Octagam
Octagam is an immunoglobulin (also known as antibody) used for treating certain conditions related to the immune system. It's given as an intravenous (IV) infusion and is available in two different strengths that treat different conditions. This medication can raise your risk of serious side effects, including blood clots and kidney problems.
What is Octagam?
What is Octagam used for?
Conditions where your immune system is missing or not working like it should:
- Trouble fighting infections (primary humoral immunodeficiency or PI) - Octagam 5% only
- Low platelets (chronic (long-term) immune thrombocytopenia or ITP) - Octagam 10% only
- Inflammation of the muscles and skin (dermatomyositis or DM) - Octagam 10% only
How Octagam works
Octagam is a replacement for immunoglobulin G (IgG). IgG is an antibody that your immune system makes to help protect against organisms like viruses, bacteria, and fungi.
Certain medical conditions can cause your immune system to be too active or too inactive. The exact way Octagam works to treat these medical conditions isn't fully known. It's thought to boost your immune system to help prevent infections. It also might help prevent an overly active immune system from attacking parts of your own body by mistake.
Drug facts
Side effects of Octagam
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
Less Common Side Effects
- Vomiting
- Chills
- Muscle or bone pain
- Higher blood pressure
- Confusion
- Changes in vision
- Difficulty breathing
Octagam serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Blood clots: lungs (cough, difficulty breathing, chest pain); legs (redness, pain, tenderness, swelling of the skin); heart attack (chest pain, pain in the arms or shoulders, pain in the neck or jaw); stroke (difficulty speaking, numbness on one side of the body, confusion)
- Kidney problems: tiredness, dry and itchy skin, low appetite, urinating less than usual, foamy or bloody urine, muscle cramps
- Serious allergic reaction: difficulty breathing, tightness in the throat, swelling in the face or tongue, hives, itching, fast heartbeat, nausea, stomach pain, dizziness, lightheadedness
- Breakdown of red blood cells: tiredness, dizziness, weakness, yellowing of the skin or eyes, dark-colored urine
- Brain inflammation: severe headache, neck stiffness, sensitivity to light, painful eye movements
- Lung problems: severe breathing problems, chest pain or tightness
The following Octagam 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
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
- Fever, neck pain or stiffness, sensitivity to light, headache, nausea, vomiting, confusion, which may be signs of meningitis
- 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
- Low sodium level—muscle weakness, fatigue, dizziness, headache, confusion
- Shortness of breath or trouble breathing, cough, unusual weakness or fatigue, blue skin or lips
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Octagam
Pros
- Octagam 5% works well for the treatment of PI.
- Octagam 10% works well for chronic ITP and DM.
- Octagam 5% can be used in children as young as 6 years old for PI.
- Can be given at home by a provider, if approved
Cons
- Needs to be given as an injection by a provider
- Has a lot of potential risks, such as kidney and lung problems
- Available as brand name only, which can be expensive
Pharmacist tips for Octagam
- Mark your appointments on your calendar for when you need to see your provider and receive Octagam. This helps make sure you don't miss any doses. If you accidentally miss a dose, talk with your provider right away about rescheduling your appointment.
- Bring a book or other activity to your infusion appointment to help pass the time.
- Octagam can raise your risk of blood clots. Get medical help right away if you experience symptoms of a blood clot, including cough, difficulty breathing, chest pain, headache, trouble speaking, or weakness on one side of your body.
- Octagam can raise your risk of kidney problems. Contact your provider right away if you experience symptoms of kidney problems, such as tiredness, trouble sleeping, dry and itchy skin, low appetite, urinating less than usual, foamy or bloody urine, or muscle cramps.
- Before getting any vaccines, let your provider know you're receiving Octagam because it can interfere with your response to live vaccines (e.g., MMR (measles, mumps, and rubella vaccine)).
- If you're receiving Octagam for PI (poor immune system), let your provider know right away if you've been exposed to measles or are planning to travel to places at high risk for measles. You might need additional doses of Octagam to help prevent infection or protect you against serious illness.
- If your provider instructs you to have a supply of medication for your home infusion, you can store Octagam 10% in the refrigerator for 3 years (36 months) from the date it was manufactured, or at room temperature for 9 months. You can keep Octagam 5% at room temperature for 2 years (24 months) from the date it was manufactured. Don't put the medication in the freezer because this can damage it.
Common questions about Octagam
It depends. Although Octagam is only available as an IV infusion and must be given by a healthcare provider, you might have the option to receive it at home. Discuss with your provider if receiving Octagam at home or in an infusion clinic is best for you.
Because Octagam can cause side effects that affect different parts of your body, your provider will order some tests to check your health before you start this medication and also regularly throughout treatment. Some tests you can expect include those that monitor your kidney and lung health as well as blood cell count, blood protein levels, and blood triglyceride (a type of fat) levels. Ask your provider if you have any questions about these tests or what they're used to check for.
How long the Octagam IV infusion takes can be different from one person to another. It can sometimes take several hours. It usually depends on your dose, the speed that your provider is giving you Octagam, and how well you tolerate the medication.
Yes, Octagam can be used in people 65 years and older. However, providers will likely monitor you more closely, as there's a higher risk of severe side effects, such as blood clots and kidney problems, in this age group. If you're 65 years or older, your provider will usually use the lowest dose that works for you and give you the medication at the slowest possible speed to minimize the risk of side effects.
Octagam hasn't been well studied during pregnancy, so it's not known whether this medication is safe in pregnant females or their unborn babies. Similarly, there's currently no information on the safety of breastfeeding while receiving Octagam. If you're breastfeeding, pregnant, or thinking of becoming pregnant, talk with your provider about the risks and benefits of using Octagam before starting this medication.
