GAMASTAN by is a Other medication manufactured, distributed, or labeled by GRIFOLS USA, LLC, Grifols Therapeutics LLC. Drug facts, warnings, and ingredients follow.
Warnings and Precautions, Transmissible Infectious Agents (5.4) 2/2018
GAMASTAN is a human immune globulin indicated:
For intramuscular use only. Do not administer intravenously.
Indication | Dosage | Instruction |
Hepatitis A (2.1) | 0.1 mL/kg | Administer within two weeks of prior exposure to hepatitis A. |
Administer before departure to persons traveling to areas with endemic hepatitis A: | ||
0.1 mL/kg | if the length of stay will be up to 1 month | |
0.2 mL/kg | if the length of stay will be up to 2 months; repeat every 2 months for longer stays. | |
Measles (2.1) | 0.25 mL/kg | Administer within 6 days of exposure. |
0.5 mL/kg | Immediately administer (maximum dose, 15 mL) to an immunocompromised child. | |
Varicella (2.1) | 0.6 mL/kg to 1.2 mL/kg | Administer promptly if Varicella-Zoster Immune Globulin (Human) is unavailable. |
Rubella (2.1) | 0.55 mL/kg | Only administer to exposed pregnant women who will not consider a therapeutic abortion. |
GAMASTAN is a sterile, 16.5% protein solution supplied in 2 mL and 10 mL single-dose vials. (3)
The most common adverse reaction reported for GAMASTAN S/D during post-approval use was fatigue. (6)
To report SUSPECTED ADVERSE REACTIONS, contact Grifols Therapeutics LLC at 1-800-520-2807 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
See 17 for PATIENT COUNSELING INFORMATION.
Revised: 2/2018
GAMASTAN is a human immune globulin indicated for:
GAMASTAN is indicated for prophylaxis following exposure to hepatitis A.(1,2) The prophylactic value of GAMASTAN is greatest when given before or soon after exposure to hepatitis A. GAMASTAN is not indicated in persons with clinical manifestations of hepatitis A or in those exposed more than 2 weeks previously.
GAMASTAN is indicated to prevent or modify measles in a susceptible person exposed fewer than 6 days previously.(3) A susceptible person is one who has not been vaccinated and has not had measles previously.
GAMASTAN is indicated to modify varicella.
GAMASTAN is indicated to modify rubella in exposed women who will not consider a therapeutic abortion.
For intramuscular use only.
Do not administer intravenously.
Indication | Dosage | Instruction |
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Prophylaxis for exposure to hepatitis A | 0.1 mL/kg* | Administer within two weeks of prior exposure for household and institutional hepatitis A case contacts. |
Administer before departure to persons traveling to areas with endemic hepatitis A: | ||
0.1 mL/kg | if the length of stay will be up to 1 month(9,10) | |
0.2 mL/kg | if the length of stay will be up to 2 months(9,10) | |
0.2 mL/kg | if the length of stay will be 2 months or longer; repeat every 2 months.(9,10) | |
Prevent or modify measles in a susceptible person exposed fewer than six days previously | 0.25 mL/kg† | Administer to a susceptible person within 6 days of exposure. |
0.5 mL/kg | Immediately administer (maximum dose, 15 mL) to an immunocompromised child. | |
Modify varicella | 0.6 mL/ kg to 1.2 mL/kg | Administer promptly only if Varicella-Zoster Immune Globulin (Human) is unavailable. |
Modify rubella only in an exposed woman who will not consider a therapeutic abortion | 0.55 mL/kg | Only administer to an exposed pregnant woman who will not consider a therapeutic abortion. |
GAMASTAN is contraindicated in:
Administer GAMASTAN cautiously to patients with a history of prior systemic allergic reactions following the administration of human immunoglobulin preparations.(11) Have epinephrine available for treatment of acute allergic symptoms, should they occur.
Do not perform skin tests. In most patients the intradermal injection of concentrated gamma globulin solution with its buffers causes a localized area of inflammation which can be misinterpreted as a positive allergic reaction. In actuality, this does not represent an allergy; rather, it is localized tissue irritation of a chemical nature. Misinterpretation of the results of such tests can lead the physician to withhold beneficial human immunoglobulin from a patient who is not actually allergic to this material.
