Immunoglobulin (Prophylaxis) Pregnancy: Intended for use in pregnancy. No study drug-related adverse events were reported in children of women who received antepartum Rhophylac 300 micrograms. Can be used during breastfeeding.

Anti-D Immunoglobulin

Brand names: D-Gam, Rhophylac

Anti-D immunoglobulin is a human plasma-derived antibody preparation used to prevent rhesus D (RhD) sensitisation in RhD-negative women exposed to RhD-positive fetal red cells.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 300 micrograms (1500 IU) as a single dose for prevention of Rh(D) isoimmunisation in Rh(D) negative women (antepartum and postpartum prophylaxis)

Route: Intravenous or intramuscular injection (slow injection)

Frequency: Single dose per event

Max: 3000 micrograms (15,000 IU) in incompatible transfusion — not to be exceeded due to risk of haemolysis

Dose is determined by level of exposure to Rh(D) positive RBCs: 0.5 ml packed Rh(D) positive RBCs or 1 ml Rh(D) positive blood is neutralised by approximately 10 micrograms (50 IU). PROPHYLAXIS in Rh(D) negative women: Planned antepartum prophylaxis 300 micrograms single dose at 28-30 weeks; antepartum prophylaxis following complications 300 micrograms as soon as possible within 72 hours (may repeat at 6-12 week intervals if needed); postpartum 300 micrograms as soon as possible within 72 hours of delivery of a Rh(D) positive infant (when given IV, a minimum of 200 micrograms may suffice if large foeto-maternal haemorrhage excluded). Postpartum dose must still be given even if antepartum prophylaxis was administered. LARGE FOETO-MATERNAL HAEMORRHAGE (>4 ml Rh(D) positive foetal blood): 300 micrograms single dose PLUS additional 10 micrograms (50 IU) per 0.5 ml Rh(D) positive foetal RBCs (or per 1 ml Rh(D) positive foetal blood); determine extent by Kleihauer-Betke or flow cytometry. INCOMPATIBLE TRANSFUSION of RBCs in Rh(D) negative patients: 20 micrograms (100 IU) per 2 ml transfused Rh(D) positive blood (or per 1 ml Rh(D) positive RBC concentrate); dose to be determined in consultation with a specialist in blood transfusion; follow-up tests every 48 hours with further anti-D until all Rh(D) positive RBCs cleared. Observe patient for at least 20 minutes after administration. If large volume required (>5 ml for adults) and IM chosen, give in divided doses at different sites. In patients with BMI >=30, IV administration should be considered. Data extracted from Rhophylac 300 micrograms / 2 ml SPC.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients
Hypersensitivity to human immunoglobulins
Intramuscular route contraindicated in persons with severe thrombocytopenia or other disorders of haemostasis

Side effects

Hypersensitivity / anaphylactic shock (rare)
Headache (uncommon)
Skin reaction, erythema, pruritus (uncommon)
Pyrexia, malaise, chills (uncommon)
Injection-site reactions: swelling, pain, erythema, induration, warmth, pruritus, rash (rare); tachycardia, hypotension, dyspnoea, nausea, vomiting, arthralgia (rare)

Clinical monograph

How it works

It binds and promotes clearance of any RhD-positive fetal red cells from the maternal circulation before the mother can mount her own immune response, preventing formation of anti-D antibodies.

Prescribing in practice

It must only be given to RhD-negative women who are not already sensitised (no preformed anti-D antibodies), and must be administered within the recommended interval after a potentially sensitising event.
It is required after potentially sensitising events such as delivery of an RhD-positive baby, miscarriage, ectopic pregnancy, antepartum haemorrhage, and invasive procedures, and is also given as routine antenatal prophylaxis.
It is a blood-derived product, so administration should follow local protocols for traceability and counselling about theoretical infection risk.

Monitoring

A maternal sample should be tested to confirm RhD status and antibody screen, and the size of any fetomaternal haemorrhage assessed to determine whether additional doses are needed.

Counselling the patient

Explain that this injection protects future pregnancies by preventing your body reacting to a rhesus-positive baby's blood.
Tell your maternity team about any bleeding, abdominal trauma, or procedures during pregnancy so prophylaxis can be given promptly.
It is given by injection and a record is kept because it is made from human plasma.

Evidence & guidelines

Routine antenatal anti-D prophylaxis for RhD-negative women is recommended by NICE to reduce the risk of sensitisation and haemolytic disease of the newborn.

Reference: NICE NG25; BCSH Guidelines Anti-D Administration; RCOG Green-top 22; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators