IV Globulin SN (Green Cross) Privigen (CSL Behring)
Concentration 2.5g/50mL (5%) 5g/50mL (10%)
Storage 2-8°C. Do not freeze. 2-25°C. (Can be stored in room temperature)
Administration
Initial rate of 0.01-0.02mL/kg/min for 30 mins. If well tolerated, the rate may be gradually increased to a
maximum of 0.1mL/kg/min.
Initial rate of 0.3ml/kg/hr for 30 mins. If well tolerated, the rate may be gradually increased to
a maximum of 4.8ml/kg/hr. In patients with immunodeficiency syndrome who have tolerated substitution treatment with Privigen
well, the maximum rate may be 7.2ml/kg/hr.
A s s e e n f r o m t h e t a b l e a b o v e , t h e p r i c e i n c r e m e n t i s s i g n i f i c a n t l y h i g h e r w i t h I V I G 2 . 5 g ( 5 % ) . H e n c e I V I G 5 g ( 1 0 % ) m a y b e m o r e c o s t e f f e c t i v e w i t h a l o w e r p r i c e / g r a m .
S C A R C I T Y O F I V I G - P L E A S E U S E J U D I C I O U S L Y . I V I G P R O D U C T S A N D U S A G E R E V I E W I N H C T M
Privigen Product Information 2. https://www.privigen.com/common/pdf/privigen-dosing-infusion-rate-brochure.pdf References:
3.I.V. Globulin SN Inj, Green Cross Product Information 4. Jian Lynn Lee, et. al. Prescribing Practices of IVIG in Tertiary Care Hospitals in Malaysia;2022.1.
Comparison between 2 strengths of IVIG available in HCTM
Pharmacy Bulletin
Pharmacy Deparment, Hospital Canselor Tuanku Muhriz
Edition 23, Issue 4
S O M E B A C K G R O U N D O N T H E S C A R C I T Y O F I V I G . . .
B A C K G R O U N D : I V I G h a s b e e n u s e d i n m a n y i n d i c a t i o n s , b o t h F D A a p p r o v e d , a n d o f f - l a b e l . I V I G p r o d u c t s a r e d e r i v e d f r o m h u m a n p l a s m a . I n t h e p a s t , m a j o r w o r l d w i d e s h o r t a g e s w e r e n o t e d i n t h e l a t e 1 9 9 0 s . I n 2 0 1 9 , t h e U n i t e d S t a t e s s u f f e r e d i n s u f f i c i e n t s u p p l y o f I V I G ,
r e s u l t i n g i n l o c a l s h o r t a g e s a n d r a t i o n i n g . F u r t h e r m o r e , t e n s i o n o n g l o b a l p l a s m a s u p p l y w a s a d d e d o n b y C O V I D - 1 9 . T h e u n p r e c e d e n t e d g l o b a l c r i s i s r e s u l t e d i n a r e d u c t i o n i n d o n o r p o o l . T h e h i g h d e m a n d c o u p l e d w i t h l a r g e q u a n t i t y p r o d u c t i o n c h a l l e n g e s h a s r e s u l t e d i n
i n c r e a s i n g g l o b a l s h o r t a g e s, u s a g e l i m i t a t i o n s a n d r a t i o n i n g o f i m m u n o g l o b u l i n .
I S S U E : A n n u a l l y , M i n i s t r y o f H e a l t h M a l a y s i a w o u l d s e n d a p p r o x i m a t e l y 8 0 , 0 0 0 p a c k s o f b l o o d t o t h e C o m m o n w e a l t h S e r u m L a b o r a t o r y f o r f r a c t i o n a t i o n . H o w e v e r , t h e i n s u f f i c i e n t c o l l e c t i o n o f i m m u n o g l o b u l i n G f r o m t h e l o c a l p o p u l a t i o n r e s u l t e d i n c o l l e c t i o n f r o m g l o b a l c o m m e r c i a l m a r k e t s . A s s u c h , s c a r c i t y r e m a i n s t h e m a j o r c o n c e r n .
