- Prevention or attenuation of CMV disease in kidney, liver, lung, pancreas, heart or bone marrow transplant recipients.
- Available as 50 mg/mL injection. Further dilution not recommended
- Refrigerate. Stable 24 hours in PVC bags.
- Solution Compatible: no information
- Additive/Above Cassette Compatible: no information
- Y-site Compatible: preferably should be administered via a separate infusion line undiluted. May be piggy-backed into a preexisting line containing: NS injection or up to 20% dextrose injection as long as the dilution of Cytogam: fluid does not exceed 1:2. Manufacturer recommends cytogam NOT be admixed with other drugs.
- Incompatible: no information
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM | NO |
| IV Direct |
NO |
| IV Intermittent Infusion |
YES, Use a 0.2 micron in-line filter 0.3 mL/kg/hr or 15 mg/kg/hr x 15 min; if tolerated increase to Flush IV with 25 mL D5W after infusion complete |
| IV Continuous Infusion | NO |
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
- For prevention or treatment of CMV disease in kidney recipients: 100 to 150 mg/kg/dose IV Q 2 weeks for 16 weeks
- Treatment must begin within 72 hours of transplant
- Infusion rate reactions: flushing, chills, muscle cramps, back pain, fever, nausea, arthralgia, and wheezing;
- Many adverse reactions are related to infusion rates; therefore, slowing or temporarily stopping the infusion rate may stop the reaction.
- If anaphylaxis or drop in blood pressure occurs during the infusion, discontinue infusion and use antidote such as diphenhydramine and epinephrine
- This medication contains albumin or human blood products. Consent (Informed Consent for Transfusion of Blood/Blood Products - form #1084) is required prior to administration to the patient.
Contraindicated in patients who have a severe reaction to CMV-IGIV or any other immune globulin, and in patients with selective IgA deficiency. Cytogam must be administered through a 0.2 micron in-line filter. Monitor vital signs with BP pre-infusion, Q15 MIN for one hour, then hourly during infusion and 30 minutes post-infusion Notify doctor and hold infusion if:
- heart rate 30/minute > baseline
- respiratory rate 10/minute > baseline
- temperature 1.5°C > baseline
- blood pressure changes
- wheezing, chills, rash, urticaria, flushing, myalgia, CNS or behavioural
change, headache or other unusual symptoms Drug interactions: Live virus vaccines (measles, mumps, rubella, varicella) Contains 5 % sucrose and 1%albumin as stabilizing agents Contains 1-1.5 mEq of Na/50 mL
ANAPHYLAXIS PRECAUTIONS:
- Have epinephrine, diphenhydramine and hydrocortisone available at bedside and
in portable kit for patient transport off unit.
- Dosage guidelines (Administer in sequence listed):
- Epinephrine (Adrenalin®) (1:1,000 is 1 mg/mL)______ mg = _______mL(0.01 mg/kg/dose = 0.01 mL/kg/dose, Max. 0.5 mg = 0.5 mL) IM in the thigh or alternative large muscle q15 minutes x 2, then Q4H PRN.
- Diphenhydramine [Benadryl®] __________ mg (1 mg/kg/dose, Max. 50 mg) I.V. x 1, then Q6H PRN.
- Hydrocortisone [Solu-cortef®] __________ mg (5 mg/kg/dose) I.V. x 1, then Q4H