Thrombosis may occur following treatment with immune globulin products, including GAMASTAN.(12-14) Risk factors may include: advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, use of estrogens, indwelling central vascular catheters, hyperviscosity, and cardiovascular risk factors. Thrombosis may occur in the absence of known risk factors.
Consider baseline assessment of blood viscosity in patients at risk for hyperviscosity, including those with cryoglobulins, fasting chylomicronemia/markedly high triacylglycerols (triglycerides), or monoclonal gammopathies. For patients at risk of thrombosis, do not exceed the recommended dose of GAMASTAN. Ensure adequate hydration in patients before administration. Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk for hyperviscosity. [see Boxed Warning, Patient Counseling Information (17)]
Inject intramuscularly only. Do not administer GAMASTAN intravenously because of the potential for serious reactions (e.g., Renal Dysfunction/Failure/Hemolysis, Transfusion-Related Acute Lung Injury [TRALI]). Do not inject into a blood vessel. [see Dosage and Administration (2.3)]
GAMASTAN is made from human blood and may carry a risk of transmitting infectious agents, e. g, viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent, and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent. GAMASTAN is purified from human plasma obtained from healthy donors. When medicinal biological products are administered, infectious diseases due to transmission of pathogens cannot be totally excluded. However, in the case of products prepared from human plasma, the risk of transmission of pathogens is reduced by: (1) epidemiological controls on the donor population and selection of individual donors by a medical interview and screening of individual donations and plasma pools for viral infection markers; (2) testing of plasma for hepatitis C virus (HCV), human immunodeficiency virus (HIV), hepatitis B virus (HBV), HAV, and human parvovirus (B19V) genomic material; and (3) manufacturing procedures with demonstrated capacity to inactivate/remove pathogens.
No cases of transmission of viral diseases, vCJD, or CJD have ever been identified for products manufactured with the same core manufacturing process as GAMASTAN. ALL infections suspected by a physician possibly to have been transmitted by this product should be reported by the physician or other healthcare provider to Grifols Therapeutics LLC [1-800-520-2807].
The most common adverse reaction reported for GAMASTAN S/D during post-approval use was fatigue.
The following adverse reactions have been identified during post-approval use with GAMASTAN made using the previous manufacturing process, GAMASTAN S/D. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Among patients treated with GAMASTAN S/D, cases of allergic/hypersensitivity reactions including anaphylaxis have been reported. Anaphylactic reactions, although rare, have been reported following the injection of human immune globulin preparations.(11) Anaphylaxis was more likely to occur if GAMASTAN S/D was given intravenously; therefore, GAMASTAN S/D and GAMASTAN must be administered only intramuscularly.
The following have been identified as the most frequently reported post-marketing adverse reactions.
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Immune system disorders | Anaphylactic reaction*, hypersensitivity* |
Nervous system disorders | Headache |
Gastrointestinal disorders | Nausea |
General disorders and administration site conditions | Injection site pain, injection site inflammation, fatigue, pyrexia |
Risk Summary
There are no data with GAMASTAN use in pregnant women to inform a drug-associated risk. Animal reproduction studies have not been conducted with GAMASTAN. It is not known whether GAMASTAN can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. In the U.S. general population, the estimated background risk of major birth defect and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.
Risk Summary
There is no information regarding the presence of GAMASTAN in human milk, the effect on the breastfed infant, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for GAMASTAN and any potential adverse effects on the breastfed infant from GAMASTAN or from the underlying maternal condition.
GAMASTAN is a clear or slightly opalescent, and colorless or pale yellow or light brown sterile solution of polyvalent human immune globulin for intramuscular administration. GAMASTAN contains no preservative. GAMASTAN is prepared from pools of human plasma collected from healthy donors by a combination of cold ethanol fractionation, caprylate precipitation and filtration, caprylate incubation, anion-exchange chromatography, nanofiltration and low pH incubation. GAMASTAN consists of 15% to18% protein at pH of 4.1 to 4.8 in 0.16 to 0.26 M glycine.
When medicinal biological products are administered, infectious diseases due to transmission of pathogens cannot be totally excluded. However, in the case of products prepared from human plasma, the risk of transmission of pathogens is reduced by epidemiological surveillance of the donor population and selection of individual donors by medical interview; testing of individual donations and plasma pools; and the presence in the manufacturing processes of steps with demonstrated capacity to inactivate/remove pathogens.
