Intravenous Immunoglobulin (IVIG)

What is immunoglobulin?

An immunoglobulin is also known as an antibody. It is a protein made by plasma cells (part of the blood). It is an important part of the immune system. Antibodies help to fight off infection.

What is IVIG?

Immunoglobulin can be collected from the plasma of donated blood. It takes the plasma from thousands of people to make a dose of immunoglobulin. This is then given, by intravenous (IV) infusion, to a patient. The patient’s body then uses the antibodies from the infusion to prevent or fight an illness.

There are many brands of IVIG available. Different brands contain different levels of certain antibodies. Your care team will choose the IVIG that has the best mix of antibodies for your needs.

What is IVIG used for?

There are quite a few reasons IVIG may be used. These can include:

• Patients who have an immunodeficiency syndrome (a poorly functioning immune system).
• Helping the body fight off an infection from hepatitis A, measles, rubella, and varicella.
• Treat idiopathic thrombocytopenic purpura (ITP), a disease where the body’s platelets are mistakenly attacked by the immune system. This leads to bruising and bleeding that can become serious.
• After bone marrow transplant, it may be given to patients that have low levels of immunoglobulin.
• To treat pneumonia caused by CMV (cytomegalovirus) after bone marrow transplant.

How is IVIG given?

IVIG is given through an intravenous (IV) infusion. The length of the infusion will depend on the brand of IVIG used, how you do with the infusion, and the protocol at the hospital or infusion center.

The infusion is generally started at a slow rate for a period of time. If you do not have any reaction, the rate can be increased. Your nurse will monitor you closely during the infusion. Your nurse will observe you for any reactions and check blood pressure, pulse and breathing throughout the infusion.

There are some immunoglobulin products that are given by an injection into the muscle (called IM) or under the skin (called subQ).

What are the potential side effects of this medication?

The most concerning side effect is an anaphylactic (allergic) reaction. Signs of this include: difficulty breathing, tightness in the chest or throat, swelling of the face, tongue or throat, drop in blood pressure, flushing, hives, rash, dizziness, sweating, nausea and vomiting. If you experience any of these, let your nurse know immediately.

Each brand of IVIG has reported side effects and these vary. Your nurse or pharmacist can explain any side effects specific to the medicine you are getting.

In general, other possible side effects include: headache, fever, chills, nausea, and achy muscles. In rare cases, IVIG can cause kidney problems or blood clots. If you experience any side effects, report them to your nurse.

Is there anything else to consider while getting this medicine?

• IVIG is made from blood products, so there is a small risk of the medicine being contaminated with an infectious agent. However, several steps are taken during the manufacturing process to prevent this from happening.
• You should avoid having live vaccines while receiving this medication, as they may not work as well. These include herpes zoster (Zostavax) for shingles prevention, oral polio, measles, nasal flu vaccine (FluMist®), rotovirus, and yellow fever vaccines.
• If you have an infection or are being treated for an infection, let your care team know. In some cases, the IVIG infusion may be delayed to allow the infection to resolve.