Intravenous immunoglobulin
(Redirected from IVIG)
Administration
- Type: Immunologic agent
- Dosage Forms:
- Routes of Administration: IV
- Common Trade Names: Gammagard, Gammar-IV, Gamimune-N, Camunex, Carimune/Panglobulin, Iveegam, Polygam S/D, Sandoglobulin, Venoglobulin, KIOVIG
Note: components of each brand vary
Adult Dosing
Varies depending on formulation
Pediatric Dosing
Varies depending on formulation
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk minimal
- Renal dosing: administer at minimum infusion rate possible
- Hepatic dosing: no adjustment
Indications
- FDA-approved indications:
- Immune thrombocytopenic purpura
- Kawasaki
- Common variable immunodeficiency, primary immunodeficiency associated with humoral imunodeficiency
- Kidney transplant with high antibody recipient or ABO incompatible donor
- Chronic B-cell leukemia, stem cell transplantation
- Off-label indications
- TTP, HUS
- Aplastic anemia, autoimmune hemolytic anemia
- Myasthenia gravis, Lambert-Eaton myasthenic syndrome
- Guillain-Barre syndrome
- Anti-NMDA receptor encephalitis
- Severe Pyoderma, severe Pemphigus vulgaris
- Acute GVHD
- Immune-mediated neutropenia
- Recurrent C. diff
Contraindications
- Allergy to class/drug
- Hereditary intolerance to sucrose or fructose
- Hyperprolinemia
- IgA deficiency with antibodies
- all IVIG contain trace IgA
- Gammagard and Polygram have the least
Adverse Reactions
Serious
- MI, chest pain
- Tachycardia
- Hemolytic anemia
- Thrombosis, PE
- Acute renal failure
- Hyponatremia
- Aseptic meningitis
- Transfusion related acute lung injury
Common
- Hypertension, hypotension
- Peripheral edema
- Pruritus, rash, injection site reaction
- Hyperthermia
- Nausea, vomiting, diarrhea, abdominal pain
- Aphthous ulcer
- Arthralgia, myalgia, backache, headache
- Dizziness, fatigue
- Otalgia
- Asthma, nasal congestion, wheezing, pharyngitis
- Fever, rigors, shivering
- Infusion reaction
Pharmacology
- Half-life: 5-37 days
- Metabolism:
- Excretion:
Mechanism of Action
- Interference with Fc receptors on the cells of the reticuloendothelial system for autoimmune cytopenias and ITP