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DRUGS REQUIRING SPECIAL HANDLING
BIOLOGICAL PRODUCTS
STRENGTH/FORM DOSAGE COMMENTS
Hepatitis B vaccine Children: 5
mcg/0.5 mL of
HBsAg in a 0.5 mL
single-dose vial
Adult: 10 mcg/mL
of HBsAg in a 1 mL
single-dose vial
Dialysis: 40
mcg/mL of HBsAg
in a 1 mL single-
dose vial
20 yrs: 1.0 mL
Hepa B vaccine should be
administered intramuscularly.
Do not inject intravenously or
intradermally
Diptheria and Tetanus
Toxoid and acellular
pertusis vaccine
Each 0.5mL VIAL
contains: -2 IU (2.5
Lf U) of diphtheria
toxoid
- 20 IU (5 Lf U) of
tetanus toxoid
-8 mcg of pertussis
toxoid,
- 8 mcg of
filamentous
haemagglutinin
and 2.5 mcg of
pertactin
0.5 mL BOOSTRIX is administered by
deep intramuscular injection,
preferably in the deltoid region
THE VACCINE SHOULD NEVER
BE ADMINISTERED
INTRAVENOUSLY.
Haemophilus influenza
type b (Hib) conjugate
vaccine
Single dose vial 0.5 mL Hib is injected into the upper le
muscle in infants under 12
months of age. In children over
12 months of age the injection
will be given in the upper arm
muscle.
First dose: 2 months of age
Second dose: 4 months of age
Third dose: 6 months of age.
To ensure long term protection booster dose is generally given
in the second year of life .
Inacctivated Polio virus
vaccine (IPV)
Single-dose vials
and prefilled
syringes containing
a 0.5-mL
0.5 mL Children
Primary series consists of 3
doses of 0.5 mL. Separate first 2
doses by at least 4 weeks, but
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suspension for
injection.
preferably 8 weeks; commonly
given at 2 and 4 mo. Give third
dose at least 6 months, but
preferably 12 months, after
second dose, commonly given a
15 to 18 mo.
Adults
For unvaccinated adults at
increased risk of exposure to
poliovirus, give primary series o
IPV: 2 doses at 1 to 2-mo
interval, with third dose 6 to 12
months later. If less than 3
months, but older than 2 month
remain before protection is
needed (e.g., planned
international travel), give 3
doses of IPV at least 1 month
apart.
Measles ,mumps ,and
rubella vaccine (MMR)
Each 0.5mL dose
contains not less
than:
-103.0 CCID50 (cell
culture infectious
dose 50%) of the
Schwarz measles
-103.7 CCID50 of
the RIT 4385
mumps, and-103.0 CCID50 of
the Wistar RA 27/3
rubella virus
Strains
vial
0.5 mL This vaccine is injected under
the skin (subcutaneously) or
into muscle. PRIORIX is
generally injected into the uppe
leg muscle in infants under 12
months of age. In children over
12 months of age and older
children and adults the injection
3
This may be given in the upper
arm muscle.
Varicella Vaccine Each 0.5mL dose
contains not less
than 103.3 plaque-
forming units of the
varicella-zostervirus.
vial
0.5 mL injected under the skin
(subcutaneously) of the
shoulder or thigh.
The vaccine should never be
given intravenously.
In children from 9 months up to
and including 12 years, the
appropriate time and number o
doses that will be given will be
determined by your doctor on
the basis of appropriate official
recommendations. Adults and
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adolescents aged 13 years and
older are generally given two
doses at least six weeks apart.
Each dose is given at a separate
visit.
The need for booster doses is
uncertain at present.
Pneumococcal Vaccine 0.5ml dose of
SYNFLORIX
contains 1
microgram of
Pneumococcal
polysaccharide
serotypes 1, 5, 6B,
7F, 9V, 14 and
23F and 3
micrograms of
Pneumococcal
polysaccharide
serotypes 4, 18C
and 19F.
0.5 mL Usually, your child will receive
three injections with an interva
of
at least one month between eac
one. The first injection can be
given from the age of 6 weeks
onwards. At least six months
after
the third injection, your child
will
receive an additional injection.
(booster)
Hepatitis A Vaccine 0.5-mL single-dose
vials and prefilled
syringes.
1-mL single-dose
vials and prefilled
syringes
19 yrs; 1.0
mL
HAV should be administered by
intramuscular injection only.
HAVRIX should not be
administered in the gluteal
region; such injections may
result in suboptimal response.
