no need [1%:<4 mg/mL prepared using 0.9% sodium chloride injection, 5% dextrose and 0.225% sodium chloride injection, or 5% dextrose and 0.45% sodium chloride injection are stable for up to 24 hours. b Dextrose injection should not be used as a diluent for antithymocyte globulin (equine) solution. b Highly acid infusion solutions should not be used as a diluent for antithymocyte globulin (equine) solution. b Although reconstituted solutions are physically and chemically stable at room temperature for up to 24 hours, room temperature storage is not recommended by the manufacturer since the preparation contains no preservatives; use immediately. b Use diluted solutions immediately. b Actions Equine-derived polyclonal antibody immunosuppressive agent. 7 10 17 18 19 20 21 22 23 24 25 26 27 28 30 31 32 33 34 35 51 52 53 54 55 83 a b c Exact mechanism of immunosuppressive action not fully elucidated; appears to involve clearance of peripheral antigen-reactive T lymphocytes (T cells) and/or alteration of T-cell function. 2 3 4 5 6 8 9 14 a b Exact mechanism of hematologic effects variable, complex, and not fully elucidated. 48 49 89 90 a In vitro studies indicate ATG (equine) essentially binds to all circulating lymphocytes (both T and B cells), 58 87 a granulocytes, 87 a and platelets. 87 a May produce leukopenia, 2 7 19 32 35 a b thrombocytopenia, 2 7 17 19 23 33 35 a b and/or hemolysis. 2 a b Also produces a hematopoietic response in some patients with aplastic anemia. 36 37 38 39 40 41 42 91 107 108 a Appears to have some antineoplastic activity against malignant lymphomas. 57 58 59 60 a Advice to Patients Importance of informing patients about the potential benefits of ATG (equine) and attendant risks of immunosuppressive therapy. b Risk of decreased number of WBCs (including lymphocytes), which could increase risk of infection; less commonly, anemia and hemolysis also may occur. a b Necessity of administration under supervision of a clinician with careful monitoring for signs of reduced WBC and platelet counts. a b Importance of informing clinicians promptly if any signs or symptoms of infection occur. a b Advise patient of risk of possible fever, chills, allergic reactions, malaise, arthralgia, nausea and vomiting, lymphadenopathy, and/or rash during or following ATG (equine) infusion and that medication will be given to help control these reactions. a b Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs and herbal or nutritional supplements, as well as any concomitant illnesses. b Importance of women informing their clinicians if they are or plan to become pregnant or plan to breast-feed. b Importance of informing patients of other important precautionary information. b (See Cautions.) Preparations Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. Antithymocyte Globulin (Equine) Routes Dosage Forms Strengths Brand Names Manufacturer Parenteral For injection, concentrate, for IV use only 50 mg of equine IgG per mL Atgam (with glycine) Pfizer AHFS DI Essentials. Copyright 2017, Selected Revisions June 1, 2012. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. Use is not currently included in the labeling approved by the US Food and Drug Administration. References 1. Pharmacia. Atgam prescribing information. Kalamazoo, MI; 2000 Jun. 2. The Upjohn Company. Drug reference: Atgam . Kalamazoo, MI; 1981 Nov. 3. Lance EM. Mode of action of antilymphocyte serum. 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[PubMed 16365468] Next Interactions Print this page Add to My Med List More about Atgam (lymphocyte immune globulin, anti-thy (equine)) Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Español 0 Reviews Add your own review/rating Drug class: selective immunosuppressants Consumer resources Atgam equine Atgam Professional resources Atgam (FDA) Antithymocyte Globulin (Equine) (AHFS Monograph) Related treatment guides Aplastic Anemia Renal Transplant> ]} FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx Availability Prescription only C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Manufacturer Pfizer Inc. Drug Class Selective immunosuppressants Related Drugs Aplastic Anemia Promacta , eltrombopag , Leukine , sargramostim , lymphocyte immune globulin, anti-thy (equine) , More... 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