tetanus immune globulin, human (TIG)
BayTet

Available forms
Available by prescription only
Injection: 250 units/ml in 1-ml vial or syringe

Indications and dosages
 Tetanus prophylaxis. Adults and children age 7 and older: 250 units I.M. For severe wounds or delay in starting prophylaxis, give 500 units I.M.
 Tetanus treatment. Adults and children age 7 and older: Although optimal therapeutic doses haven’t been established, single doses of 3,000 to 6,000 units I.M. have been used. Dosages should be adjusted based on severity of the infection. Don’t give at same site as toxoid.

Pharmacodynamics
Antitetanus action: TIG provides passive immunity to tetanus. Antibodies remain at effective levels for 3 weeks or longer. TIG protects the patient for the incubation period of most tetanus cases.

Pharmacokinetics
Absorption: Absorbed slowly.
Distribution: No information available.
Metabolism: No information available.
Excretion: Serum half-life is about 28 days.

Contraindications and precautions
Contraindicated in patients with thrombocytopenia or any coagulation disorder that contraindicates I.M. injection unless potential benefits outweigh risks. Contraindicated for use in patients hypersensitive to thimerosal or TIG. Not recommended for use in immunoglobulin A deficiency. Don’t give I.V.

Interactions
None reported.

Adverse reactions
CNS: slight fever, pain.
GU: nephrotic syndrome.
Musculoskeletal: stiffness.
Skin: erythema at injection site.
Other: hypersensitivity reactions, anaphylaxis, angioedema.

Effects on lab test results
None reported.

Overdose and treatment
No information available.

Special considerations
• Don’t confuse drug with tetanus toxoid, which should be given at the same time (but at different site) to produce active immunization.
• Monitor patient for hypersensitivity reactions and site injection reactions.
• Have epinephrine solution 1:1,000 available to treat allergic reactions.
• TIG is used for prophylaxis in patients with dirty wounds if patient has had fewer than three previous tetanus toxoid injections or if the immunization history is unknown or uncertain.
• TIG hasn’t been linked to an increase of AIDS cases. The immune globulin is devoid of HIV. Immune globulin recipients don’t develop antibodies to HIV.
• Refrigerate TIG between 36° and 46° F (2° and 8° C). Don’t freeze.
Pregnant patients
• Tetanus increases risks of severe morbidity and mortality in both mother and fetus if untreated. No fetal risk from the use of immune globulin has been reported to date.
Breast-feeding patients
• It isn’t known whether TIG appears in breast milk. Use cautiously in breast-feeding women.

Patient education
• Tell patient that current data indicate that TIG administration doesn’t cause AIDS or hepatitis.
• Inform patient that he may experience some local pain, swelling, and tenderness at the injection site. Recommend acetaminophen to alleviate these minor effects.
• Instruct patient to report headache, skin changes, or difficulty breathing.

Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE THREATENING.
◆ Canada only
◇ Unlabeled clinical use