Canterbury DHB
See the prescription sheet for Atgam horse.
DAY 1 - 4 |
Atgam® (Horse ATG). 40 mg/kg/day IV infusion over 12 hours. (Atgam®-Lymphocyte immune globulin (ATG) - equine is the standard preparation currently used in NZ). Each daily dose should be preceded by methylprednisolone 1 mg/kg IV and chlorphenamine 10 mg IV. Platelet transfusions should maintain a safe platelet count ideally above 30 X 109/L. |
DAY 4 - 13 |
Prednisone PO 1 mg/kg/day. If unable to take oral prednisone, give IV methylprednisone (4 mg methylprednisone is equivalent to 5 mg prednisone). |
DAY 14 - 16 |
Prednisone PO 0.5 mg/kg/day. |
DAY 17 - 19 |
Prednisone PO 0.25 mg/kg/day. |
DAY 19 |
Start cyclosporin PO 2.5 mg/kg/BD, check levels weekly (Mondays), and adjust dose to maintain level between 100 to 200 micrograms/L. Continue while the blood count continues to rise and continue for a further 12 months. Then taper by 25 mg every 2 to 3 months. |
Topic Code: 4930