Rhogam
RhoGAM is an injectable medication used to prevent a condition called Rhesus (Rh) incompatibility. It's commonly given to Rh-negative pregnant mothers who are expecting a Rh-positive baby. RhoGAM contains a type of antibody called an immunoglobulin that stops the mother’s body from making Rh antibodies against the baby’s blood. The shot is typically injected into the muscle by a healthcare professional. Your care team will decide on the correct dose and time for you to receive this medication. Common side effects include injection site reactions, such as swelling and pain.
This medication is also available under other brand names, like HyperRHO.
What is RhoGAM?
What is RhoGAM used for?
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To prevent Rh incompatibility in certain Rh-negative mothers with one of the following conditions:
- 26 to 28 weeks of pregnancy carrying a potential Rh-positive baby
- Delivery of a Rh-positive baby
- Bleeding during pregnancy with a Rh-positive baby (e.g., amniocentesis, belly injury)
- Actual or threatened loss of pregnancy (e.g., miscarriage, abortion)
- Ectopic pregnancy (pregnancy outside of the uterus)
-
To prevent Rh incompatibility in Rh-negative people receiving Rh-positive blood through blood transfusion
How RhoGAM works
RhoGAM contains a type of antibody called immune globulin. It helps stop the body from making Rh antibodies. These antibodies can attack red blood cells if a person with Rh-negative blood is exposed to Rh-positive blood.
It's not exactly clear how RhoGAM works, but it helps Rh-negative pregnant mothers prevent their Rh-positive babies from severe anemia and other problems during pregnancy and after birth.
Drug facts
More on RhoGAM essentials
Side effects of RhoGAM
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Injection site reactions (swelling, redness, pain, tenderness, mild pain)
Less Common Side Effects
- Mild fever
- Skin rash
- Body aches
RhoGAM serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe allergic reactions: wheezing, chest tightness, trouble breathing, low blood pressure, dizziness, vomiting, itchy rash, hives, tongue or throat swelling
- Breakdown of red blood cells: fever, back pain, nausea, vomiting, shaking, chills, changes in blood pressure, discolored urine, or blood in urine
The following RhoGAM side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Hemolytic anemia—unusual weakness or fatigue, dizziness, headache, trouble breathing, dark urine, yellowing skin or eyes
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Chills
- Dizziness
- Headache
- Pain, redness, or irritation at injection site
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Pros and cons of RhoGAM
Pros
- No significant interactions with most medications or supplements
- Safe during pregnancy or while breastfeeding
- Injects into the muscle instead of the vein, so it's more convenient
Cons
- Risk of severe allergic reaction
- Must be given by a healthcare professional in a hospital setting
- Requires specific timing and monitoring
Pharmacist tips for RhoGAM
- If you're receiving RhoGAM during your pregnancy checkup, be sure to plan for extra time after your appointment. Your healthcare team will need to monitor you for signs and symptoms of severe allergic reactions for at least 20 minutes after your injection.
- Let your healthcare team know right away if you experience wheezing, dizziness, fainting, fast heartbeat, chest pain, rash, itching, hives, and swelling of the tongue or throat after you've received RhoGAM. These are signs and symptoms of allergic reactions.
- RhoGAM commonly causes injection site reactions, which include swelling, redness, and mild pain. Some people might also notice a slight fever. Let your healthcare team know if these side effects become bothersome.
- Avoid getting live vaccines within 12 weeks of receiving RhoGAM unless your healthcare team tells you it's safe to do so. During this time, live vaccines might not work as well and could raise your risk of infection.
- After receiving your first dose of RhoGAM, your care team will give you a completed identification card with information about your injection. Keep the identification card with you and present it to other healthcare professionals when appropriate.
- RhoGAM can interfere with blood tests that check for antibodies, such as the Coombs test. This is because it contains antibodies from donor blood. Talk with a healthcare professional or lab technician about your medication history before any blood tests.
Common questions about RhoGAM
People with Rh-negative blood might need RhoGAM. The Rh factor is a protein on red blood cells (RBCs). If your RBCs it, you're Rh-positive; if not, you're Rh-negative. The Rh factor helps determine if blood from two people can mix safely. This is especially important during pregnancy, as blood can sometimes pass between the mother and baby.
If you're Rh-negative, it's recommended to receive RhoGAM during every pregnancy. This shot prevents your immune system from making antibodies that could attack your baby's red blood cells (RBCs) if they have Rh-positive blood. Without RhoGAM, an Rh-positive baby might be at risk for anemia and other problems during pregnancy and after birth.