Do not administer this product
intravenously, intradermally, orsubcutaneously
Influenza Vaccine IM injection 0.5 mL The Centers for Disease Control
and Prevention (CDC)
recommend that everyone 6
months and older should receiv
the flu vaccine.
Anthrax vaccine
adsorbed(biothrax)
5.0 mL multidose
vials containing
ten 0.5 mL doses.
5mL Vial Biothrax is given to patient
ntramuscularly.
Digoxin Immune Fab,ovine
(digiblind)
Each vial, which
will bind
approximately
0.5 mg of digoxin
(or digitoxin),
contains 38 mg of
digoxin-specific
Fab fragments
derived from
sheep plus 75 mg
0.5 mg each vial Ingestion of more than 10 mg of
digoxin in previously healthy
adults or 4 mg of digoxin in
previously healthy children, or
ingestion causing steady-state
serum concentrations greater
than 10 ng/mL, often results in
cardiac arrest
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of sorbitol as a
stabilizer and
28 mg of sodium
chloride.
Diptheria Toxoid /Tetanus
toxoid/Acellular Pertussis
vaccine adsorbed
Daptacel,infanrix,tripedia)
Each 0.5 mL
Diphtheria toxoid
not 1 year of age, the
deltoid is the preferred site since
use of the anterolateral thigh
results in frequent complaints of
limping due to muscle pain.13
After insertion of the needle,
aspirate to ensure that the needl
has not entered a blood vessel.
Do not inject IV
Hepatitis A vaccine
(Inactivated)
160/ 80 pre-filled
syringe
(inj) 160 antigen
units/0.5 mL
80 antigen
units/0.5 mL
0.5-mL pediatric
dose in single-dose
vials and prefilled
syringes. 1-mL
adult dose in
single-dose vials
For intramuscular administratio
only.
Children/Adolescents:
vaccination consists of a 0.5-mL
primarydose administered
intramuscularly, and a 0.5-mL
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(Avaxim) and prefilled
syringes
booster doseadministered
intramuscularly 6 to 18 months
later.
Adults: vaccination consists of a
1-mL primary dose administered
intramuscularly, and a 1-mL
booster dose administeredIntramuscularly 6 to 18 months
later.
Hepatitis B immune
globulin(Bay Hep,Nabi-
HB)
1 mL dose in a
single-use vial
(>312 IU)
5 mL dose in a
single-use vial
(>1560 IU)
0.5mL This product is for intramuscula
use only.
The use of this product by the
intravenous route is not
indicated.
Hepatitis B vaccine
Recombinant(engerix
B,Recombivax HB
Vaccine inj 10
mcg/0.5 mL
(monodose,
pediatric dose). 20
mcg/mL
(monodose, adult
dose).
A 1.0 mL dose of
the formulation of
the vaccine for use
in
dialysis/predialysis
patients contains
40 mcg of HBsAg
IMAdult20 yr20 mcg/dose.
Neonate, infant & childn19 yr10
mcg/dose.
Immune globulin Human
(Bay Gam)
2 mL and 10 mL
single dose vials.
2 mL and 10 mL 20 IU/kg body wt IM as a single
dose.
Immune Globulin
Intravenous Human
(sandoglobuli IV)
white lyophilized
powder in 1, 3, 6
and 12 g size vials.
The only diluents
which may be
used toreconstitute the
product are sterile
(0.9%) Sodium
Chloride Injection
USP, 5% Dextrose,
or Sterile Water.
The product should
be infused at a rate
less than 2 mg
Ig/kg/min.
Replacement therapy in
primary immunodeficiency Initia
dose: 0.4-0.8 g/kg body wt
followed by 0.2-0.8 g/kg body w
every 2-4 wk to obtain IgG troug
level of at least 4-6g/L. Replacement therapy in
secondary immunodeficiency 0.2
0.4 g/kg body wt every 3-4 wk to
obtain IgG trough level of at leas
4-6 g/L.Replacement therapy in
childn w/ AIDS 0.2-0.4 g/kg bod
wt every 3-4 wk.Idiopathic
thrombocytopenic purpura 0.8-1
g/kg body wt on day 1, repeated
once w/in 3 days or 0.4 g/kg
body wt/day for 2-5 days.
