Intravenous Immunoglobulin (IVIG)

What is immunoglobulin?

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

What is IVIG?

IVIG is an Intravenous (IV) form of immunoglobulin. 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 to you by IV infusion. Your body then uses the antibodies from the infusion to prevent or fight an illness.

There are many brand names of IVIG. Different brands have 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:

• If you have an immunodeficiency syndrome (an immune system that does not work as it should).
• To help your body fight off an infection from hepatitis A, measles, rubella, and/or varicella.
• To treat idiopathic thrombocytopenic purpura (ITP), a disease where your body’s immune system mistakenly attacks platelets. 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 depends on the brand of IVIG used, how you do with the infusion, and the protocol at the hospital or infusion center.

The infusion is started at a slow rate for a period of time. If you do not have any reaction, the rate can be increased. Your care team will monitor you closely during the infusion. Your nurse will observe you for any reactions and check your 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 possible side effects of this medication?

The most serious side effect is an anaphylactic (allergic) reaction. Signs of this are: having a hard time breathing, tightness in the chest or throat, swelling of the face, tongue or throat, a drop in blood pressure, flushing, hives, rash, dizziness, sweating, nausea and vomiting. If you have any of these, let your nurse know right away.

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 notice 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.
• 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 let the infection heal.