Varizig (varicella-zoster immune globulin/maltose)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Varicella zoster immune globulin (VZIG) is a specific immune globulin (hyperimmune globulin). VZIG contains immune globulin G (IgG) prepared from plasma of donors selected for high titers of antibodies to varicella zoster virus (anti-VZV) and is used to provide temporary passive immunity to VZV.
Varicella zoster immune globulin (VZIG) is a lyophilized preparation of purified immune globulin G (IgG) fraction containing antibodies to varicella zoster virus (anti-VZV) prepared from plasma of healthy adults with high titers of anti-VZV. Potency of VZIG is expressed in international units by comparison to the World Health Organization (WHO) international anti-VZV immune globulin reference preparation. Each vial contains 125 units of anti-VZV.
Each 125-unit vial of VZIG contains less than 250 mg of total protein, mostly human IgG and also contains sodium chloride, glycine, and polysorbate 80; the diluent provided by the manufacturer contains 0.8% sodium chloride and sodium phosphate. The pH of reconstituted VZIG is 7. VZIG does not contain thimerosal or any other preservatives.
VZIG provides passive immunity in susceptible individuals exposed to VZV. Anti-VZV antibodies in VZIG bind to proteins on varicella virus, and may prevent or reduce severity of varicella infection if administered to susceptible individuals within 10 days after exposure. After a single VZIG dose, anti-VZV antibodies persist for at least 6 weeks, and protection against VZV may last for approximately 3 weeks.
The exact concentration of anti-VZV antibodies necessary to prevent or attenuate varicella is not known.
Following IM administration, bioavailability of VZIG is expected to be almost 100%. Anti-VZV antibodies are detected within 2-3 days and concentrations peak within 3-7 days. Following IV+ administration, peak concentrations are attained in less than 3 hours.
Although concentrations of passively-acquired antibody are higher and achieved more quickly following IV+ administration than IM administration, levels of circulating antibodies over time are expected to be similar with both routes. Anti-VZV is expected to be quickly distributed between plasma and extravascular spaces. Immune globulins are metabolized in the reticuloendothelial system.
Based on studies with other immune globulins, the elimination half-life of VZIG is expected to show interindividual variation. Half-life has been reported to be about 23-30 days following IM administration .
USES: This medication is used to help provide protection (antibodies) against a certain virus infection (varicella zoster) commonly known as chickenpox. It is used by certain people who have not been vaccinated or had the infection before and have had recent contact with someone infected with chickenpox. This medication is made from healthy human blood that has high levels of a certain substance (varicella zoster antibodies) which helps fight the infection.
Routine vaccination is usually the best way to protect against infection.
Generic name: varicella-zoster immune globulin/maltose
Pronunciation: (VAR-i-SEL-a ZOS-ter i-MUNE GLOB-ue-lin)
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Varizig
Indications
The following indications are listed for Varizig:
- Prevention Of Varicella After Exposure
Also known as: Passive Immunization Against Varicella Zoster Virus, Prevention Of Varicella After Contact With Varicella Zoster Virus, Varicella Post-Exposure Prophylaxis.
Dosing
No dosing information is available for this tab.
VZIG is labeled by the FDA for administration by IM injection only. VZIG also has been administered by IV injection+.
VZIG should not be mixed with any other drug or solution.
VZIG should not be administered concomitantly with varicella virus vaccine live. (See Live Vaccines under Drug Interactions: Vaccines.)
No dosing information is available for this tab.
No dosing information is available for this tab.
Drug interactions
There is no enhanced messaging for this drug.
There are no contraindication interactions for this drug.
There are no severe interactions for this drug.
There are no moderate interactions for this drug.
Contraindications
History of anaphylactic or severe systemic (hypersensitivity) reactions to any human immune globulin preparation.
IgA deficiency with antibodies against IgA and history of hypersensitivity reaction. (See IgA Deficiency under Warnings/Precautions: Sensitivity Reactions, in Cautions.)
There are no contraindication contraindications for this drug.
There are no severe contraindications for this drug.
There are no moderate contraindications for this drug.
Adverse reactions
The most common adverse effects reported with VZIG in clinical trials in pregnant women, infants, and immunocompromised adults and children were injection site pain (2%), headache (2%), chills, fatigue, rash, and nausea. The highest incidence of adverse effect occurred in pregnant women and included injection site pain (9%), headache (4%), chills (2%), and fatigue (2%).
There are no severe adverse reactions for this drug.
There are no less severe adverse reactions for this drug.
Precautions
No enhanced messaging available.
Safety and efficacy of VZIG have been evaluated for postexposure prophylaxis of varicella in pediatric patients, including preterm neonates and infants, term neonates and infants, children, and adolescents. (See Uses.)
Category C. (See Users Guide)
VZIG should be used during pregnancy only when clearly needed. (See Pregnant Women under Uses: Postexposure Prophylaxis of Varicella.)
The US Public Health Service Advisory Committee on Immunization Practices (ACIP) states that there are no known risks for the fetus from use of immune globulin preparations for passive immunization in pregnant women.
It is not known whether VZIG is distributed into milk. The immune globulin should be used with caution in nursing women.
Clinical studies of VZIG for postexposure prophylaxis of varicella did not include sufficient numbers of individuals 65 years of age or older to determine whether geriatric individuals respond differently than younger adults.
VZIG should be used with caution in individuals 65 years of age and older who are at increased risk of thrombotic events. (See Thrombotic Events under Cautions: Warnings/Precautions.)
When used in geriatric individuals, VZIG should only be administered IM and the recommended dosage should not be exceeded.
ICD codes
No ICD codes are available for this drug.
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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