Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

  1. Yimmugo

Descriptions


Immune globulin-dira injection contains antibodies that make your immune system stronger. It is used for patients who have primary humoral immunodeficiency (PI), including congenital agammaglobulinemia, common variable immunodeficiency, X-linked agammaglobulinemia, Wiskott-Aldrich syndrome, and other severe combined immune system problems.

This medicine is to be given only by or under the supervision of your doctor.

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of immune globulin-dira injection in children younger than 2 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of immune globulin-dira injection in the elderly. However, elderly patients are more likely to have age-related heart, kidney, or liver problems, which may require caution for patients receiving immune globulin-dira injection.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adenovirus Vaccine Type 4, Live
  • Adenovirus Vaccine Type 7, Live
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Bumetanide
  • Cholera Vaccine, Live
  • Dengue Tetravalent Vaccine, Live
  • Ebola Zaire Vaccine, Live
  • Ethacrynic Acid
  • Etozolin
  • Furosemide
  • Influenza Virus Vaccine, Live
  • Measles Virus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Piretanide
  • Poliovirus Vaccine, Live
  • Pozelimab-bbfg
  • Ravulizumab-cwvz
  • Rotavirus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Smallpox Monkeypox Vaccine, Live Non-Replicating
  • Smallpox Vaccine
  • Torsemide
  • Typhoid Vaccine, Live
  • Varicella Virus Vaccine, Live
  • Yellow Fever Vaccine
  • Zoster Vaccine, Live

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bleeding problems, history of or
  • Hyponatremia (low sodium in the blood) or
  • Kidney problems—Use with caution. May make these conditions worse.
  • Blood clotting problems, history of or
  • Diabetes or
  • Heart or blood vessel disease or
  • Hyperproteinemia (high protein in the blood) or
  • Hyperviscosity (thick blood) or
  • Hypovolemia (low blood volume or major loss of body fluids) or
  • Paraproteinemia (paraproteins in the blood) or
  • Sepsis (serious infection in the body)—Use with caution. May cause side effects to become worse.
  • IgA (immunoglobulin A) deficiency with antibodies against IgA—Should not be used in patients with this condition.

Proper Use

A doctor or other trained health professional will give you this medicine in a medical facility. It is given through an IV catheter that is placed into one of your veins.

Precautions

It is very important that your doctor check your progress closely for any problems that may be caused by this medicine. Blood and urine tests may be needed to check for unwanted effects.

This medicine is made from donated human blood. Some human blood products have transmitted certain viruses (eg, Creutzfeldt-Jakob disease) to people who have received them, although the risk is low. Human donors and donated blood are both tested for viruses to keep the transmission risk low. Talk with your doctor if you have concerns about this risk.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you have a rash, itching, hives, chest pain, dizziness or lightheadedness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after receiving this medicine. Certain people, including those with IgA (an immunoglobulin) deficiency and antibodies against IgA and a history of hypersensitivity to human immunoglobulin products should not use this medicine.

This medicine may cause bleeding (hemolysis) or hemolytic anemia. Tell your doctor right away if you have stomach or back pain, dark urine, decreased urination, difficulty with breathing, an increased heart rate, tiredness, or yellow eyes or skin after you receive this medicine.

This medicine may increase your risk of developing blood clots. Check with your doctor right away if you have swelling and pain in your arms, legs, or stomach, chest pain, loss of sensation, confusion, problems with muscle control or speech, or trouble breathing.

Check with your doctor right away if you start having red or dark brown urine, lower back or side pain, sudden weight gain, swollen face, arms, or legs, decreased urine output, or any problems with urination after you receive this medicine. These may be symptoms of a serious kidney problem.

Check with your doctor right away if you start to have a stiff neck, drowsiness, fever, severe headache, nausea, vomiting, painful eye movements, or eye sensitivity to light. These could be symptoms of a serious condition called aseptic meningitis syndrome (AMS).

Check with your doctor right away if you start having chest pain, difficult, fast, or noisy breathing, blue lips and fingernails, fever, pale skin, increased sweating, coughing that sometimes produces a pink frothy sputum, or swelling of the legs and ankles after receiving this medicine. These may be symptoms of a serious lung problem, including transfusion-related acute lung injury (TRALI).

While you are being treated with immune globulin injection, do not have any immunizations (vaccines) without your doctor's approval.

Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

  1. Body aches or pain
  2. chills
  3. cough
  4. ear congestion
  5. fever
  6. headache
  7. increased blood pressure
  8. loss of voice
  9. sneezing
  10. sore throat
  11. stuffy or runny nose
  12. trouble breathing
  13. unusual tiredness or weakness

Incidence not known

  1. Agitation
  2. anxiety
  3. back pain
  4. black ,tarry stools
  5. blistering, peeling, loosening of the skin
  6. blue lips and fingernails
  7. bluish color of the fingernails, lips, skin, palms, or nail beds
  8. blurred vision
  9. burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  10. change in color vision
  11. changes in skin color
  12. chest pain, discomfort, or tightness
  13. coma
  14. confusion
  15. cough
  16. coughing that sometimes produces a pink frothy sputum
  17. dark urine
  18. decreased urination
  19. depression
  20. diarrhea
  21. difficulty in speaking
  22. difficulty seeing at night
  23. difficulty swallowing
  24. dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  25. double vision
  26. drowsiness
  27. dry mouth
  28. fast, pounding, or irregular heartbeat or pulse
  29. hallucinations
  30. hives, itching, skin rash
  31. hostility
  32. hyperventilation
  33. inability to move the arms, legs, or facial muscles
  34. inability to speak
  35. increased sensitivity of the eyes to sunlight
  36. increased thirst
  37. irritability
  38. joint or muscle pain
  39. large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  40. lethargy
  41. light-colored stools
  42. mood or mental changes
  43. muscle pain, cramps, or twitching
  44. nausea or vomiting
  45. nervousness
  46. no blood pressure or pulse
  47. pain, redness, or swelling in the arm or leg
  48. pain or discomfort in the arms, jaw, back, or neck
  49. painful or difficult urination
  50. pale skin
  51. pounding in the ears
  52. puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  53. restlessness
  54. red irritated eyes
  55. red skin lesions, often with a purple center
  56. seizures
  57. shakiness in the legs, arms, hands, or feet
  58. shaking
  59. slow speech
  60. sores, ulcers, or white spots on the lips or in the mouth
  61. stiff neck
  62. stomach pain
  63. stopping of the heart
  64. stupor
  65. sweating
  66. swelling of the face, ankles, or hands
  67. swelling of the fingers, hands, feet, or lower legs
  68. swollen glands
  69. temporary blindness
  70. trembling or shaking of the hands or feet
  71. trouble sleeping
  72. unconsciousness
  73. unusual bleeding or bruising
  74. weakness in arm and/or leg on one side of the body, sudden and severe
  75. weight gain
  76. yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

  1. Arm or leg pain
  2. burning sensation
  3. difficulty in moving
  4. loss or thinning of the hair
  5. muscle aches or stiffness
  6. swollen joints
  7. unusual drowsiness, dullness, tiredness, weakness or feeling of sluggishness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: Oct. 01, 2024

Original article: https://www.mayoclinic.org/drugs-supplements/immune-globulin-dira-intravenous-route/precautions/drg-20571299