|CYTOMEGALOVIRUS IMMUNE GLOBULIN (CMVIG, CMV-IVIG)
Classifications: biologic response modifier; immunoglobulin; Therapeutic: immunoglobulin
Prototype: Interferon alfa-2a
Pregnancy Category: C
50 mg/mL injection
Cytomegalovirus immune globulin (CMVIG) is a preparation of immunoglobulin G (IgG) antibodies derived from a large number
of healthy donors with high concentrations of antibodies directed against cytomegalovirus (CMV).
The CMV antibodies attenuate or reduce the incidence of serious CMV disease, such as CMV-associated pneumonia, CMV-associated
hepatitis, and concomitant fungi and parasitic superinfections.
Attenuation of primary cytomegalovirus (CMV) disease associated with kidney transplantation.
Prevention of CMV disease in other organ transplants (especially heart) when the recipient is seronegative for CMV and the
donor is seropositive.
History of previous severe reactions associated with CMVIG or other human immunoglobulin preparations, selective immunoglobulin
A (IgA) deficiency; pregnancy (category C).
Myelosuppression, maltose or sucrose hypersensitivity; cardiac disease, lactation.
Route & Dosage
|Prevention of CMV Disease
Adult: IV 150 mg/kg within 72 h of transplantation, then 100 mg/kg 2, 4, 6, and 8 wk posttransplant, then 50 mg/kg 12 and 16 wk posttransplant
- CMVIG should be administered through a separate IV line using an infusion pump. See manufacturer's directions if this is
PREPARE: IV Infusion: Use a double ended transfer needle or large syringe to reconstitute with 50 mL sterile water. Gently rotate vial to dissolve;
do not shake. Allow 30 min to dissolve powder. Reconstituted solution contains 50 mg/mL. Must be completely infused within
12 h since solution contains no preservative.
ADMINISTER: IV Infusion: Use a constant infusion pump and give at rate of 15, 30, 60 mg/kg/h over first 30 min, second 30 min, third 30 min, respectively.
Monitor closely during and after each rate change. If flushing, nausea, back pain, fever, or chills develops, slow or temporarily
discontinue infusion. If BP begins to decrease, stop infusion and institute emergency measures. Infusion of Subsequent IV Doses: The intervals for increasing the dose from 15 to 30 to 60 mg may be shortened from 30 to 15 min. Never infuse more than 75
- Reconstituted solution should be started within 6 h and completed within 12 h of preparation. Discard solution if cloudy.
Adverse Effects (≥1%)Body as a Whole:
Muscle aches, back pain, anaphylaxis
(rare), fever and chills during infusion. CV:
Hypotension, palpitations. GI:
Nausea, vomiting, metallic taste. CNS:
Headache, anxiety. Respiratory:
Shortness of breath, wheezing. Skin:
May interfere with the immune response
to live virus vaccines (BCG, measles/mumps/rubella, live polio),
with live viral vaccines for approximately 3 mo after administration
of CMVIG; revaccination may be necessary
if these vaccines were given shortly after CMVIG.
Assessment & Drug Effects
- Monitor vital signs preinfusion, before increases in infusion rate, periodically during infusion, and postinfusion.
- Notify physician immediately if any of the following occur: flushing, nausea, back pain, fall in BP, other signs of anaphylaxis.
- Emergency drugs should be available for treatment of acute anaphylactic reactions.
- Monitor for CMV-associated syndromes (e.g., leukopenia, thrombocytopenia, hepatitis, pneumonia) and for superinfections.
Patient & Family Education
- Familiarize yourself with potential adverse effects and know which to report to physician.
- Defer vaccination with live viral vaccines for 3 mo after administration of CMVIG.