Antithymocyte Globulin ‒ Rabbit (Thymoglobuline)

Also known as Rabbit-ATG, rATG. 

See separate monograph for Antithymocyte Globulin – Rabbit (Grafalon)

Trade name

Thymoglobuline

Presentation and Preparation

Vial size (powder volume)	Fluid to add	Volume to add	Resulting concentration
25 mg (negligible)	Water for injections	5 mL	5 mg/mL

Allow vial contents to reach room temperature before reconstitution (approximately 30 minutes). 

Reconstitute with 5 mL of water for injections, added slowly down the vial wall to avoid foaming.Tilt and roll vial gently until completely dissolved.  Do not swirl, invert or shake vial.

Further dilute prior to administration.

IV administration

Dilute reconstituted solution to 0.5 mg/mL or weaker.

Infuse over at least 6 hours through a 0.22 micron low-protein binding filter in-line filter, preferably via a central line or high flow vein.

The first dose should be administered at a reduced infusion rate for the first 30 minutes; see local protocols or guidelines.

If infusion over 6 hours is tolerated, subsequent doses may be infused over 4 hours; refer to local protocols or guidelines.

Other routes of administration

IM: Not recommended.

SC: Not recommended.

Compatible IV fluids

Glucose 5%

Sodium chloride 0.9%

Additional information

Observe closely for anaphylactic reactions.

Use only when facilities for cardiac monitoring and cardio-respiratory resuscitation exist.

Rapid administration is associated with cytokine release syndrome.

Premedication with corticosteroids, antipyretic agents and/or antihistamine 1 hour prior to the infusion is recommended and may reduce the incidence and intensity of side effects during the infusion, refer to local protocol or guidelines.

Monitor patient for infusion reactions and reduce rate of administration if not tolerated.

Refrigerate, do not freeze.

Protect from light during storage.

Discard any unused vial contents.