Drug information of Thymoglubin


Drug group:

Thymoglobulin(antithymocyte globulin rabbit) is used to prevent and treat rejection of a kidney transplant. This medication belongs to a class of drugs known as immunosuppressants. It works by decreasing your body's natural defense (immune system). This helps prevent your body from rejecting the kidney transplant so it can work normally.

Mechanism of effect

Binds to multiple, T-cell specific antigens leading to T-lymphocyte cell death via complement mediated cytotoxicity or apoptosis.


Antithymocyte Globulin (ATG) is a concentrated anti-human T-lymphocyte immunoglobulin preparation derived from rabbits after immunization with a T-lympoblast cell line. ATG is an immunosuppressive product for the prevention and treatment of acute rejection following organ transplantation. ATG reduces the host immune response against tissue transplants or organ allografts.


Half-Life: 2-3 days

Peak Plasma: 23-170 mcg/mL


Treatment: 1.5 mg/kg IV infusion qDay x 7-14 days  

Prophylaxis: 1.5 mg/kg IV qDay with the first dose initiated prior to reperfusion of the donor kidney; usual duration is 4-7 days

Drug contraindications

Infection , Hypersensitivity to this drug


To prevent overimmunosuppression, physicians may decrease the dose of the maintenance immunosuppression regimen during the period of antithymocyte globulin rabbit use

Serious immune-mediated reactions, including anaphylaxis (including fatal anaphylaxis) or severe cytokine release syndrome (CRS), reported; if an anaphylactic reaction occurs, terminate the infusion immediately and implement emergency treatment (eg, 0.3-0.5 mL epinephrine (1 mg/mL) SC and other resuscitative measures including oxygen, IV fluids, antihistamines, corticosteroids, pressor amines, and airway management, as clinically indicated

CRS reported with rapid infusion rates; CRS is attributed to the release of cytokines by activated monocytes and lymphocytes; severe acute CRS can cause serious cardiorespiratory events and/or death; close compliance with the recommended dosage and infusion time may reduce the incidence and severity of infusion-associated reactions; slowing the infusion rate may minimize many of this risk (see Administration)

Low counts of platelets and WBCs (including low counts of lymphocytes and neutrophils) have been identified and are reversible following dose adjustments (see Dosage Modifications)

Routinely used in combination with other immunosuppressive agents; infections (bacterial, fungal, viral and protozoal), reactivation of infection (particularly CMV), and sepsis reported; these infections can be fatal; monitor carefully and administer appropriate anti-infective treatment when indicated

Immunosuppressives may increase the incidence of malignancies, including lymphoma or lymphoproliferative disorders

Points of recommendation

IV Preparation

Aseptically reconstitute required number of vials with 5 mL supplied diluent (SWI) immediately before use

Gently rotate vials to dissolve particulate matters if any; discard if particulate matters persist

Transfer all reconstituted drug into infusion bag containing saline or dextrose, invert bag to mix

Recommended volume: 50 mL of infusion solution per vial (total volume between 50-500 mL)

IV Administration

Premedicate recommended with corticosteroids, acetaminophen, and/or an antihistamine 1 hr before each infusion; may reduce the incidence and intensity of infusion-associated reactions

Infuse IV through 0.22 micron filter into high-flow vein

Infuse first dose over at least 6 hr and subsequent doses over at least 4 hr


Store refrigerated between 2-8°C (36-46°F)

Protect from light

Protect from freezing

Pregnancy level


Breast feeding warning

Has not been studied in breastfeeding women; unknown if excreted in human milk

Because other immunoglobulins are excreted in human milk, breastfeeding should be discontinued during antithymocyte globulin rabbit therapy

Related drugs

Tetanus immuneglobulin

Drug forms

ATG rabbit

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