Yes, you can still receive certain vaccines, including most flu shots. However, you shouldn't receive live vaccines until at least 3 months after you last received Octagam because it's not known if they work well while you're taking Octagam. Examples of live vaccines include the FluMist Quadrivalent (live attenuated influenza vaccine) that's given through a nasal spray and the MMR (measles, mumps, rubella vaccine). Before starting Octagam, discuss with your provider to make sure you're up to date with all vaccines. Once you've started treatment, be sure to let your providers know you're taking Octagam before you receive any vaccines.
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Risks and warnings for Octagam
Octagam 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.
Risk of blood clots
- Risk factors: Older age | Not moving much or on bed rest | History of blood clots | Medical conditions that raise your risk of blood clots | Taking medications that contain estrogen | Central IV lines or other catheters in your veins | Have thick blood | History or risk of heart problems
Octagam can raise your risk of getting blood clots in various parts of your body. Symptoms of a blood clot might be different depending on the location of the clot. They can include swelling, warmth, or tenderness in the legs. But more seriously, clots can lead to breathing problems, heart attack, or stroke and cause chest pain; difficulty breathing; or weakness of the face, legs, or arms. Call 911 if you have any of these symptoms, because this is a medical emergency.
Kidney failure
- Risk factors: Older than 65 years | History of kidney problems | High blood sugar | Sepsis | Having high amounts of certain proteins in blood (paraproteinemia) | Not enough fluids in the body | Taking medications that can cause kidney damage
Octagam can cause severe, and even fatal, kidney problems. Your risk is higher if you have certain factors like older age, diabetes, or taking medications that can cause kidney problems. Your provider will order lab tests to check your kidney health before and during treatment with Octagam. If your kidney health worsens during treatment, your provider might slow down your infusion or even have you stop taking it. Contact your provider if you develop any signs or symptoms of kidney failure, including changes in your need to urinate, tiredness, dry and itchy skin, low appetite, and muscle cramps.
Serious allergic reactions
- Risk factors: Allergy to corn
Serious allergic reactions, including life-threatening reactions like anaphylaxis (closing of the throat), are possible. Tell your provider all of your allergies before starting Octagam. This medication is made with a sugar from corn, so let them know if you have allergies to corn. If you notice a choking sensation, difficulty breathing, swelling of the lips or tongue, swelling around your eyes, sweating, dizziness, or nausea after using Octagam, get medical attention right away.
Falsely elevated blood sugar readings
- Risk factors: Type 1 or type 2 diabetes | Using insulin | Using glucose meters that use GDH-PQQ
Octagam contains maltose, which is a type of sugar. Maltose can cause your blood sugar readings to be falsely high if you use certain glucose monitors that use a substance called GDH-PQQ to detect blood sugar. This raises your risk for low blood sugar (hypoglycemia) if you give yourself insulin to correct this falsely high blood sugar level. Contact your local pharmacist or the manufacturer of the glucose monitor test you use if you're not sure if it can be used with products that have maltose in them.
Breakdown of red blood cells
- Risk factors: Doses that are 2 grams/kg or higher | Blood type other than O
Octagam can cause your body to rapidly destroy your own red blood cells. Your provider will monitor your blood cell counts before and during treatment to help make sure they don't drop too low. Contact your provider if you experience symptoms such as fatigue, dizziness, and weakness.
Swelling (inflammation) of the brain
- Risk factors: Doses that are 2 grams/kg or higher | Medication infused too fast
Although rare, Octagam can cause inflammation of the brain (aseptic meningitis). It can start to happen within several hours to 2 days after receiving Octagam. Typically, it goes away within several days of stopping treatment. Contact your provider if you experience symptoms of meningitis, including severe headache, neck stiffness, sleepiness, fever, sensitivity to light, painful eye movements, nausea, or vomiting.
Lung problems
Octagam can cause a condition called transfusion-related acute lung injury (TRALI). This condition happens when fluid backs up in your lungs. It typically occurs within 1 to 6 hours after receiving the medication. Let your provider know right away if you experience symptoms of lung injury like severe breathing problems, chest pain or tightness, a racing heartbeat, or fever.
Infection
Because Octagam is made from human blood products, there's a risk that it might contain viruses that can make you sick. However, your risk of infection is low, since the donors of these blood products are carefully screened. Also, there are high manufacturing standards put into place to make sure the viruses are killed or removed. To prevent serious infections in the rare case that your doses of Octagam are affected, let your provider know immediately if you start to feel sick or have symptoms such as feeling confused and anxious, or having trouble maintaining your balance.
Octagam dosage
Typical dosage for Octagam
Your dose will depend on your body weight. During treatment, your provider will adjust the dose based on your response to the medication. In general:
-
Primary humoral immunodeficiency (Octagam 5%): The typical dose is 300 mg/kg to 600 mg/kg of body weight injected into the veins (IV) every 3 to 4 weeks. Your provider might give you extra doses if you're at risk of measles exposure (e.g., traveling) or if you were exposed to measles.
-
Chronic immune thrombocytopenia (Octagam 10%): The typical dose is 1 gram/kg of body weight IV once per day for 2 days.
-
Dermatomyositis (Octagam 10%): The typical dose is 2 grams/kg of body weight IV. This dose is split into equal doses and given over 2 to 5 days in a row each month.
Octagam 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 Octagam will not be safe for you to take.
- Severe allergy to human immune globulin
- Immunoglobulin A (IgA) deficiency with antibodies against IgA and a history of allergic reaction
- Severe allergy to corn (Octagam 5% only)
What are alternatives to Octagam?
Conditions where your immune system is missing or not working like it should: