Octagam: A Comprehensive Guide

Drug name: Octagam

Manufacturer: Octapharma

Generic name: Human immune globulin intravenous (IGIV)

What Is Octagam Infusion?

Octagam infusion is an intravenous immune globulin (IVIG) that contains high levels of antibodies derived from the plasma of healthy people. It is a sterile liquid preparation used to boost the body’s natural immune system so it can fight infections and protect the body against diseases.

Immunocompromised people who cannot make sufficient antibodies to fight infections receive IVIG therapy.

Octagam IVIG is an FDA-approved therapy for chronic immune thrombocytopenic purpura (ITP) and primary humoral immunodeficiencies (PI), such as:

• Wiskott-aldrich syndrome 
• X-linked agammaglobulinemia 
• Congenital agammaglobulinemia 
• Common variable immunodeficiency
• Severe combined immunodeficiencies

The FDA also approves Octagam for the treatment of dermatomyositis (DM) in adults, which is a rare, chronic autoimmune disorder that causes muscle weakness and skin rash. Octagam is the first and only IVIG medication approved for this rare condition. 

Octagam infusion is available as 5% and 10% liquid preparations; however, the 5% preparation is only approved for the treatment of primary humoral immunodeficiency (PI).

Mechanism of Action

The exact mechanisms by which Octagam works vary depending on the condition being treated and are not yet entirely understood. Octagam is mostly used to treat primary immunodeficiency (PI), chronic immune thrombocytopenic purpura (ITP), and dermatomyositis (DM).

Here’s how Octagam is thought to work for different health problems:​

For Primary Immunodeficiency (PI):

Some people don’t have enough antibodies to fight germs, making them get sick often. Octagam gives these people the antibodies they need, helping their bodies defend against infections. ​

For Chronic Immune Thrombocytopenic Purpura (ITP):

ITP is a condition where the body’s immune system mistakenly attacks its own platelets, which are cells that help blood clot. While doctors aren’t entirely sure how Octagam helps with ITP, one idea is that it stops the immune system from destroying these platelets. ​

For Dermatomyositis:

Dermatomyositis is a rare disease causing muscle weakness and skin rashes. The exact way Octagam helps with dermatomyositis isn’t fully understood. However, IVIG interacts with various components of the immune system, leading to immunomodulatory effects that may benefit patients with autoimmune conditions like dermatomyositis.

Side Effects

Common Side Effects

• Fever
• Nausea
• Headache
• Increased heart rate (reported with >5% incidence)

Dangerous Adverse Reactions

• Hemolytic anemia
• Aseptic meningitis
• Thromboembolic events
• Immediate anaphylactic reactions

Call your healthcare provider immediately if you have symptoms of allergic reactions such as hives; difficulty breathing; wheezing; neck stiffness; swelling in lips, tongue, throat; and dizziness.

Other Side Effects

• Chills
• Cough
• Diarrhea
• Flushing
• Vomiting
• Back pain
• Muscle cramps
• Abdominal pain
• Chest pain/discomfort
• Pain and swelling at the injection site

Who Should Avoid Octagam IVIG?

Patients with a history of immune globulin allergy, corn allergy, and immune globulin A (IgA) deficiency with IgA antibodies should not use Octagam infusions. The infusion can cause thrombosis and renal dysfunction.

Before starting treatment, discuss with your healthcare provider if you have any of the following conditions or factors:

• Sepsis
• Diabetes
• Pregnant
• Older than 65
• Kidney disease
• Paraproteinemia
• Hyperproteinemia
• Using birth control pills
• Severe illness and bedridden
• History of thrombosis and stroke
• Using indwelling vascular catheters
• Heart disease or blood circulation disorders

Warnings

Stop using Octagam and seek medical attention if you observe the following symptoms:

Symptoms of Clotting in the Brain

Vision and balance problems, confusion, weakness, and numbness. (Monitor signs and symptoms of thrombosis.)

Signs of Clots in the Lungs and Heart

Coughing blood, difficulty breathing, elevated heart rate, wheezing, and chest pain.

Signs of Clot Formation in Legs

Pain and swelling in legs.

Signs of Kidney Problems

Swelling or urination problems. (Monitor serum creatinine, blood urea nitrogen, and urine output.)

What Are Octagam’s Uses?

Octagam infusion contains antibodies that are defensive substances against specific infectious agents. These antibodies fight and protect the body from infections. These infusions increase the number of platelets and are therefore used to treat blood disorders. 

IVIG therapy also helps treat muscle weakness problems and nerve disorders.

Octagam IVIG Indications and Dosing

Octagam infusions are available as 5% and 10% liquid preparation.

Octagam 5

Octagam 5 is a 5% sterile solution containing 50 mg/ml of human immune globulin G (IgG). It helps treat primary humoral immunodeficiencies (PI) such as X-linked agammaglobulinemia, congenital agammaglobulinemia, Wiskott-Aldrich syndrome, and severe combined immunodeficiencies.

It is administered intravenously only. Its dose for treating primary humoral immunodeficiency (PI) is 300 – 600 mg/kg every 3 to 4 weeks with an initial infusion rate of 0.5 mg/kg/min and a 3.33 mg/kg/min maintenance infusion rate if tolerated.

Available strengths include 1 g, 2.5 g, 5 g, 10 g, or 25 g.

Octagam 10

Octagam 10 is a 10% sterile solution containing 100 mg/ml of human immune globulin G (IgG). It helps treat chronic immune thrombocytopenic purpura (ITP) in adults. It prevents bleeding in adults by quickly increasing platelet count.

Octagam 10 infusion is administered intravenously only. Its dose for the treatment of chronic immune thrombocytopenic purpura (ITP) is 1 g/kg daily for two consecutive days with an initial infusion rate of 1 mg/kg/min (0.01 ml/kg/min) and up to 12 mg/kg/min (Up to 0.12 ml/kg/min) maintenance infusion rate if tolerated.

Available strengths include 2 g, 5 g, 10 g, 20 g, or 30 g.

What Is the Cost?

Octagam 5% intravenous sterile solution costs $460.25 for 50 ml ($9.21 per unit). The cost of the 10% solution is $370.10 for 20 ml ($18.51 per unit).

The cost of Octagam 5% intravenous solution is shown in the table below:

The cost of Octagam 10% intravenous solution is shown in the table below:

Octagam Copay Assistance Programs

HealthWell Foundation sponsors a copay assistance program to assist patients by providing free or discounted medications to those who meet the following eligibility criteria:

1. Must be a resident of the USA.
2. Must have a disease diagnosis approved by the FDA.
3. May have insurance.

Octagam infusions are included in this program.

For more details, please call 800-675-8416 or visit the HealthWell Foundation website.

Patient Assistance Programs

There are patient assistance programs to help with treatment costs of Octagam. To explore these options or other financial assistance opportunities, please contact us to speak with a specialist.