II. Indications
III. Contraindications
- IgA Deficiency
IV. Mechanism
- Pooled donor plasma extracted for IgG antibodies and administered as an subcutaneous Blood Product
V. Dosing
- Precautions
- Maintain adequate hydration to reduce the risk of Acute Kidney Injury
-
Primary Immunodeficiency
- Dose 100 to 200 mg/kg SQ weekly
- Adjust frequency adjusted based on IgG trough levels
- Conversion from prior Intravenous Immunoglobulin dosing (IVIG)
- SQ Dose = (prior IV dose) * 1.37 / (nWeeklyDoses)
- Dose 100 to 200 mg/kg SQ weekly
- Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
- Maintenance: 0.2 g/kg SQ each week
VI. Adverse Effects
- Thrombosis (black box warning)
- Caution in Hypercoagulable states and cardiovascular disease
- 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)
-
Acute Kidney Injury
- Caution with concurrent Nephrotoxic Drugs, Chronic Kidney Disease
- Transfusion-Related Acute Lung Injury (TRALI)
- Aseptic Meningitis syndrome
- 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
VII. Safety
- Pregnancy Category C
- Unknown safety in Lactation
- Monitoring
- Renal Function tests and Urine Output
VIII. Resources
- Subcutaneous Immune Globulin - Hizentra (DailyMed)