A p a r t f r o m t h a t , t h e i n c r e a s e d u s a g e o f I V I G f o r o f f - l a b e l i n d i c a t i o n s h a v e a u g m e n t e d t h e s h o r t a g e p r o b l e m a s t h e y a r e u s e d f o r i n d i c a t i o n s w h i c h a r e n o t s u p p o r t e d b y s t r o n g l e v e l o f e v i d e n c e . T o a d d o n t o t h e t e n s i o n o f s c a r c i t y , t h e r e h a s b e e n a s i g n i f i c a n t p r i c e i n c r e m e n t o f I V I G p r o d u c t s i n M a l a y s i a a s s e e n i n t h e t a b l e b e l o w .
H C T M h a s o b t a i n e d a n e w h i g h e r c o n c e n t r a t i o n I V I G i t e m
1 0 % ( 5 g / 5 0 m L ),
c o m p a r e d t o o u r u s u a l s t r e n g t h o f
5 % ( 2 . 5 g / 5 0 m L ). T h e c o m p a r i s o n b e t w e e n b o t h
i t e m s a r e a s b e l o w .
HCTM Formulary App is on...
D u e t o i n c r e a s i n g d e m a n d , l i m i t e d a v a i l a b i l i t y , a n d f r e q u e n t i n t e r r u p t i o n s o f g l o b a l p l a s m a s u p p l y , p l e a s e c o n s i d e r e v i d e n c e c a t e g o r y
a n d s t r e n g t h o f
r e c o m m e n d a t i o n i n c l i n i c a l d e c i s i o n - m a k i n g w h e n u s i n g I V I G . T h i s w i l l e n s u r e s u f f i c i e n t s u p p l y f o r t h o s e w i t h t h e u t m o s t c l i n i c a l n e e d .
U S A G E R E V I E W O F I V I G I N H C T M
( A P R I L 2 0 2 2 - A P R I L 2 0 2 3 )
R e f e r e n c e s :
1 . L e e e t a l . , 2 0 2 2 , F r o n t i e r s i n p h a r m a c o l o g y , 1 3 : 8 7 9 2 8 7 . h t t p s : / / w w w . n c b i . n l m . n i h . g o v / p m c / a r t i c l e s / P M C 9 2 1 8 5 9 7 /
D e f i n i t i o n o f t h e c a t e g o r i z a t i o n o f e v i d e n c e , s t r e n g t h o f r e c o m m e n d a t i o n a n d b e n e f i c i a l
t r e a t m e n t o f r e c o m m e n d a t i o n .
B a s e d o n a p p r o v e d i n d i c a t i o n s b y t h e D r u g s a n d T h e r a p e u t i c s C o m m i t t e e ( U s a g e d a t a a c c o r d i n g t o a c t u a l d i s p e n s e d v i a l s r e c o r d e d b y I n p a t i e n t P h a r m a c y )
W h a t c a n w e d r a w f r o m a l l t h i s i n f o r m a t i o n ?
R E G I S T E R N O W I N O U R H C T M F O R M U L A R Y A P P T O V I E W T H E
P R I C E S O F N F I T E M S !
I n H C T M , I V I G i s s u p p l i e d f r e e f o r
6 d i f f e r e n t i n d i c a t i o n s ,
e a c h w i t h d i f f e r e n t l e v e l s o f e v i d e n c e . O t h e r u n a p p r o v e d , o f f - l a b e l u s a g e w i l l b e c h a r g e d t o p a t i e n t s .
Editors: Michelle Tan Hwee Pheng [email protected] Nur Hafiza Saripin [email protected] Produced By: Leanne Lew Hwui Ser [email protected] Editorial board:
Drug Information Pharmacy Usage data contributed by:
Inpatient Pharmacy
Pau Lok Ying [email protected]
