Tetanus Immune Globulin

250 units/mL (1ml), pre-filled syringes (IM)

Executive Summary

(June 2021)


Tetanus Immune Globulin (TIG) is indicated for tetanus disease treatment and prophylaxis (the latter in individuals without updated or an  unknown tetanus immunization who have suffered a contaminated or a  tetanus-prone wound).

Adult dose for tetanus treatment:

500 units IM with part of the dose infiltrated close to the source wound. 


Adult dose for tetanus prophylaxis:

Mechanism of Action and Dosage 

TIG consists of human antibodies derived from healthy donors used for the treatment of tetanus disease and tetanus prophylaxis. It provides passive immunity towards tetanus by neutralizing unbound toxins produced by Clostridium tetani (tetanus toxin or tetanospasmin). It improves survival and is considered to be standard treatment. 

 

Tetanus Prophylaxis Scheme (1):

*Tetanus-prone wounds: >6 hours, >1cm depth, high risk of contamination due to the mechanism of injury (missile, crush, burn, frostbite, agriculture-related injuries), presence of devitalized tissue, presence of contaminants (dirt, saliva, etc).

Adult dose

Adult dose for tetanus treatment:
500 units IM.


Adult dose for tetanus prophylaxis:
250 units IM*.

Pediatric dose

<7 years: 4 units/kg IM.

>7 years: 250 units IM.

Renal, hepatic, geriatric or other adjustments

No adjustments needed. 

Dosage Forms

Cautions

Frequency not defined:

<1%, postmarketing, and/or case reports: Anaphylactic shock, angioedema, nephrotic syndrome.

Product of human plasma, may potentially contain infectious agents which could transmit disease. Screening of donors, as well as testing and/or inactivation or removal of certain viruses, reduces the risk. 

Monitor closely the administration of live vaccines: adenovirus type 4 and 7, BCG, measles (rubeola), measles-mumps-rubella, measles-mumps-rubella-varicella, varicella virus, rubella, smallpox. As tetanus immune globulin decreases their effect. Separate any by 3 months (4).

Pregnancy and Lactation

Pharmacology

References

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EMDrugs Team