Skip to main content

For US Healthcare Professionals only

Graphic with the text ‘Thymoglobulin® [Anti‑thymocyte Globulin (Rabbit)’] with an injection bottle icon on a green background with kidney line patterns behind an elderly man and a small disclaimer ‘Not an actual patient’.

Dosing & Administration: Dosing

The Right Dose of Thymoglobulin® [Anti-thymocyte Globulin (Rabbit)] Offers Clinically Demonstrated Protection for Your Patient's New Kidney

Appropriate dosing for Thymoglobulin is different from dosing for other anti-thymocyte globulin (ATG) products, as protein composition and concentrations vary depending on the source of ATG used. Physicians should therefore exercise care to ensure that the dose prescribed is appropriate for the ATG product being administered.1

Table showing Thymoglobulin dosing¹ information for intravenous use only, including indication, dose, duration, and cumulative dose. For prophylaxis of acute rejection, 1.5 mg/kg of body weight is administered daily for 4 to 7 days, starting before reperfusion of the donor kidney, with a cumulative dose of 6 to 10.5 mg/kg. For treatment of acute rejection, 1.5 mg/kg of body weight is administered daily for 7 to 14 days, with a cumulative dose of 10.5 to 21 mg/kg.
Dosing for THYMOGLOBULIN is different from dosing for other anti-thymocyte globulin (ATG) products, because protein composition and concentrations vary depending on the source of ATG. The prescribing physician must ensure that the dose prescribed is appropriate for the ATG product being administered.

Total WBC and platelet counts should be monitored to determine the need for any dose modifications1

  • Reduce the Thymoglobulin dose by one-half if the WBC count is between 2,000 and 3,000 cells/mm3 or if the platelet count is between 50,000 and 75,000 cells/mm3
  • Consider stopping treatment with Thymoglobulin if the WBC count falls below 2,000 cells/mm3 or if the platelet count falls below 50,000 cells/mm3
  • Cytopenias including anemia, neutropenia, and thrombocytopenia have occurred with Thymoglobulin administration and require monitoring of blood counts. Adjust dose accordingly to reverse cytopenias.
  • Thymoglobulin is used with concomitant immunosuppression. To prevent over-immunosuppression, physicians may wish to decrease the dose of the maintenance immunosuppression regimen during the period of Thymoglobulin use1   
     

  • Thymoglobulin overdosage may result in leukopenia, including lymphopenia and neutropenia and/or thrombocytopenia, which can be managed with dose reductions1

     

Example Dose: 70 kg (154 lb) patient 

 

The indicated dose of Thymoglobulin is 1.5 mg/kg of body weight administered daily for 4 to 7 days. 

 

For this patient, 105 mg of Thymoglobulin would be administered per day, which would require 5 vials each day. 

 

Over 4 to 7 days, this would equate to a cumulative dose of 420-735 mg or 20-35 vials.

Human icon on a rectangular green card with white text reading “Patient 70 kg (154 lb) 105 mg/day of Thymoglobulin,” on a light green background with a fingerprint pattern.

Dosing Adjustments and Considerations

The immunodeficiency that results from immunosuppression predisposes patients to disorders of immune surveillance and response, including infection and malignancy. The increased risk of infection and malignancy are related more to the overall intensity of immunosuppression than to any specific agent.2,3

  •  To prevent over-immunosuppression, physicians may wish to decrease the dose of maintenance immunosuppression regimen during the period of Thymoglobulin use1

During Thymoglobulin therapy, monitoring total lymphocyte count may help assess the degree of T-cell depletion.1

  • WBC and platelet counts should be monitored during and after therapy to assess the degree of neutropenia and thrombocytopenia, respectively1

Personalizing Thymoglobulin dose can help manage your patient’s overall immunosuppression

In all appropriate patients, the Thymoglobulin dose should be reduced to prevent over-immunosuppression1,*

Loading spinner icon with a green dotted circle.

Full dose of Thymoglobulin
 

  • If WBC count is >3,000 cells/mm3
     
  • If platelet count is >75,00 cells/mm3
Loading spinner icon with a gray and green dotted circle.

Reduce dose of Thymoglobulin by half
 

  • If WBC count is 2,000-3,000 cells/mm3
     
  • If platelet count is 50,000-75,000 cells/mm3
A Stop hand icon in a green octagon.