Influenza Virus vaccineSubviron (Fluvirin)
0.5 mL single-doseprefilled syringe
(3, 11) 5.0
mL multi-dose vial
containing 10
doses (each dose
is 0.5 mL) (3,11)
0.5 mL Adults and children aged fourand over: 0,5 mL by deep
subcutaneous or intramuscular
injection. Young children who
may not have been previously
infected, or who have not
received trivalent influenza
vaccine in the past four years,
https://www.mims.com/Philippines/diagnoses/Info/1207https://www.mims.com/Philippines/diagnoses/Info/1207https://www.mims.com/Philippines/diagnoses/Info/2680https://www.mims.com/Philippines/diagnoses/Info/3236https://www.mims.com/Philippines/diagnoses/Info/3236https://www.mims.com/Philippines/diagnoses/Info/3236https://www.mims.com/Philippines/diagnoses/Info/3236https://www.mims.com/Philippines/diagnoses/Info/2680https://www.mims.com/Philippines/diagnoses/Info/1207https://www.mims.com/Philippines/diagnoses/Info/12077/29/2019 Pre Drugs Ko
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may require two doses of vaccin
given at an interval of 4 -
6 weeks, to ensure a protective
antibody response.
Influenza virus vaccine
(Flu shield,Fluzone)
Suspension for
injection in a
prefilled
microinjection
system, 0.1 mL
A single 0.1 mL
dose for
intradermal
injection in adults
18 through 64
years of age
IM or deep SC injAdult & childn
>36 mth 0.5 mL. Childn 6-35
mth Limited clinical data. Doses
of 0.25 mL or 0.5 mL have been
used. Childn who have not been
previously vaccinatedAdminister
a 2nd dose after an interval of at
least 4 wk.
Measles Virus Vaccine live
(attenuvax)
The reconstituted
vaccine is for
subcutaneous
administration.
Each 0.5 mL dose
contains not less
than 1,000 TCID50
(tissue culture
infectious doses)
of measles virus.
0.5 mL 0.5 mL administered
subcutaneously, preferably into
the outer aspect of the upper
arm.
The recommended age for
primary vaccination is 12 to 15
months.
Revaccination with M-M-RII is
recommended prior to
elementary school entry.
Children first vaccinated when
younger than 12 months of age
should receive another dose
between 12 to 15 months of age
followed by revaccination prior
to elementary school entry.
Measles/mumps/rubellavirus vaccine MMR11
The reconstitutedvaccine is for
subcutaneous
administration.
Each 0.5 mL dose
contains not less
than 1,000 TCID50
(tissue culture
infectious doses)
of measles virus..
Single 0.5-mL dose administered by SC/IM inj.The dose for any age is 0.5 mL
administered subcutaneously,
preferably into the outer aspect
of the upper arm.
The recommended age for
primary vaccination is 12 to 15
months.
Revaccination with M-M-RII is
recommended prior to
elementary school entry.
Children first vaccinated when
younger than 12 months of ageshould receive another dose
between 12to15 months of age
followed by revaccination prior
to elementary school entry.
Meningitis vaccine
(menomune)
Powd for inj
(monodose vial +
0.78 mL diluent)
0.5mL SCImmunization 0.5
mL. Revaccination for childn
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Mumps Virus Vaccine
(mumps vax)
The reconstituted
vaccine is for
subcutaneous
administration.
Each 0.5 mL dose
contains not less
than 20,000TCID50 (tissue
culture infectious
doses) of mumps
virus.
0.5 mL The dose for any age is 0.5 mL
administered subcutaneously,
preferably into the outer aspect
of the upper arm.
The recommended age for
primary vaccination is 12 to 15
months.
Individuals first vaccinated with
MUMPSVAX at 12months of age
or older should be revaccinated
with M-M-R*II (Measles, Mumps
and Rubella Virus Vaccine Live)
prior to elementary school entry
Revaccination may seroconvert
primary failures or boost
antibody titers of those
individuals whose titers have
declined.
Pneumococcal vaccine(
Diptheria Protein)-
Prevnar
Syringe, 1 Dose 0.5mL For infants, the immunization
series of Prevnar consists of
three doses of 0.5 mL each, at
approximately 2-month interval
followed by a fourth dose of 0.5
mL at 12-15 months of age. The
customary age for the first dose
is 2 months of age, but it can be
given as young as 6 weeks of age
The recommended dosing
interval is 4 to 8 weeks. Thefourth dose should be
administered at approximately
12-15 months of age, and at leas
2 months after the third dose.
Pneumococcal vaccine
(pneumovax 23-Pnu
immune23)
Vaccine 0.5 mL
(inj, single-dose
vial, clear,
colorless soln)
0.5 mL Primary immunization Single 0.5
mL inj. Reimmunization Single
0.5 mL inj. Must not be given
w/in 5 yr except for high-risk
subjects or those under
immunosuppressive therapy.
