Anti-thymocyte Globulin (ATG) (Generic Name)

Other Names: Thymoglobulin

About this drug

ATG is a special ATG is a special antibody that is used to treat aplastic anemia and graft-versus-host disease in patients having a stem cell transplant. It is given in the vein (IV).

Possible Side Effects (More Common)

Serious allergic reactions may happen. While you are getting this drug, tell your nurse right away if you have any of these symptoms of an allergic reaction:

  • Trouble catching your breath
  • Feeling like your tongue or throat are swelling
  • Feeling your heart beat quickly or in a not normal way (palpitations)
  • Feeling dizzy or lightheaded
  • Flushing, itching, rash, and/or hives
  • Chest pain

Possible Side Effects (Less Common)

  • Fever and chills within a few hours after the first dose are common
  • Bone marrow depression: this is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired or weak (fatigued), and raise your risk of bleeding.
  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours or many hours after your treatment and may last up to 72 hours. Medicines are available to stop or lessen these side effects.
  • Headache
  • Loose bowel movements (diarrhea).
  • Flu-like symptoms about a week after the first dose, lasting for several weeks. You may have a rash, joint pain, muscle aches, and tired feeling.
  • Blood clots (rare): A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause shortness of breath, pain when breathing, and/or chest pain.
  • Phlebitis (vein inflammation): If this drug is given through a vein in your arm, the vein and skin surrounding the vein may become painful, swollen, warm, or red.
  • Long-term effects: this drug may cause an increased risk of developing a second cancer.

Infusion Reactions

While you are getting this drug in your vein (IV) you may have a reaction. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain.

These reactions may happen the first 24 hours after you get this drug. Call 911 for emergency care.

  • Less serious reactions to this drug may happen. You will be given medicines to help stop or lessen these symptoms. Your vital signs will be checked during the infusion and for several hours after the infusion. Tell your doctor or nurse right away if you have any of these symptoms any time during the infusion and/or for the first 24 hours after getting this drug.
  • Fever, chills, or shaking chills
  • Feeling dizzy or lightheaded
  • Headache
  • Nausea or throwing up

Allergic Reactions

Serious allergic reactions including anaphylaxis can happen. While you are getting this drug in your vein, tell your nurse right away if you have any of the following symptoms of an allergic reaction:

  • Trouble catching your breath
  • Feeling like your tongue or throat are swelling
  • Feeling your heart beat quickly or in a not normal way (palpitations)
  • Feeling dizzy or lightheaded
  • Flushing, itching, rash and/or hives

Treating side effects

  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements you should drink more fluids so that you do not become dehydrated (lack water in the body due to losing too much fluid).
  • Ask your doctor or nurse about medicine that is available to help stop or lessen diarrhea.
  • If you are dizzy, get up slowly after sitting or lying down
  • Ask your doctor or nurse about medicine that is available to help stop or lessen fever, headache, joint and muscle pain, nausea, and throwing up.
  • Do not put anything on a rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry.
  • Food and drug interactions

When to call the doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Bleeding or bruising that is not usual
  • Wheezing or trouble breathing
  • Rash or itching
  • Feeling dizzy or lightheaded
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
  • Blurred vision or other changes in eyesight
  • Pain when passing urine; blood in urine
  • Pain in your lower back or side
  • Confusion or agitation
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Symptoms of a stroke, such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired or weak, unusual itching, or yellowing of the eyes or skin

Call your doctor or nurse as soon as possible if any of these symptoms happen:

  • Change in hearing, ringing in the ears
  • Decreased urine
  • Unusual thirst or passing urine often
  • Painful mouth or throat that makes it hard to eat or drink
  • Nausea that is not relieved by prescribed medicines
  • Rash that is not relieved by prescribed medicines
  • Heavy menstrual period lasting longer than normal
  • Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
  • Trouble walking or changes in the way you walk, clumsiness in buttoning clothes, opening jars, or other routine hand motions
  • Swelling of legs, ankles, or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Headache that does not go away
  • Painful, red, or swollen areas on your hands or feet.
  • No bowel movement for 3 days or you feel uncomfortable
  • Extreme weakness that interferes with normal activities

Reproduction Concerns

  • Pregnancy warning: It is not known if this drug may harm an unborn child. For this reason, be sure to talk with your doctor if you are pregnant or planning to become pregnant while getting this drug
  • Breast feeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

Revised June 2014

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