Posology : מינונים

4.2 Posology and method of administration
Recommended Dose
ADACEL-POLIO should be administered as a single injection of 1 dose (0.5 mL) by the intramuscular route. The preferred site is the deltoid muscle.
Fractional doses (doses <0.5 mL) should not be given. The effect of fractional doses on safety and efficacy has not been determined.
Health-care professionals should refer to the National Advisory Committee on Immunization (NACI) guidelines for tetanus prophylaxis in routine wound management shown in Table     1.
Table 1: NACI Recommended Use of Immunizing Agents in Wound
Management (1)

Clean, minor             All other wounds
History of Tetanus             wounds
Immunization                             TIG†                        TIG† Td     (Human            Td*      (Human)
)
Uncertain or <3 doses            Yes         No           Yes           Yes of an immunization series‡
฀3 doses received in an          No&         No           No**        No†† immunization series‡
* Adult-type tetanus and diphtheria toxoid.
† Tetanus immune globulin, given at a separate site from the Td.
‡ Primary immunization is at least 3 doses at age appropriate intervals. & Yes, if >10 years since last booster.
** Yes, if >5 years since last booster.
†† Yes, if persons are known to have a significant humoral immune deficiency state (e.g., HIV, agammaglobulinemia) since immune response to tetanus toxoid may be suboptimal.
A thorough attempt must be made to determine whether a patient has completed primary immunization. Persons who have completed primary immunization against tetanus and who sustain wounds that are minor and uncontaminated, should receive a booster dose of a tetanus toxoid-containing preparation if they have not received tetanus toxoid within the preceding 10 years.
For tetanus-prone wounds (e.g., wounds contaminated with dirt, feces, soil and saliva, puncture wounds, avulsions and wounds resulting from missiles, crushing, burns or frostbite), a booster is appropriate if the patient has not received a tetanus 
toxoid-containing preparation within the preceding 5 years.
For adults who have not previously received a dose of acellular pertussis vaccine, a single tetanus-diphtheria (Td) booster dose should be replaced by a combined tetanus-diphtheria- acellular pertussis vaccine (Tdap).

Method of administration

Inspect for extraneous particulate matter and/or discolouration before use. If these conditions exist, the product should be discarded.
Shake the vial or syringe well until a uniform, cloudy, suspension results. When administering a dose from a stoppered vial, do not remove either the stopper or the metal seal holding it in place. Use a separate sterile needle and syringe, or a sterile disposable unit for each individual patient to prevent disease transmission.
Needles should not be recapped but should be disposed of according to biohazard waste guidelines.
Before injection, the skin over the site to be injected should be cleansed with a suitable germicide.
A single injection of one dose (0.5 mL) of ADACEL-POLIO should be administered by intramuscular route. Administration should preferably be performed in the deltoid muscle.