IV Immunuglobulin

What is IV Immunoglobulin

Intravenous immunoglobulin (IVIg) is a mixture of blood proteins called antibodies that are made by the immune system to fight infections. Immunoglobulins are extracted from healthy donated blood and are used to treat a number of medical conditions. IVIg is given to patients as an intravenous infusion.

How does IV immunoglobulin work?

In some medical conditions the body’s immune system becomes overactive and starts attacking a person’s own body tissues, such as nerves, muscle or skin. IVIg is given to patients with these inflammatory conditions to reduce and alter the immune system’s response to improve the condition.

Indications for use

IVIg has been shown to be beneficial in many medical conditions including certain inflammatory disorders and to treat patients who do not have sufficient antibodies.
Some examples of conditions where IVIg may be used:

• Inflammatory myopathy (muscle disease), such as polymyositis and dermatomyositis
• Kawasaki disease (a disease which results in inflammation of various organs)
• Myasthenia gravis
• Multifocal motor neuropathy
• Guillian Barré syndrome (a disease with multiple inflammations of the nervous system) of the whole body
• Lambert-Eaton myaesthenic syndrome (an autoimmune disorder causing muscle weakness in the arms and legs).

The above list of conditions are just some examples of the many medical conditions in which IVIg may be used. Ask your doctor if you have questions about the use of IVIg in your particular condition.

How is IV immunoglobulin given?

IVIg is given as an intravenous infusion. At the beginning of the treatment, the infusion will be set at a slow rate. Depending upon how comfortable you are, your doctor may then gradually increase the infusion rate.

What is the dosage?

Your doctor will decide how much IVIg will be given to you. The dosage will vary depending on your condition and how much you weigh. The dosage will vary for different individuals. You may receive a different dose at each visit depending upon your condition.
Ask your doctor if you have questions about your dose of IVIg.

How many times will I be given IV immunoglobulin?

Your doctor will review your condition after your IVIg treatment and will decide if you need further doses. It is commonly given monthly for rheumatological conditions.

Are there any side effects?

You might experience side effects with your treatment. Tell your doctor as soon as possible if you do not feel well while you are receiving treatment with IVIg.

Most common possible side effects

• The following reactions may occur at the site of the infusion (where the drip is put into your vein): redness, warmth, itching, swelling, mild or moderate pain, or bruising.
• Other common side effects that may occur during your IVIg infusion: headache, migraine, chills, mild fever, tiredness, weakness, nausea, rash, increased heart rate, abdominal pain, joint pain, dizziness or increased blood pressure (hypertension).

Less common or rare possible side effects

Tell your doctor as soon as possible if you notice any of the following:

• Fever or other signs of infection
• Chest pain, breathing problems or new fatigue
• Night sweats
• Reduced urination, sudden weight gain, or swelling in your legs. These could be signs of a kidney failure problem
• Brown or red urine, fast heart rate, yellow skin or eyes. These could be signs of a liver failure problem or a blood problem.

If you experience any of the following, tell your doctor immediately or go to the Emergency department at your nearest hospital:

• Hives, swelling in the mouth or throat, itching, trouble breathing, wheezing, fainting or dizziness. These could be signs of a serious allergic reaction.
• Bad headache with or without nausea, vomiting, stiff neck, fever and sensitivity to light. These could be signs of irritation of the lining around your brain or swelling of the brain.
• Pain, swelling, warmth, redness or a lump in your legs or arms. These could be signs of a blood clot.
• Chest pain or trouble breathing, blue lips or extremities. These could be signs of a serious heart or lung problem.

Tell your doctor or pharmacist immediately if any of the side effects that you experience get worse, or if you notice any side effects not listed in this leaflet.

There are some differences in the side effects between different brands of IVIg. This is because different brands of IVIg may have different excipients.

IVIg is extracted from donated blood and undergoes vigorous testing to check for possible viruses. There are additional procedures in manufacturing to reduce the possible risk of viruses. Despite these stringent measures during the manufacturing process, the risk of contamination by viral and other unknown agents cannot be eliminated but is very low.

What precautions are necessary?

Vaccines

You must tell your doctor if you are planning to get any vaccinations. IVIg may impair the effects of some live virus vaccines such as measles, mumps, rubella and varicella.

Use in pregnancy & breastfeeding

• You should tell your rheumatologist if you are pregnant, planning to become pregnant or if you are breastfeeding.
• Your doctor will consider the benefits and risks of using IVIg for your particular medical condition, if you are pregnant or breastfeeding.
• More detailed information is available at https://rheumatology.org.au/For-Healthcare-Professionals/Clinical-Resources/Pregnancy-Prescribing-Info

Important things to remember

• If you are worried about any possible side effects, you should contact your rheumatologist as soon as possible.

For more information see the IV Immunuglobulin – printable information sheet.