Hyper-Tet Special Precautions

Hyper-Tet should not be given IV. IV injection of immunoglobulin intended for IM use can, on occasion, cause a precipitous fall in blood pressure, and a picture like anaphylaxis. Injections should only be made IM and care should be taken to draw back on the plunger of the syringe before injection in order to be certain that the needle is not in a blood vessel. IM injections are preferably administered in the anterolateral aspects of the upper thigh and the deltoid muscle of the upper arm. The gluteal region should not be used routinely as an injection site because of the risk of injury to the sciatic nerve. If the gluteal region is used, the central region must be avoided; only the upper, outer quadrant should be used.
Chemoprophylaxis against tetanus is neither practical nor useful in managing wounds. Wound cleaning, debridement when indicated, and proper immunization are important. The need for tetanus toxoid (active immunization), with or without TIG (passive immunization), depends on both the condition of the wound and the patient's vaccination history. Rarely has tetanus occurred among persons with documentation of having received a primary series of toxoid injections. (See table under Indications.)
Skin tests should not be done. The intradermal injection of concentrated IgG solutions often causes a localized area of inflammation which can be misinterpreted as a positive allergic reaction. In actuality, this does not represent an allergy; rather, it is localized tissue irritation. Misinterpretation of the results of such tests can lead the physician to withhold needed human antitoxin from a patient who is not actually allergic to this material. True allergic responses to human IgG given in the prescribed IM manner are rare.
Although systemic reactions to human immunoglobulin preparations are rare, epinephrine should be available for treatment of acute anaphylactic reactions.
Use in pregnancy: Pregnancy Category C: Animal reproduction studies have not been conducted with Hyper-Tet. It is also not known whether Hyper-Tet can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Hyper-Tet should be given to a pregnant woman only if clearly needed.
Use in children: Safety and effectiveness in the pediatric population have not been established.