In the manufacturing process of GAMASTAN, there are several steps with the capacity for viral inactivation or removal. The main steps of the manufacturing process that contribute to the virus clearance capacity are as follows:
To provide additional assurance of the pathogen safety of the final product, the capacity of the GAMASTAN manufacturing process to remove and/or inactivate viruses has been demonstrated by laboratory spiking studies on a scaled down process model using a wide range of viruses with diverse physicochemical properties.
The combination of all of the above mentioned measures provides the final product with a high margin of safety from the potential risk of transmission of infectious viruses.
The caprylate/chromatography manufacturing process was also investigated for its capacity to decrease the infectivity of an experimental agent of transmissible spongiform encephalopathy (TSE), considered as a model for the variant Creutzfeldt-Jakob disease (vCJD), and Creutzfeldt-Jakob disease (CJD) agents.(15) These studies provide reasonable assurance that low levels of vCJD/CJD agent infectivity, if present in the starting material, would be removed by the caprylate/chromatography manufacturing process.
The polyclonal antibody in GAMASTAN is a passive immunizing agent to neutralize viruses, such as hepatitis A and measles viruses, to prevent or ameliorate disease.
The prophylactic value of GAMASTAN is greatest when given before or soon after exposure.
Peak levels of immunoglobulin G are obtained approximately two days after intramuscular injection of GAMASTAN.(16) The half-life of IgG in the circulation of individuals with normal IgG levels is 23 days.(17)
In a clinical study, 12 healthy human subjects received a 20 IU/kg intramuscular dose of HYPERRAB, (Rabies Immune Globulin (Human)), made using the same manufacturing process as GAMASTAN. Detectable passive rabies neutralizing antibody was present by 24 hours and persisted through the 21 day follow-up evaluation period. The figure below shows the mean levels of rabies virus antibodies in IU/mL across the 21 day evaluation period and indicates that the titer remains stable during this period.
Manufactured by:
Grifols Therapeutics LLC
Research Triangle Park, NC 27709 USA
U.S. License No. 1871
3047928/3052566
Immune Globulin (Human)
GamaSTAN®
Solution for Intramuscular Injection
10 mL
One Single Dose Vial
NDC: 13533-335-12
GRIFOLS
The patient and physician should discuss the risks and benefits of this product.
FOR INTRAMUSCULAR INJECTION ONLY. DO NOT GIVE INTRAVENOUSLY.
For complete dosage and administration information, read enclosed package insert.
Store at 2–8ºC (36–46ºF). Do not freeze.
If the shrink band is absent or shows any sign of tampering, do not use the product and notify Grifols Therapeutics LLC immediately.
Not returnable for credit or exchange.
Rx only
Immune Globulin (Human) is a sterile solution of immunoglobulin containing 15%–18% protein stabilized with 0.16 to 0.26 M glycine.
No U.S. standard of potency for viral hepatitis antibodies.
Not made with natural rubber latex.
No preservative
Grifols Therapeutics LLC
Research Triangle Park, NC 27709 USA
U.S. License No. 1871
Carton: 3046690
GTIN 0013533335120
LOT
XXXXXXXXXX
EXP
DDMMMYYYY
SN XXXXXXXXXXXXXXXX
NDC 13533-335-13
Immune Globulin (Human)
GamaSTAN® 10 mL
Grifols Therapeutics LLC
Research Triangle Park,
NC 27709 USA
U.S. License No. 1871
The patient and physician should discuss the risks and benefits of this product.
One Single Dose Vial
Do not give intravenously.
Dosage: Read package insert.
Rx only
3047798
Lot/Exp.
GAMASTAN
immune globulin (human) injection, solution |
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GAMASTAN
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Labeler - GRIFOLS USA, LLC (048987452) |
Establishment | |||
Name | Address | ID/FEI | Business Operations |
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Grifols Therapeutics LLC | 611019113 | manufacture(13533-335, 13533-635) |
Mark Image Registration | Serial | Company Trademark Application Date |
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GAMASTAN 78627286 3199710 Live/Registered |
GRIFOLS THERAPEUTICS LLC 2005-05-11 |
GAMASTAN 72183886 0784730 Dead/Expired |
CUTTER LABORATORIES, INC. 1964-01-02 |