Canterbury DHB


Immunosuppression - ATG/ALG and Cyclosporin

Treatment schedule

See the prescription sheet for Atgam horse.

DAY 1 - 4

Atgam® (Horse ATG).

See ALG/ATG guidelines.

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.

In This Section

ATG/ALG Guidelines

About this Canterbury DHB document (4930):

Document Owner:

Not assigned (see Who's Who)

Last Reviewed:

November 2019

Next Review:

November 2022


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Topic Code: 4930