. Consideration should be given to re-vaccination approximately three months after the immunoglobulin was given.
  • Passive Transfer of Antibodies and Interference with Serological Testing:
    • After injection of Zoster Immunoglobulin-VF, the transitory rise of the various passively transferred antibodies in the patient's blood may result in misleading positive results in serological testing.

Monitoring

  • Recipients should remain under observation for 20 minutes following administration in case they experience an immediate adverse event requiring treatment.

DO NOT

  • DO NOT add medications to blood products.

Doses

  • Zoster Immunoglobulin-VF should be administered as soon as possible after exposure of at-risk patients to chickenpox or shingles but may be administered up to 10 days post exposure. Note that this is a longer period than described in the datasheet.
    Indications: see datasheet. Note that Zoster Immunoglobulin-VF requires prior authorisation by an NZBS Medical Officer.
  • Dose:
    • 0-10 kg: 1 vials (200 IU)
    • 10.1-30 kg: 2 vials (400 IU)
    • >30.1 kg: 3 vials (600 IU)
  • Intragam®P may also be used for Zoster prophylaxis, especially where:
    • the patient is thrombocytopenia
    • the patient already has an intravenous line in situ
    • Zoster Immunoglobulin-VF is not available or in short supply
    The required dose is 125 IU per 10 kg bodyweight. Please discuss with Blood Bank the volume of Intragamp®P required to achieve this.

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