Patient education: Intravenous immune globulin (IVIG) (The Basics)

What is intravenous immune globulin? — Intravenous immune globulin ("IVIG") is a treatment made up of proteins called "antibodies." Antibodies are part of the body's immune system, which helps fight infections. The treatment is given by IV, which is a thin tube that goes into a vein.

The antibodies in IVIG come from the plasma of thousands of donors. Plasma is the liquid part of blood, with all of the cells removed. Using plasma from lots of people means that IVIG contains many different types of antibodies.

IVIG can treat 2 main types of health problems:

●Humoral immunodeficiency – This happens when your body cannot make enough antibodies on its own. It can be mild or severe. IVIG can help your body prevent or fight infections. People with severe humoral immunodeficiency usually need IVIG treatment for life.

●Certain autoimmune disorders – In these disorders, your immune system starts making "autoantibodies." These are antibodies that attack your own cells. IVIG works by blocking the autoantibodies that your body makes. People getting IVIG to treat an autoimmune disorder might only need a few doses.

How do I prepare for IVIG? — The doctor or nurse will tell you if you need to do anything special to prepare:

●They might ask you to drink plenty of fluids. This is because being well hydrated before you get IVIG lowers the risks of side effects or other reactions. You might get extra fluids through your IV before getting IVIG.

●The staff will also make sure that you do not have an infection or other problems. This is because some infections should be treated with antibiotics before you get IVIG.

Most people getting IVIG do not need to do anything else to prepare. In some cases, people might have a reaction to IVIG. To lower this risk, you might be asked to take diphenhydramine (sample brand name: Benadryl), acetaminophen (sample brand name: Tylenol), or a steroid. These can be taken as pills or given through the same IV as the IVIG. These medicines have side effects, so do not take them unless your doctor tells you to.

What happens during IVIG? — Most people go to their doctor's office, a hospital, or a place called an "infusion center" for IVIG. But in some cases, you might be able to get IVIG at home.

When it is time for the procedure:

●You will get an IV.

●You might be given fluids or other medicines through your IV, if needed.

●You will be given IVIG. This is called an "infusion." It usually takes between 1 and 4 hours.

What happens after IVIG? — After you get IVIG, your IV will be removed.

Your doctor will tell you whether you will need more doses of IVIG, and the schedule. They will also let you know if you need more blood tests to check how well your treatment is working.

What side effects can happen? — Many people do not have side effects from IVIG. But they do happen sometimes. Side effects can be mild or severe. Side effects are most common during the first IVIG infusion.

Some side effects from IVIG happen during or right after the treatment. These include:

●Headache

●Flu-like symptoms, including muscle aches and pains

●Feeling tired

●Skin rash

●Allergic reactions – Most allergic reactions to IVIG are mild, with hives, itchy skin, and swelling of the face or lips. Rarely, there can be a serious allergic reaction, called "anaphylaxis." This can cause swelling of the face or tongue, trouble breathing, nausea or vomiting, and low blood pressure.

There are ways to lower the chances of getting these side effects. They include:

●Being hydrated before and during treatment

●Getting the infusion more slowly

●Dividing larger doses of IVIG into smaller doses given over several days

●Getting certain medicines before your treatment

●Getting the antibodies a different way, such as an injection under your skin. This is called "subcutaneous" immune globulin. Your doctor can talk to you about whether this is an option for you.

The person giving your IVIG infusion will monitor you for side effects. If you notice any side effects after your treatment, call for advice.

Other side effects can happen later, after several days. These include:

●Blood clots

●Kidney problems

The chance of getting these side effects can be lowered by staying well hydrated and moving around.

Some people worry about getting infections or other diseases from IVIG, since it is made from other people's blood. This is unlikely. The process of making IVIG generally kills viruses.

What else should I know?

●Sometimes, if you get a vaccine in the weeks or months following IVIG treatment, the vaccine might not work as well as it could. But you are still better protected with a vaccine than without one. Talk to your doctor about the best timing for vaccines.

●There are different brands of IVIG. Each is slightly different. Write down the name and "product number" of the IVIG you are getting. If that brand and product number are working well for you, your doctor will try to keep giving you that brand.

●Sometimes, people being treated for immunodeficiency can get immune globulin "subcutaneously" instead of by IV. This means that the treatment is given under the skin instead of into a vein. Your doctor will talk to you about whether this is an option for you.

More on this topic

Patient education: Immune thrombocytopenia (ITP) (The Basics)
Patient education: Guillain-Barré syndrome (The Basics)
Patient education: Autoimmune hemolytic anemia (The Basics)
Patient education: Myasthenia gravis (The Basics)

Patient education: Intravenous immune globulin (IVIG) (Beyond the Basics)