General
HepaGam B is made from human plasma. Products made from human plasma may
contain infectious agents, such as viruses and theoretically, the Creutzfeldt-Jakob
disease agent. The risk that such products can transmit an infectious agent
has been reduced by screening plasma donors for prior exposure to certain viruses,
by testing for the presence of certain current virus infections, and by inactivating
and/or removing certain viruses. The HepaGam B (hepatitis b immune globulin (human)) manufacturing process includes
a solvent/detergent treatment step (using tri-n-butyl phosphate and Triton X-100)
that is effective in inactivating known enveloped viruses such as HBV, HCV,
and HIV. HepaGam B (hepatitis b immune globulin (human)) is filtered using a Planova 20N Virus Filter that is effective
in reducing the levels of some enveloped and non-enveloped viruses. These two
processes are designed to increase product safety. Despite these measures, such
products can still potentially transmit disease. There is also the possibility
that unknown infectious agents may be present in such products. ALL infections
thought by a physician to have been transmitted by this product should be reported
by the physician or other healthcare provider to Cangene Corporation at 1-877-CANGENE
(226-4363). The physician should discuss the risks and benefits of this product
with the patient.
Anaphylactic Precautions
Although allergic reactions have not been reported following HepaGam B administration
[see ADVERSE REACTIONS], the product should
be administered only in a setting where appropriate equipment and personnel
trained in the management of acute anaphylaxis are available. If hypotension
or anaphylaxis occurs, the administration of HepaGam B (hepatitis b immune globulin (human)) should be discontinued
immediately and supportive care given as needed.
Interference with Blood Glucose Testing
The maltose contained in HepaGam B (hepatitis b immune globulin (human)) can interfere with some types of blood
glucose monitoring systems, i.e., those based on the glucose dehydrogenase pyrroloquinequinone
(GDH-PQQ) method. This can result in falsely elevated glucose readings and,
consequently, in the inappropriate administration of insulin, resulting in life-threatening
hypoglycemia. Cases of true hypoglycemia may go untreated if the hypoglycemic
state is masked by falsely elevated results.
Monitoring: Serum anti-HBs Antibody Levels
Liver transplant patients should be monitored regularly for serum anti-HBs
antibody levels using a quantitative assay [See DOSAGE
AND ADMINISTRATION].
Infusion Reactions
Certain adverse drug reactions may be related to the rate of infusion. The
recommended infusion rate given under DOSAGE
AND ADMINISTRATION must be closely followed. Patients must be closely
monitored and carefully observed for any symptoms throughout the infusion period
and immediately following an infusion.
Coagulation Disorders
For postexposure prophylaxis indications, HepaGam B™ (Hepatitis B Immune
Globulin Intravenous [Human]) must be administered intramuscularly only. In
patients who have severe thrombocytopenia or any coagulation disorder that would
contraindicate intramuscular injections, HepaGam B (hepatitis b immune globulin (human)) should be given only if the
expected benefits outweigh the potential risks.
Nonclinical Toxicology
Nonclinical pharmacology studies have not been performed with Hepatitis B Immune Globulin Intravenous (Human) as there is broad experience in humans with intravenous and intramuscular administration of immune globulin products. Since the product is of human origin, immunogenicity is expected when administered to animals.
Toxicology studies have not been performed with Hepatitis B Immune Globulin Intravenous (Human) because the product has been formulated with ingredients that are know to be non-toxic at the levels at which they are present in the final product.
Use in Specific Populations
Pregnancy Category C
Animal reproduction studies have not been conducted with HepaGam B (hepatitis b immune globulin (human)) . It is also not known whether HepaGam B (hepatitis b immune globulin (human)) can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. HepaGam B (hepatitis b immune globulin (human)) should be given to a pregnant woman only if clearly indicated.
Nursing Mothers
It is not known whether HepaGam B is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when HepaGam B (hepatitis b immune globulin (human)) is administered to a nursing mother.
Last reviewed on RxList: 2/20/2009
This monograph has been modified to include the generic and brand name in many instances.