An ectopic pregnancy happens when a fertilized egg grows outside of the uterus and the unborn baby can't survive in that location. If the mother is Rh-negative and the unborn baby is Rh-positive, the mother's body will make antibodies to attack the unborn baby's blood. And this can cause complications in future pregnancies. In this case, RhoGAM can prevent the mother's immune system from reacting to the unborn baby's blood.
Typically, you'll need a RhoGAM injection between week 26 to 28 of pregnancy and a second dose within 72 hours after you deliver your baby.
You'll typically receive RhoGAM in a hospital setting with a healthcare team who can respond to any life-threatening allergic reactions right away. A healthcare professional will make sure you get this medication at the correct dose and time.
If you're Rh-negative and your unborn baby is Rh-positive, not receiving RhoGAM can cause your immune system to create antibodies that attack your unborn baby's blood. This can lead to anemia, jaundice, and reduced oxygen levels, which can cause serious complications or even death for the baby.
RhoGAM typically lasts 150 days, while HyperRHO S/D typically lasts between 115 to 130 days. This is based on their half-life, which is the time it takes for half of the medication to leave your body. Factors like age, gender, and health can also affect how long the medication stays in your system.
RhoGAM and HyperRHO S/D are both medications given to Rh-negative people exposed to Rh-positive blood. They both have the same ingredient - Rh immune globulin. Keep in mind that RhoGAM is currently in short supply, so your healthcare team might give you HyperRHO S/D instead.
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Risks and warnings for RhoGAM
RhoGAM can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Serious allergic reaction
- Risk factors: People with low levels of immune globulin A (IgA)
In rare cases, RhoGAM can cause life-threatening allergic reactions. If you don't have a type of antibody called IgA in your body, you might be at a higher risk when taking this medication. That's because [EDITOR|DRUG_DISPLAY_NAME]] contains a small amount of IgA. These reactions can happen even if you've received the injection before. Your healthcare team will observe you for at least 20 minutes after your injection to make sure it's safe. Watch out for signs of an allergic reaction, such as wheezing, chest tightness, shortness of breath, low blood pressure, dizziness, vomiting, itchy rash, hives, and tongue or throat swelling. Get medical help right away if you have any of these symptoms.
Possible risk of serious infections
Since RhoGAM is made from human blood products, it can potentially carry a small risk of viruses or harmful proteins, such as variant Creutzfeldt-Jakob disease (vCJD). But the risk is very low because blood donors are carefully screened, and each sample is tested in the lab to reduce the chance of infections. If you suspect you've developed an infection from this medication, let your healthcare team know right away. Talk with your care team about the benefits and risks of receiving RhoGAM.
Break down of red blood cells
- Risk factors: Rh-positive people
People who are Rh-positive are at a higher risk of red blood cells breaking down when receiving RhoGAM. Your healthcare team will monitor you for blood problems after you've received RhoGAM. Tell your care team immediately if you experience fever, back pain, nausea, vomiting, shaking, chills, changes in blood pressure, discolored urine, or blood in urine. Since these signs and symptoms don't always happen right away, make sure to check in with your care team if they occur later.
Interaction with vaccines
- Risk factor: Receiving live vaccines
RhoGAM can make live vaccines, like MMR (measles, mumps, and rubella) and Varivax (varicella vaccine), not work as well. This is because RhoGAM contains antibodies that can weaken your body's response to live vaccines. It can also raise the risk of infection from live vaccines, which are made from weakened viruses. Generally live vaccines aren't recommended within 12 weeks of receiving RhoGAM. But if you recently gave birth and need to receive the MMR vaccine, you'll need a blood test 12 weeks later to confirm that the vaccine is working. Talk to your care team about your vaccination schedule before receiving RhoGAM.
RhoGAM dosage
Syringe| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 1500iu | 1 syringe | $124.33 | $124.33 |
| 250iu | 1 syringe | $59.35 | $59.35 |
Typical dosage for RhoGAM
RhoGAM is usually given in a hospital setting with a healthcare team who can respond to any life-threatening allergic reactions right away. A healthcare professional will make sure you get this medication at the correct dose and time. The brand name you'll receive will depend on your condition and what's available.
- RhoGAM or HyperRHO S/D Full Dose: The typical dose is 300 mcg injected into the muscle (IM), usually within 72 hours of the condition being treated.
- MICRhoGAM or HyperRHO S/D Mini Dose (people who're at or less than 12 weeks pregnant or received less than 2.5 mL of Rh-positive red blood cells through transfusion): The typical dose is 50 mcg injected into the muscle (IM), usually within 72 hours of the condition being treated.
How much does RhoGAM cost?
$59.35
RhoGAM contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because RhoGAM will not be safe for you to take.
- Rh-positive blood
- History of allergic reaction to human immunoglobulin products
