Intravenous Immunoglobulin (IVIG)
Intravenous Immunoglobulin (IVIG) and Subcutaneous 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 to fight off infections. IVIG/SCIG does not increase the risk for infection. IVIG/SCIG work to prevent the body from attacking itself and to decrease several types of bodily inflammation. 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 systemic lupus erythematosus. Additionally, it can be used to treat immunodeficiency.
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 once, or monthly over one to five days. 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 but usually is based on body weight.
Side Effects
The majority of people do well with treatment, 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 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 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 you 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 March 2025 by Rebecca Fitzpatrick, 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.