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

Dosing & Administration: Preinfusion and Storage

Storage & Handling 

Thymoglobulin® [Anti-thymocyte Globulin (Rabbit)] is supplied for injection as a single-dose 10-mL vial containing 25 mg of rabbit anti-thymocyte globulin (ATG) sterile lyophilized powder intended for reconstitution prior to intravenous administration.1

  • Store in refrigerator at 2°C to 8°C (36°F to 46°F)1
  • Protect from light1
  • Do not freeze1
  • Do not use after the expiration date indicated on the label1
  • Reconstituted Thymoglobulin is physically and chemically stable for up to 24 hours at room temperature1
  • Room-temperature storage of Thymoglobulin is not recommended1
  • Reconstituted product contains no preservatives and should be used immediately1
  • Discard any unused drug remaining after infusion1

Certain Medications Should Be Given Prior to Thymoglobulin Infusion

Thymoglobulin is routinely used in combination with other immunosuppressive agents. Infections (bacterial, fungal, viral, and protozoal), reactivation of infection (particularly CMV), and sepsis have been reported after Thymoglobulin administration in combination with multiple immunosuppressive agents. These infections can be fatal.1 Monitor patients carefully and administer appropriate anti-infective treatment when indicated
Prophylactic antifungal and antibacterial therapy is recommended if clinically indicated1
Antiviral prophylactic therapy is recommended for patients who are seropositive for CMV at the time of transplant and for CMV-seronegative patients scheduled to receive a kidney from a CMV-seropositive donor1

 

Premedicate with corticosteroids, acetaminophen, and/or an antihistamine 1 hour prior to each infusion of Thymoglobulin to reduce the incidence and intensity of infusion-related reactions (IRRs)1

 

Hypersensitivity and Infusion-Related Reactions Severe hypersensitivity and infusion-related reactions, including fatal anaphylaxis and severe CRS, have been reported with the use of Thymoglobulin. 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-related reactions. Slowing the infusion rate may minimize the risk of infusion-related reactions. If a hypersensitivity or infusion-related reaction occurs, terminate the infusion immediately and provide supportive treatment according to clinical practice.1

Educate your Patients about Treatment with Thymoglobulin® [Anti-thymocyte Globulin (Rabbit)]

Advise patients receiving Thymoglobulin of the following treatment  considerations:

Icon of a central cell connected to five outer nodes inside a green circle.

Hypersensitivity and Infusion-related reactions

Advise patients of the signs and symptoms of IRRs (flu-like symptoms; eg, fever, chills, nausea, muscle or joint pain) and the need to take premedications as prescribed.1 Determine if the patient has known allergies to rabbits or rabbit proteins. Determine if the patient has had significant exposure to rabbits.1 Refer to recommendations in the Prescribing Information to help reduce IRRs1

Icon of bacteria and microbes inside a green circle

Infections

Inform patients of the increased risk of infection while taking immuno-suppressive therapy. Instruct patients to immediately report signs or symptoms of infection and to take prophylactic anti-infectives as prescribed1

Icon of a virus inside a green circle.

Malignancies

Inform patients of the increased risk of malignancies while taking immuno-suppressive therapy, especially skin cancer. Instruct patients to limit exposure to sunlight and UV light by wearing protective clothing and using sunscreen with a high protection factor1

Icon of a immunizations shield inside a green circle.

Immunizations

Advise patients that they should not receive immunizations with live viral vaccines if they have recently been treated with Thymoglobulin1

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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.

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Important Safety Information

CMV, cytomegalovirus; CRS, cytokine release syndrome; IRRs, infusion-related reactions; UV, ultraviolate.

Reference:

1. Thymoglobulin [prescribing information]. Cambridge, MA: Genzyme Corporation; 2026.

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

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