|Vaccinia Immune Globulin (VIG-IV)
Classifications: biologic response modifier; immunoglobulin; Therapeutic: immunoglobulin
Prototype: Immune globulin intravenous
Pregnancy Category: C
50 mg/mL injection
Vaccinia immune globulin, VIG (VIG-IV) is a purified human immunoglobulin G (IgG) with trace amounts of IgA and IgM. It
is derived from adult human plasma collected from donors who received booster immunizations with the smallpox vaccine. VIG
(VIG-IV) contains high titers of antivaccinia antibodies.
VIG is effective in the treatment of smallpox vaccine adverse reactions secondary to continued vaccinia virus replication
Prevention of serious complications of smallpox vaccine; treatment of progressive vaccinia; severe generalized vaccinia;
eczema vaccinatum; vaccinia infection in patients with skin conditions (e.g., burns, impetigo, varicella-zoster, poison
ivy, or eczematous skin lesions); treatment or modification of aberrant infections induced by vaccinia virus.
Predisposition to acute renal failure (i.e., preexisting renal insufficiency, diabetes mellitus, volume depletion, sepsis,
patients >65 y); AIDS; chronic skin conditions (e.g., burn, atopy); bone marrow suppression; chemotherapy; radiation therapy;
corticosteroid therapy, eczema; hematologic disease; herpes infection; postvaccinal encephalitis; pregnancy (category C);
lactation; infants <12 mo.
Concurrent administration of known nephrotoxic drugs; autoimmune disease; cardiomyopathy, cardiac disease.
Route & Dosage
Adults: IV 100500 mg/kg
Maximum dose: 400 mg/kg
PREPARE: IV Infusion: No dilution required. Use solution as supplied.
ADMINISTER: IV Infusion: Begin infusion within 6 h of entering the vial. Complete infusion within 12 h of entering the vial. Use in-line filter (0.22
microns), infusion pump, and dedicated IV line [may infuse into a preexisting catheter if it contains NS, D2.5W, D5W, D10W,
or D20W (or any combination of these)]. Infuse at 1.0 mL/kg/h the first 30 min, increase to 2.0 mL/kg/h the next 30 min,
and then increase to 3.0 mL/kg/h until infused.
Adverse Effects (≥1%) Body as a Whole:
Injection site reaction. CNS:
Dizziness, headache. GI:
Abdominal pain, nausea, vomiting. Musculoskeletal:
Arthralgia, back pain. Respiratory:
Upper respiratory infection. Skin:
May interfere with the immune response to live virus vaccines
. Vaccination with live virus vaccines
should be deferred until approximately 6 mo after administration of VIG-IV.
Assessment & Drug Effects
- Monitor vital signs continuously during infusion, especially after infusion rate changes.
- Slow infusion rate for any of the following: flushing, chills, muscle cramps, back pain, fever, nausea, vomiting, arthralgia,
- DC infusion, institute supportive measures, and notify physician for any of the following: increase in heart rate, increase
in respiratory rate, shortness of breath, rales or other signs of anaphylaxis.
- Have loop diuretic available for management of fluid overload.
Patient & Family Education
- Promptly report any discomfort that develops while drug is being infused.