In the U.S.—

Other commonly used names are Anti-thymocyte immunoglobulin

• Immunosuppressant

Anti-thymocyte globulin (rabbit) (an-tee-THI-mo-cite) is an immunosuppressant. It is used to reduce the body's natural immunity in patients who receive kidney transplants.

When a patient receives an organ transplant, the body's white blood cells will try to get rid of (reject) the transplanted organ. Anti-thymocyte globulin (rabbit) works by preventing the white blood cells from doing this.

The effect of anti-thymocyte globulin (rabbit) on the white blood cells may also reduce the body's ability to fight infections. Before you begin treatment, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Anti-thymocyte globulin (rabbit) is to be administered only by or under the immediate supervision of your doctor. It is available in the following dosage form:

Parenteral
• Injection (U.S.)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For anti-thymocyte globulin (rabbit), the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to anti-thymocyte globulin (rabbit) or to rabbits. Anti-thymocyte globulin came from rabbit cells. Also tell your doctor and pharmacist if you are allergic to any other substances, such as preservatives.

Pregnancy—Studies on effects in pregnancy have not been done in either humans or animals. It is not known whether anti-thymocyte globulin (rabbit) causes harmful effects on the fetus. Before receiving this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding—It is not known whether anti-thymocyte globulin (rabbit) passes into breast milk. Anti-thymocyte globulin (rabbit) has not been reported to cause problems in nursing babies. However, it may be necessary for you to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Children—Although there is no specific information comparing use of anti-thymocyte globulin (rabbit) in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of anti-thymocyte globulin (rabbit) in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving anti-thymocyte globulin (rabbit), it is especially important that your doctor and pharmacist know if you are taking any of the following: Immunosuppressants—There may be an increased risk of infection and development of cancer because anti-thymocyte globulin (rabbit) reduces the body's ability to fight them. Your doctor may need to change your dose.

• Allergic to rabbit protein (history of)—Risk of serious allergic reaction, bleeding, and infection.

• Infection—Anti-thymocyte globulin (rabbit) decreases your body's ability to fight infection.

Dosing—

The dose of anti-thymocyte globulin (rabbit) may be different for different patients. Anti-thymocyte globulin (rabbit) is usually given by a doctor or nurse in the hospital. The following information includes only the average doses of anti-thymocyte globulin (rabbit):

• For injection dosage form:
  • To treat kidney transplant rejection:
    • Adults—1.5 milligrams for every kilogram (2.2 pounds) of your body weight injected into a vein every day for 7 to 14 days.
    • Children—Use and dose must be determined by your doctor.

Treatment with anti-thymocyte globulin (rabbit) may also increase the chance of getting other infections. If you can, avoid people with colds or other infections. If you think you are getting a cold or other infection, check with your doctor.

This medicine commonly causes fever and chills within a few hours after the first dose. These effects should be less after the second dose. However, check with your doctor or nurse immediately if you have chest pain, rapid or irregular heartbeat, shortness of breath or wheezing, or swelling of the face or throat after any dose.

Along with its needed effects, a medicine may cause some unwanted effects.

Because of the way that anti-thymocyte globulin (rabbit) acts on the body, there is a chance that it may cause effects that may not occur until years after the medicine is used. These delayed effects may include certain types of cancer, such as lymphomas and skin cancers. Discuss these possible effects with your doctor.

Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• More common
  • Black, tarry stools;  bladder pain;  chest pain;  chills;  cloudy or bloody urine;  cold;  confusion;  cough or hoarseness;  fast heartbeat;  fever;  flu-like symptoms;  frequent urge to urinate;  high blood pressure;  irregular or slow heartbeat;  lower back or side pain;  numbness or tingling around lips hands, or feet;  painful or difficult urination;  shortness of breath or troubled breathing;  sore throat;  sores, ulcers, or white spots on lips or in mouth;  swollen glands;  tiredness or weakness ;  unexplained anxiety;  unusual bleeding or bruising;  weakness or heaviness of legs 
  
  

• Less common
  • Burning or stinging of skin;  painful cold sores or blisters on lips, nose, eyes, or genitals 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome.

• More common
  • Abdominal pain;  diarrhea;  difficult or labored breathing;  dizziness ;  general feeling of discomfort or illness;  headache;  loss of strength or energy ;  muscle pain or weakness;  nausea;  pain;  swelling of ankles, feet, and fingers;  tightness in chest;  unusual weak feeling;  wheezing 
  
  

• Less common
  • White patches on mouth, tongue, or throat 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.