Administer IM or SC.
Polio vaccine Inacctivated(ipol)
Single-dose vialsand prefilled
syringes
containing a 0.5-
mL suspension for
injection.
0.5 mLChildrenPrimary series consists of 3 dose
of 0.5 mL. Separate first 2 doses
by at least 4 weeks, but
preferably 8 weeks; commonly
given at 2 and 4 mo. Give third
dose at least 6 months, but
preferably 12 months, after
second dose, commonly given at
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15 to 18 mo.
Adults
For unvaccinated adults at
increased risk of exposure to
poliovirus, give primary series o
IPV: 2 doses at 1 to 2-mo interva
with third dose 6 to 12 monthslater. If less than 3 months, but
older than 2 months remain
before protection is needed (e.g.
planned international travel),
give 3 doses of IPV at least 1
month apart.
Rabies Immune vaccine
(Imovax/ rabavert)
One vial of freeze-
dried vaccine
containing a single
dose. - One sterile
syringe containing
diluent. A separate
plunger is
provided for
insertion and use.
- One sterile
disposable needle
for reconstitution.
1.0 mL For adults and older children, th
vaccine should be injected into
the deltoid muscle. In infants and
small children, the anterolateral
aspect of the thigh may be
preferable, depending on age an
body mass. Care should be taken
to avoid injection into or near
blood vessels and nerves. If bloo
or any suspicious discoloration
appears in the syringe, do not
inject but discard contents and
repeat procedure using a new
dose of vaccine at a different site
Respiratory Syncytial
Virus immune globulin
,Human(Respigam)
Injection, Solution 20 mL For preventing respiratory
syncytial virus (RSV) infection.
Adults and children 24 months oage and olderUse is not
recommended.
Infants and children younger
than 24 months of age750milligrams (mg) per kilogram
(kg) (340.9 mg per pound) of
body weight injected into a vein
once a month for five months.
Rho Immune Globulin
Human
1 prefilled single-
dose syringe of
RhoGAM
5 prefilled single-dose syringes of
RhoGAM
25 prefilled single-
dose syringes of
RhoGAM
50 g
300 g
For intramuscular use only. Do
not inject RhoGAM or
MICRhoGAM intravenously. In
the case of postpartum use, theproduct is intended for maternal
administration. Do not inject the
newborn infant.
Parenteral drug products should
be inspected visually for
particulate matter and
discoloration prior to
administration.
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A single dose (approximately 50
g)* is contained in each prefille
syringe of MICRhoGAM. This dos
will suppress the immune
response to 2.5 mL of Rh-positiv
red blood cells. MICRhoGAM is
therefore indicated within 72hours after termination of
pregnancy up to and including 1
weeks gestation. At or beyond 1
weeks gestation, RhoGAM shoulbe administered instead of
MICRhoGAM.
A single dose (approximately 30
g) is contained in each prefilledsyringe of RhoGAM. This is the
usual dose for the indications
associated with pregnancy unles
there is clinical or laboratory
evidence of a fetal-maternal
hemorrhage (FMH) in excess of
15 mL of Rh-positive red blood
cells. RhoGAM should be
administered within 72 hours of
known or suspected exposure to
Rh-positive red blood cells.
Rubella Virus Vaccine Live
(attenuvax)
The reconstituted
vaccine is for
subcutaneous
administration.Each 0.5 mL dose
contains not less
than 1,000 TCID50
(tissue culture
infectious doses)
of measles virus..
0.5 mL 0.5 mL administered
subcutaneously, preferably into
the outer aspect of the upper
arm.The recommended age for
primary vaccination is 12 to 15
months.
Revaccination with M-M-RII is
recommended prior to
elementary school entry.
Children first vaccinated when
younger than 12 months of age
should receive another dose
between 12 to 15 months of age
followed by revaccination prior
to elementary school entry.Tetanus and Diptheria
Toxoidsadsorbed(Td)
Single-dose (0.5
ml) vials.
Each 0.5 ml dose
of Td is
formulated to
contain the
following active
0.5 ml PRIMARY IMMUNIZATION
MassBiologics Td may be used inpersons 7 years of age and older
who have not been previously
immunized against tetanus and
diphtheria, as a primary
immunization series consisting o
three 0.5 ml doses. The first two
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ingredients: 2 Lf of
tetanus toxoid and
2 Lf of diphtheria
toxoid.
doses are administered 4-8
weeks apart and the third dose i
administered 6-12 months after
the second dose.
