II. Indications: FDA Approved
- Idiopathic Thrombocytopenic Purpura
- Bone Marrow Transplant
- Primary Humoral Immunodeficiency
- Chronic Lymphocytic Leukemia (B Cell)
- Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
- Kawasaki Disease
- Pediatric HIV
III. Indications: Off-Label (non-FDA approved)
IV. Contraindications
- IgA Deficiency
- Caution in conditions with higher risk of adverse effects
- Thrombotic conditions (including Thrombophilia)
- Congestive Heart Failure
- Renal Insufficiency
V. Mechanism
- Pooled donor plasma extracted for IgG antibodies and administered as an intravenous Blood Product
VI. Dosing
- Precautions
- Caution in patients with thrombotic conditions, Congestive Heart Failure and Renal Insufficiency
- Consider pretreatment with Acetaminophen, Diphenhydramine to reduce infusion reaction symptoms
- Infuse at lowest possible rate of the lowest available concentration (minimize risk of adverse effects)
- Initial Infusion Rate at 0.5 mg/kg/min (0.005 mL/kg/min)
- Subsequent infusion rates as tolerated up to 4 to 8 mg/kg/min (0.04 to 0.08 mL/kg/min)
- Primary Humoral Immunodeficiency
- Adult or Child: 200 to 300 mg/kg (up to 400 to 800 mg) IV monthly
-
Idiopathic Thrombocytopenic Purpura (Induction Dose)
- Adult or Child: 400 mg/kg IV daily for 5 days (or 1000 mg/kg IV daily for 1-2 days)
-
Bone Marrow Transplant (BMT, age >=20 years)
- Adult Pre-BMT: 500 mg/kg IV on day 7 and day 2 before BMT
- Adult: Post: BMT: 500 mg/kg IV weekly for 90 days after BMT
-
Kawasaki Disease
- Infuse 400 mg/kg IV daily for 4 days (or 2000 mg/kg IV once over 10 hours)
- Other dosing regimens vary by indication
- See other references and specific condition guidelines for up to date dosing regimens
VII. Adverse Effects
- Thrombosis (black box warning)
- Caution in Hypercoagulable states and cardiovascular disease
- Infuse at lowest possible rate of the lowest available concentration
-
Acute Kidney Injury or Renal Failure (Black Box warning)
- Kidney injury is more common with sucrose containing solutions
- Caution with concurrent Nephrotoxic Drugs, Chronic Kidney Disease
- Infuse at lowest possible rate of the lowest available concentration
- Fluid and Electrolyte Abnormalities
- Hyperproteinemia
- Hyponatremia
-
Hemolytic Anemia
- Intravascular Hemolysis or RBC sequestration
- Increased risk with high IVIG doses and Non-O Blood Group
- Cardiopulmonary
- Bloodborne Communicable Disease
- As with all donor Blood Products, carefully screened in U.S., but risk is not 0%
- Potential risk of Creutzfeldt Jakob Disease (or its variant)
- Other common effects
VIII. Safety
- Pregnancy Category C
- Unlnown safety in Lactation
- Monitoring
IX. Resources
- Arumugham and Rayi (2023) Intravenous Immunoglobulin (IVIG) , StatPearls, Treasure Island, Florida
- Intravenous Immunoglobulin - Privigen (DailyMed)
- Intravenous Immunoglobulin - Gamunex (DailyMed)
- Intravenous Immunoglobulin - Gammagard (DailyMed)
- Intravenous Immunoglobulin - Alyglo (DailyMed)
- Intravenous Immunoglobulin - Octagam (DailyMed)
Images: Related links to external sites (from Bing)
Related Studies
Definition (HL7V3.0) | <p>immune globulin, intravenous</p> |
Definition (MSH) | Immunoglobulin preparations used in intravenous infusion, containing primarily IMMUNOGLOBULIN G. They are used to treat a variety of diseases associated with decreased or abnormal immunoglobulin levels including pediatric AIDS; primary HYPERGAMMAGLOBULINEMIA; SCID; CYTOMEGALOVIRUS infections in transplant recipients, LYMPHOCYTIC LEUKEMIA, CHRONIC; Kawasaki syndrome, infection in neonates, and IDIOPATHIC THROMBOCYTOPENIC PURPURA. |
Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129) |
MSH | D016756 |
SnomedCT | 34245000, 350344000 |
HL7 | 87 |
English | Immune Globulin, Intravenous, Immunoglobulins, IV, Intravenous IG, Intravenous Immune Globulin, Intravenous Immunoglobulins, IV Immunoglobulins, IVIG, Immune Globulin IV, Immune Globulin Intravenous, IV IG, IG IV, immune globulin intravenous, Immunoglobulins, Intravenous [Chemical/Ingredient], intravenous immunoglobulin, IV immunoglobulin, intravenous immunoglobulins, Antibodies, Intravenous, Intravenous Antibodies, immune globulin, intravenous, Immune globulin IV, Immune globulin IV (product), Intravenous immunoglobulin, Intravenous immunoglobulin (product), Immune globulin IV (substance), Intravenous immunoglobulin (substance), Immunoglobulins, Intravenous, IGIV, GLOBULIN,IMMUNE (IV) |
Swedish | Immunglobuliner, intravenösa |
Czech | imunoglobuliny pro intravenózní infúzi, imunoglobuliny intravenózní |
Finnish | Suonensisäiset immunoglobuliinit |
Russian | VNUTRIVENNYE IMMUNOGLOBULINY, ANTITELA VNUTRIVENNYE, IMMUNOGLOBULINY VNUTRIVENNYE, VNUTRIVENNYE ANTITELA, IVIG, АНТИТЕЛА ВНУТРИВЕННЫЕ, ВНУТРИВЕННЫЕ АНТИТЕЛА, ВНУТРИВЕННЫЕ ИММУНОГЛОБУЛИНЫ, ИММУНОГЛОБУЛИНЫ ВНУТРИВЕННЫЕ |
Italian | IVIG, Ig per uso endovenoso, Immunoglobuline IV, Immunoglobuline per uso endovenoso |
French | Immunoglobulines par voie veineuse, Anticorps par voie intraveineuse, Immunoglobulines intraveineuses, Immunoglobulines par voie intraveineuse, Immunoglobulines intra-veineuses, Ig intraveineuses, Anticorps par voie veineuse, IgIV |
Croatian | IMUNOGLOBULINI, INTRAVENOZNI |
Polish | Immunoglobuliny dożylne, Immunoglobuliny stosowane dożylnie |
Spanish | inmunoglobulina endovenosa (producto), IGEV, inmunoglobulina endovenosa, inmunoglobulina EV, inmunoglobulina endovenosa (sustancia), inmunoglobulina intravenosa (producto), inmunoglobulina intravenosa (sustancia), inmunoglobulina intravenosa, IGIV, Anticuerpos Intravenosos, Inmunoglobulinas Intravenosas |
German | IVIG, Antikörper, intravenös applizierte, Immunglobuline, intravenös applizierte, Intravenös applizierte Antikörper, Intravenös applizierte Immunglobuline |
Portuguese | IVIG, Anticorpos Endovenosos, Anticorpos Intravenosos, Imunoglobulinas Endovenosas, Imunoglobulinas Intravenosas |