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Immunosuppressant (Polyclonal Anti-T-Cell Immunoglobulin)

Antithymocyte Immunoglobulin (Rabbit)

Brand names: Thymoglobulin, ATG-Fresenius S

Rabbit antithymocyte immunoglobulin is a polyclonal antibody preparation used as a potent immunosuppressant, for example in solid-organ transplant induction or rejection and in aplastic anaemia.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It contains antibodies against human T-lymphocyte antigens, causing depletion of circulating T cells and broad suppression of cell-mediated immune responses.

Prescribing in practice

  • Severe infusion reactions, including cytokine release syndrome and anaphylaxis, can occur, so give premedication and administer slowly by intravenous infusion under close supervision.
  • Profound immunosuppression raises the risk of serious infection and reactivation of latent viruses.
  • Thrombocytopenia and leucopenia are common and may require dose adjustment.

Monitoring

Monitor full blood count (particularly platelets and lymphocytes), watch for infusion reactions, and remain alert to infection and viral reactivation.

Counselling the patient

  • Infusion reactions such as fever, chills, and rash can occur, especially with early doses; report symptoms during infusion.
  • Report any signs of infection after treatment.
  • Long-term increased infection risk and the need for surveillance will be explained by the specialist team.

Evidence & guidelines

Antithymocyte immunoglobulin is an established immunosuppressant in transplantation and aplastic anaemia; consult the SPC and current prescribing references.

Reference: NICE NG234 (Aplastic anaemia: diagnosis and management, 2022); BSH Guidelines on aplastic anaemia (2015 updated); EBMT/EHA Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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