Mass Biologics Td may be used
to complete the primary
immunization series for tetanusand diphtheria, following one or
two doses of Diphtheria and
Tetanus Toxoids and Pertussis
Vaccine Adsorbed (whole-cell
DTP), Diphtheria and Tetanus
Toxoids and A cellular Pertussis
Vaccine Adsorbed (DTaP) and/o
Diphtheria and Tetanus Toxoids
Adsorbed (DT) vaccine. Howeve
the safety and efficacy of
MassBiologics Td in such
regimens have not been
evaluated.
ROUTINE BOOSTER
IMMUNIZATION MassBiologicsTd may be used for routine
booster immunization against
tetanus and diphtheria in
persons 7 years of age and older
who have completed primary
immunization against tetanus
and diphtheria. Routine booster
immunization against tetanusand diphtheria is recommended
in children 11-12 years of age
and every 10 years thereafter.
Inject 0.5 ml of MassBiologics Tdintramuscularly. The preferred
site is the deltoid muscle. The
vaccine should not be injected
into the gluteal area or areas
where there may be a major
nerve trunk.
Do not administer this vaccine
intravenously, subcutaneously, ointradermally.
MassBiologics Td should not be
combined through reconstitution
or mixed with any other vaccine
Tetanus Immunoglobulin
(Bay Tet)
Vials containing
Human Tetanus
Immunoglobulin
equivalent to
250 I. U. / 500 I. U.
/ 1000 I. U
Prophylaxis :In High risk injuries
to non-immune and immune
patients (Above 7 Years)
In High risk injuries to non-
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Tetanus antitoxin
250 / 500 / 1000
I.U
immune and immune patients
(Below 7 Years)
250 I.U. Deep IM 500 I.U. Deep IM
(if 24 hours have not passed
since injury or with a risk of
heavy contamination)
4 Units/kg or 250 I.U. Deep IMTherapeutic: Clinical tetanus
Newborn (Tetanus Neonatorum)
Children(Above 7 Years) &
Adults
250 I.U. to 500 I.U. IM and/or 25
I.U. intrathecal. 500 to 3,000 I.U.
IM and/or 500 I.U. intrathecal.
It should not be administered
intravenously.
Tetanus Toxoid
Tetanus toxoid adsorbed
purogenated
Each single dose of
0.5 mL,of ACEL-
IMUNE is
formulated to
contain9 Lf of
diphtheria toxoid
and 5 Lf of tetanus
toxoid (both
toxoids induce not
less than 2 units of
antitoxin per mL
in the guinea pig
potency test) and300
hemagglutinating
(HA) units of
acellular pertussis
vaccine.
0.5 mL Children who have recovered
from culture co & med pertussis
need not receive further doses o
a pertussis-containing vaccine7,
but should complete the
recommended series with
Diphtheria and Tetanus Toxoids
Adsorbed for pediatric USC(DT).
It is intended for active
immunization against diphtheria
tetanus, and pertussis. It is not to
be used for treatment of actual
infection.Ifa contraindicating event td the
pertussis vaccine component
occurs, Diphtheria and Tetanus
Toxoids, Adsorbed for pediatric
use (IX) should be substituted fo
each of the remaining doses. The
Advisory Committee on
Immunization Practices (ACID)
recommends that if an immediat
anaphylactic reaction occurs, no
further vaccination with any of
the three antigens in DTP shouldbe carried out.
If passive immunization is
required, Tetanus Immune
Globulin (TIG) or Diphtheria
Antitoxin are recommended.
Varicella virus vaccine
(varivax)
Suspension for
injection
0.5 mL Children (12 months to 12 years
of age)
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(approximately
0.5-mL dose)
supplied as a
lyophilized
vaccine to be
reconstituted
using theaccompanying
sterile diluent.
If a second dose is administered,
there should be a minimum
interval of 3 months between
doses
Adolescents (13 years of age)
and Adults
Two doses of vaccine, to beadministered with a minimum
interval of 4 weeks between
doses.
Varicella Zoster Immune
Globulin
Injection 125 units
of varicella zoster
immune globulin
antibody
125 units Administer by IV or IM injection
Monitor patient for adverse
effects for at least 20 minutes
after administration of VZIG.
Do notmix with any other drugor solution.
Do notadminister concomitantly
with varicella vaccine.
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