Intravenous Immunoglobulin (IVIG)


Intravenous Immunoglobulin (IVIG) and Subcutaenous Immunoglobulin (SCIG) are therapies prepared from a pool of immunoglobulins (antibodies) from the plasma of thousands of healthy donors. Immunoglobulins are made by the immune system of healthy people for the purpose of fighting infections. Unlike many of the medications prescribed by rheumatologists, IVIG/SCIG do not increase the risk for infection. IVIG/SCIG work in different ways to prevent the body from attacking itself and to decrease several types of inflammation in the body. It is considered safe for use during pregnancy and breastfeeding.

IVIG is used for many autoimmune conditions such as Kawasaki’s disease in children, dermatomyositis, polymyositis, and juvenile dermatomyositis, systemic lupus erythematosus. Additionally, it can be useful in the treatment of conditions of immunodeficiency as well.

How to Take It

IVIG is given as an intravenous infusion (through the vein in the arm) or subcutaneous (under the skin). The infusion may be given as a one-time dose, or it may be given from anywhere between one to five days monthly. Frequency and duration of infusions depend on the condition being treated. IVIG can take several weeks to fully take effect. The dosing of IVIG also varies dependent on the condition being treated, but usually is based on body weight.

Side Effects

Most people do well with the therapy, experiencing only minor side effects. IVIG may cause infusion reactions, which may present, as fevers, chills, flushing, rash, muscle aches, and nausea. Headaches are also relatively common. These are generally not severe and improve with analgesics and antihistamines.

Rarely, IVIG may cause aseptic meningitis (inflammation of the lining of the brain without an infection). The use of medications like steroids, non-steroidal anti-inflammatories (NSAIDs), acetaminophen, and diphenhydramine, and staying well hydrated can help to prevent these complications. Rarely, an allergic reaction to IVIG can occur.

Additionally, the sugar level in the blood may be increased following an infusion. This can often be avoided by slowing down the infusions and hydrating the body well.

Additionally, because the medication is given with a large volume of liquid, it may worsen heart failure and may cause the blood pressure to increase temporarily. IVIG also increases the risk for blood clots slightly when given in high doses.

Tell Your Rheumatology Provider

If you develop a severe reaction (difficulty breathing, chest tightness, wheezing, rash, fevers) or if have severe and persistent headaches with neck stiffness, nausea and vomiting, tell your rheumatology provider. While some reactions may occur while IVIG is being administered, others occur within a few hours to days after the infusion.

While vaccines are not contraindicated while on therapy with IVIG, your body may not be able to fully respond to the vaccines. Talk to your rheumatology provider about the best time to receive a vaccine.

Updated April 2024 by Mohammad Ursani, MD, and reviewed by the American College of Rheumatology Communications and Marketing Committee.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis, and treatment of a medical or health condition.

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