Consider stopping Thymoglobulin
 

  • If WBC count is <2,000 cells/mm3
     
  • If platelet count is <50,000 cells/mm3
  • Cytopenias including anemia, neutropenia, and thrombocytopenia have occurred with Thymoglobulin administration. Monitors blood counts after Thymoglobulin administration. Adjust dose accordingly to reverse cytopenias.1

* Monitor for adverse reactions and total WBC and platelet counts to help identify appropriate patients.1

PREVIOUS
← Dosing & Administration: Preinfusion and Storage

NEXT
Dosing & Administration:
Administration →

Important Safety Information

WARNING: IMMUNOSUPPRESSION. Thymoglobulin should only be used by physicians experienced in immunosuppressive therapy in transplantation.
  • Contraindications. Thymoglobulin is contraindicated in patients with a history of allergy or anaphylaxis to rabbit proteins or to any product excipients, or who have active acute or chronic infections which contraindicate any additional immunosuppression.
  • Management of Immunosuppression. To prevent over-immunosuppression, physicians may wish to decrease the dose of the maintenance immunosuppression regimen during the period of Thymoglobulin use. Dosing for Thymoglobulin is different from dosing for other ATG products, because protein composition and concentrations vary depending on the source of ATG. Thymoglobulin should be used under strict medical supervision in a hospital setting, and patients should be carefully monitored during the infusion.
  • Immune Mediated Reactions. Serious immune-mediated reactions, including anaphylaxis or severe cytokine release syndrome (CRS), have been reported with the use of Thymoglobulin. Fatal anaphylaxis has been reported. If an anaphylactic reaction occurs, the infusion should be terminated immediately.
  • Infusion-Associated Reactions. Cases consistent with cytokine release syndrome (CRS) have been reported with rapid infusion rates. CRS is attributed to the release of cytokines by activated monocytes and lymphocytes. Severe acute CRS can cause serious cardiorespiratory events and/or death. Close compliance with the recommended dosage and infusion time may reduce the incidence and severity of infusion-associated reactions (IARs). Slowing the infusion rate may minimize many of these IARs. Reactions at the infusion site may include pain, swelling, and redness of the skin.
  • Hematologic Effects. Low counts of platelets and white blood cells (including low counts of lymphocytes and neutrophils) have been identified and are reversible following dose adjustments. Total white blood cell and platelet counts should be monitored.
  • Infection and Malignancy. Infections, reactivation of infection, febrile neutropenia, sepsis, malignancies including lymphoproliferative disorders (LPD) and other lymphomas as well as solid tumors have been reported after Thymoglobulin administration in combination with multiple immunosuppressive agents. These events can be fatal.
  • Immunization. The safety of immunization with attenuated live vaccines following Thymoglobulin therapy has not been studied; therefore, immunization with attenuated live vaccines is not recommended for patients who have recently received Thymoglobulin.
  • Overdosage. Thymoglobulin overdosage may result in leukopenia (including lymphopenia and neutropenia) and/ or thrombocytopenia, which can be managed with dose reduction.
  • Adverse Reactions. The most common adverse reactions and laboratory abnormalities (incidence >5% higher than comparator) are urinary tract infection, abdominal pain, hypertension, nausea, shortness of breath, fever, headache, anxiety, chills, increased potassium levels in the blood, and low counts of platelets and white blood cells.
  • During post-marketing surveillance, arthralgia/myalgia, lymphadenopathy, proteinuria, and decreased oxygen saturation tend to occur 5 to 15 days after Thymoglobulin infusion and are consistent with serum sickness. Symptoms are manageable with corticosteroid treatment.

Click here for full Prescribing Information including Boxed WARNING.

Click here to learn more about Sanofi's commitment to fighting counterfeit drugs.

Important Safety Information

WBC, white blood cells.

References:

1. Thymoglobulin [prescribing information]. Cambridge, MA: Genzyme Corporation; 2026.
2. Halloran PF. Immunosuppressive drugs for kidney transplantation. N Engl J Med. 2004;351(26):2715-2729.
3. Kahan BD. Individuality: the barrier to optimal immunosuppression. Nat Rev Immunol. 2003;3(10):831-838.

Thymoglobulin and Sanofi are registered trademarks of Sanofi or an affiliate. MAT-US-2600056-v1.0-03/2026

Back to top
Back to top
SitemapLegal NoticePrivacy PolicyCookie PolicyDo Not Sell or Share My Personal InformationContactAccessibility Statement
© 2026 Sanofi. All rights reserved.