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You are here: Home » eGM Resources » Health Information & Resources Portal|Home » RX Drug List (listed alphabetically) » Drug Reference (i's) » Immune Globulin



DESCRIPTION

Description Immune Globulin Intravenous (Human) [IGIVI, Gammagard® S/ D*, is a solvent/ detergent treated, sterile, freeze-dried preparation of highly purified immunoglobulin Gy (IgG) derived from large pools of human plasma. The product is manufactured by the Cohn-Oncley cold ethanol fractionation process followed by ultrafiltration and ion exchange chromatography. Source material for fractionation may be obtained from another U. S. licensed manufacturer. The manufacturing process includes treatment with an organic solvent/detergent mixture, 12 composed of tri-n-butyl phosphate, octoxynol 9 and polysorbate 80.3 The Gammagard® S/D manufacturing process provides a significant viral reduction in in vitro studies.3 These studies, summarized in Table 1, demonstrate virus clearance during Gammagard® S/D manufacturing using infectious Human Immunodeficiency virus, Types 1 and 2 (HIV-1, HIV-2); Sindbis virus (SIN), a model virus for Hepatitis C virus; Pseudorabies virus (PRy), a model virus for lipid-enveloped DNA viruses such as Herpes; and Vesicular stomatitis virus (VSV), a model virus for lipid-enveloped RNA viruses.3 These reductions are achieved through a combination of process chemistry, partitioning and/ or inactivation during cold ethanol fractionation and the solvent/detergent treatment.3

Table 1

In Vitro Virus Clearance During Gammagard® SID Manufacturing

Process

Step No.

Process Step

Evaluated

Virus Clearance, logio

HIV-1

HIV-2

SIN

PRV

VSV

1

Fraction I + II + III Wash to

Fraction I + III Supernatant

8.2*

N.D.**

5.2*

N.D.**

N.D.**

2

Fraction I + Ill Supernatant to

Fraction I + Ill Filtrate

8.2*

N.D.**

4.6*

N.D.**

N.D.**

3

Fraction I + III Filtrate to

Fraction II Precipitate

8.1*

N.D.**

N.A.***

N.D.**

N.D.**

4

Treatment of Resuspended Fraction II Precipitate with

Solvent/Detergent Mixture

8.4*

57*

5.1

43*

6.0*

* Minimum log reduction due to detection limit of the assay.

**Not determined.

***Not applicable. Sindbis virus co-precipitates with Fraction II proteins.


When reconstituted with the total volume of diluent (Sterile Water for Injection, USP) supplied, this preparation contains approximately 50 mg of protein per mL (5%), of which at least 90% is gamma globulin. The product, reconstituted to 5%, contains a physiological concentration of sodium chloride (approximately 8.5 mg/mL) and has a pH of 6.8 ±0.4. Stabilizing agents and additional components are present in the following maximum amounts for a 50/s solution: 3 mg/ mL Albumin (Human), 22.5 mg/mL glycine, 20 mg/mL glucose, 2 mg/mL polyethylene glycol( PEG), 1µg/mL tri- n- butylphosphate, 1 µg/mL octoxynol 9, and 100 pg/mL polysorbate 80. If it is necessary to prepare a 10% (100 mg/mL) solution for infusion, half the volume of diluent should be added, as described in the Dosage and Administration section. In this case, the stabilizing agents and other components will be present at double the concentrations given for the 5% solution.

The manufacturing process for Immune Globulin Intravenous (Human), Gammagard® S/D, isolates IgG without additional chemical or enzymatic modification, and the Fc portion is maintained intact. Gammagard® S/D contains all of the lgG antibody activities which are present in the donor population. On the average, the distribution of IgG subclasses present in this product is similar to that in normal plasma. 3 Gammagard® S/D contains only trace amounts of IgA (< 3.7 pg/mL in a 5% solution). IgM is also present in trace amounts. Gammagard® S/D contains no preservative.





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