Following intravenous administration of the drug immediately enters the systemic circulation relatively quickly redistributed between the plasma and the extravascular space. The equilibrium state is achieved after 3-5 days. The half-life deca durabolin for sale of about 24-36 days, the half-life may vary from gerald andriole patient to patient, particularly in patients suffering from primary immunodeficiency. Immunoglobulin G and immune complexes are destroyed immunoglobulin G cells of the reticuloendothelial system.
1. Substitution therapy.
- Primary immunodeficiency syndromes:
- congenital agammaglobulinemia and hypogammaglobulinemia,
- ungraded variable immunodeficiency,
- severe combined immunodeficiencies,
- Wiskott-Aldrich syndrome
- Multiple myeloma or chronic lymphatic leukemia with severe secondary hypogammaglobulinemia and recurrent infections.
- Congenital HIV infection with recurrent infections in children.
2. Immunomodulatory therapy.
- Idiopathic thrombocytopenic purpura (ITP) in adults and children at high risk of bleeding or prior to surgery to correct the platelet count.
- Guillain-Barre Syndrome.
- Kawasaki disease.
3. Allogeneic bone marrow transplantation.
: Hypersensitivity to the drug; intolerance or hypersensitivity to homologous immunoglobulins, especially in extremely rare cases, immunoglobulin deficiency, when the patient contains antibodies to immunoglobulin A.
Caution should be exercised when administering the drug to patients with obesity, as well as in patients with predisposing risk factors for thrombotic events such as advanced age, hypertension, diabetes mellitus, diseases of the circulatory system, the propensity to develop thrombosis, long stay in a fixed gerald andriole position, severe hypovolemia, diseases accompanied by increased blood viscosity. This is due to a relative increase in blood viscosity immunoglobulin entering the bloodstream, increasing the risk of myocardial infarction, stroke, pulmonary embolism and deep vein thrombosis.
Due to the possible development of acute renal insufficiency Caution should be exercised when administered intravenously immunoglobulin in patients with renal insufficiency, diabetes, obesity, hypovolemia, elderly patients (over 65 years), as well as patients receiving concomitant therapy with nephrotoxic drugs. In the case of acute renal failure, drug overturned immediately.
Patients groups at risk of developing acute renal failure, and thromboembolic complications of the drug is administered at the minimum speed and in minimal doses.
Use during pregnancy and lactation
The safety of the drug in pregnant women has not been established in controlled clinical trials. Therefore, pregnant and lactating women drug should be used with caution. At the same time, clinical experience with immunoglobulins suggests that their introduction does not appear to have any negative impact on the course of pregnancy, fetus and newborn.
Immunoglobulins are excreted in breast milk, and the antibodies may have a protective effect in the newborn.
Dosing and Administration
The drug is administered intravenously. Before adding the solution temperature should be brought to room temperature. The solution should be clear or slightly opalescent. Do not use cloudy and containing precipitate solutions.
Each administration of the drug is recommended to register the name and number of the series in the history of the disease or the patient’s medical card in order to be able to trace the connection status of the patient with the introduction of a specific series of drug. Any amount remaining after infusion should be destroyed.
The initial rate of introduction – from 0.01 to 0.02 ml / kg body weight per minute for 30 minutes. If the drug was well tolerated, the rate of introduction can be gradually increased to a maximum of 0.12 ml / kg body weight per minute.
The dosage regimen of the drug and duration of therapy are selected individually depending on the indication, the pharmacokinetic parameters and clinical response for a particular patient. Substitution therapy in primary immunodeficiencies dosing regime should achieve a concentration of immunoglobulin g, deca durabolin for sale measured before each subsequent infusion, within at least – 4.0-6.0 g / l. In order to correct dosing regimen should be to measure the concentration of immunoglobulin G before each subsequent infusion. Replacement therapy in myeloma or chronic lymphatic leukemia with severe secondary hypogammaglobulinemia and recurrent infections; in children with congenital HIV infection and recurrent gerald andriole infections Treatment was continued for 3 months after transplantation. In case of a constant immunoglobulin deficiency recommended administered 0.5 g / kg body weight per month as long as the immunoglobulin level normalizes.
When intravenous immunoglobulin development of side effects depend on the dose and rate of administration.
Adverse reactions Incidence is classified as follows: common ( > 1% – <10%), uncommon ( > 0.1% – <1%), very rare (<0.01%). On the part of the blood system and lymphatic system : very rarely – leukopenia, reversible hemolytic anemia, haemolysis. immune system : often – a hypersensitivity reaction; rarely -anafilaktoidnye and anaphylactic (including anaphylactic shock) reactions, angioedema, face edema. Nervous system : often – headache; very rarely – excitement, cerebrovascular accidents (including – stroke), aseptic meningitis, headache, dizziness, paresthesia. With the cardiovascular system : very rarely – myocardial infarction, tachycardia, palpitation, cyanosis, thrombosis, circulatory failure, hypotension, hypertension, deep vein thrombosis. The respiratory system : very rare – respiratory failure, pulmonary embolism, pulmonary edema, bronchospasm, dyspnea, cough. On the part of the gastrointestinal tract : often – nausea; very rare: vomiting, diarrhea, abdominal pain. From the side of the skin : rarely – eczema; very rarely – urticaria, rash (including -eritematoznaya), dermatitis, pruritus, alopecia. From the musculoskeletal system : rarely deca durabolin for sale – back pain; very rarely – arthralgia, myalgia. From the urinary system : very rarely – acute renal failure, elevated serum creatinine concentration in the blood. From the laboratory parameters : very rarely – increased values of “liver” enzymes, false positive increase in the concentration of glucose in the blood. Other: often – fever, fatigue, injection site reactions; rarely – fever, chest pain; very seldom – flushing, pyrexia, rash, malaise. Rarely gerald andriole may develop a sudden drop in blood pressure, and in some cases – anaphylactic shock, including patients that administering immunoglobulin previously tolerated. androlic