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Rhogam

RhO [D] immune globulin
Used for Immunodeficiency
Used for Immunodeficiency

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.

Last reviewed on December 9, 2024
basics-icon

What is RhoGAM?

What is RhoGAM used for?

  • 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.

Are you looking for information on WinRho (Rho(D) immune globulin) instead?

Drug Facts

Common BrandsRhoGAM, MICRhoGAM, HyperRHO
Drug ClassImmune globulin
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only

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What are the 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

Other Side Effects

  • Mild fever
  • Skin rash
  • Body aches

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

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your doctor or health care professional as soon as possible:

allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

•breathing problems

chest pain or tightness

•yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

fever

pain and tenderness at site where injected

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of RhoGAM

thumbs-up

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

thumbs-down

Cons

Must be given by a healthcare professional in a hospital setting

Requires specific timing and monitoring

pharmacist-tips

Pharmacist tips for RhoGAM

pharmacist
  • 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.

              faqs

              Frequently asked questions about RhoGAM

              What blood type requires a 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.
              Do all Rh-negative moms get RhoGAM?
              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.
              Why do you need RhoGAM in an ectopic pregnancy?
              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.
              When to get RhoGAM shot during pregnancy?
              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.
              Where can I get a RhoGAM shot?
              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.
              What happens if I don't get my RhoGAM shot?
              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.
              How long does RhoGAM last?
              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.
              What's the difference between RhoGAM and HyperRHO S/D?
              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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              What are the 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.

              risk-warning

              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.

                risk-warning

                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.

                risk-warning

                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.

                  risk-warning

                  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.

                    dosage

                    RhoGAM dosage forms

                    Typical dosing 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.

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                    contraindications-icon

                    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

                    alternatives

                    What are alternatives to RhoGAM?

                    There are a number of medications that your doctor can prescribe in place of RhoGAM. Compare a few possible alternatives below.
                    RhoGAM
                    Used for:
                    • 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

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                    References

                    Best studies we found

                    American College of Obstetricians and Gynecologists. (2024). The Rh factor: How it can affect your pregnancy.

                    American Red Cross. (2023). What is the Rh factor? Why is it important?

                    Arvas, A. (2014). Vaccination in patients with immunosuppression. Turkish Archives of Pediatrics.

                    View All References (10)

                    Barash, J. H., et al. (2014). Diagnosis and management of ectopic pregnancy. American Family Physician.

                    Centers for Disease Control and Prevention. (2024). About variant Creutzfeldt-Jakob disease (vCJD).

                    Grifols USA, LLC. (2023). Hyperrho S/D full dose (rho(d) imune globulin- human solution [package insert]. DailyMed.

                    Grifols USA, LLC. (2023). Hyperrho S/D mini-dose (rho(d) imune globulin- human solution [package insert]. DailyMed.

                    Kedrion Biopharma Inc. (n.d.). Plasma source: Committed to safety.

                    Kedrion Biopharma Inc. (2024). Rhogam ultra-filtered plus (human rho- d immune globulin injection, solution; Micrhogam ultra-filtered plus (human rho- d immune globulin injection, solution [package insert]. DailyMed.

                    MedlinePlus. (2023). Rh incompatibility.

                    MedlinePlus. (2024). Hemolysis.

                    Theis, S. R., et al. (2022). Coombs test. StatPearls.

                    U.S. Food and Drug Administration. (2024). CBER-regulated products: Current shortages.

                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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