Table of ContentsView AllTable of ContentsImmunoglobulins and IVIGReasons for IVIGAdministrationSide EffectsIs IVIG Therapy Effective?Alternatives to IVIG
Table of ContentsView All
View All
Table of Contents
Immunoglobulins and IVIG
Reasons for IVIG
Administration
Side Effects
Is IVIG Therapy Effective?
Alternatives to IVIG
Intravenousimmunoglobulin(IVIG) is a type of medication used to treat people with immunodeficiencies, when the immune system functions poorly. It is made from human blood plasma and is, therefore, known as a biologic drug product.
Immunodeficiencies can increase the risk of infection and cause illnesses, nerve damage, muscle weakness, blood abnormalities, and more. Administering IVIG products to these individuals aims to normalize their immune systems and relieve these symptoms.
This article reviews IVIG therapy, its uses, how it works, and what to expect when receiving it.
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Antigens are foreign or outside substances your body doesn’t recognize, such as bacteria, viruses, and chemicals and other toxins. Immunoglobulins attach to these foreign substances, which helps your other immune cells destroy them.
The ability to recognize and form a response to these foreign bodies depends on your immune system functioning properly, and making immunoglobulins is part of that. When a person’s immune system is not working as well as it should, they are said to be immunocompromised, which can happen in various health conditions.
Uses of IVIG Treatment
Some of the most common indications for IVIG are:
Treating MS With Intravenous Immunoglobulin (IVIG)
What to Expect When Receiving IVIG Therapy
IVIG therapy is given as an IV infusion. This means a healthcare professional will start an IV line, typically in your arm, and the medication will be run through the thin tube into your bloodstream.
You may initially feel a prick and a bit of pain, but otherwise, the infusion should be pain free.
How long an IVIG infusion takes depends on the dose, the number of infusions being received, and the drugs being given, but a common range is one to four hours.
Once you tolerate a slower rate, it can be increased at intervals of about 30 minutes to an hour. Once you’ve had several successful infusions without any reactions, your infusion may take just one to two hours.
Many people are on IVIG indefinitely, but the good news is that most IVIG products only need to be infused around once every few weeks, so they should not take up too much of your time overall.
Side Effects of IVIG
IVIG is widely used and tolerated well in general, but there are potential side effects.
Most side effects—particularly immediate reactions that occur within the first 30 minutes to an hour of the infusion starting—are mild and subside once an IVIG infusion is stopped or slowed down. These include:
Other delayed reactions are much more rare but can be serious, such as:
When to Contact a Healthcare Provider
You will not be receiving IVIG therapy without a healthcare practitioner being present, but some symptoms to look for that require the immediate attention of the administering practitioner include signs of a potentially life-threatening allergic reaction calledanaphylaxis, which are:
Along with ordering IVIG, your prescribing provider typically includes prescriptions for other medications that can help with infusion reactions. Home health nurses helping you with your infusion at home will typically follow a protocol for infusion reactions.
These steps typically involve stopping or slowing the IVIG infusion and administering one or more infusion reaction medicines such as an EpiPen (epinephrine) or Benadryl (diphenhydramine), notifying your prescribing provider of the reaction, and calling emergency medical services if the reaction does not resolve.
Many studies have demonstrated that IVIG is an effective, safe, and tolerable treatment that helps restore the immune system in people with immunodeficiencies. For most of these conditions, it is considered standard therapy.
In one study, people who received a new IVIG product every three to four weeks were evaluated for one year. The results showed:
Another study looked at how effective IVIG therapy was for CIDP. Participants received an IVIG or placebo infusion every three weeks. Disability was measured at 24 weeks. The results showed:
While IVIG is widely considered a safe and effective treatment, not everyone is a candidate due to cost, logistical hindrances, or shortages of immunoglobulin availability.
Some potential alternatives that may be appropriate for certain conditions normally treated with IVIG include:
Summary
Intravenous immunoglobulin, or IVIG, is made from the blood of thousands of healthy donors. It isolates antibodies from donor blood and can be given directly into the bloodstream of individuals with immunodeficiencies—conditions in which the immune system is less able to fight off infections.
You can expect to receive an IVIG infusion at an outpatient clinic, a medical provider’s office, or in your own home with a healthcare provider supervising the infusion.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.UpToDate.Patient education: intravenous immune globulin (IVIG) (beyond the basics). February 13, 2023.MedlinePlus.Immune response. January 23, 2022.Hooper JA.Intravenous immunoglobulins: evolution of commercial IVIG preparations.Immunol Allergy Clin North Am. 2008;28(4):765-778. doi:10.1016/j.iac.2008.06.002Perez EE, Orange JS, Bonilla F, et al.Update on the use of immunoglobulin in human disease: a review of evidence.J Allergy Clin Immunol. 2017;139(3S):S1-S46. doi:10.1016/j.jaci.2016.09.023CDC.Primary Immunodeficiency (PI).Jusufović E, Sinanović O, et al.Multifocal motor neuropathy: case reports.Acta Clin Croat. 2018 Sep;57(3):581-587.Guo Y, Tian X, et al.Adverse effects of immunoglobulin therapy.Front Immunol. 2018;9:1299. doi:10.3389/fimmu.2018.01299Kaveri SV, Maddur MS, et al.Intravenous immunoglobulins in immunodeficiencies: more than mere replacement therapy.Clin Exp Immunol. 2011;164 Suppl 2(Suppl 2):2-5. doi:10.1111/j.1365-2249.2011.04387.xPerez EE, Hébert J, et al.Efficacy, safety and tolerability of a new 10% intravenous immunoglobulin for the treatment of primary immunodeficiencies.Front Immunol. 2021;12:707463. doi:10.3389/fimmu.2021.707463Allen JA, Gelinas DF, et al.Immunoglobulin administration for the treatment of CIDP: IVIG or SCIG?J Neurol Sci. 2020;408:116497. doi:10.1016/j.jns.2019.116497Zahavi D, Weiner L.Monoclonal antibodies in cancer therapy.Antibodies (Basel). 2020;9(3):34. doi:10.3390/antib9030034Castagnoli R, Delmonte OM, et al.Hematopoietic Stem Cell Transplantation in Primary Immunodeficiency Diseases: Current Status and Future Perspectives. Front Pediatr. 2019 Aug 8;7:295.Zaki HA, Iftikhar H, et al.Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barré syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysis.eNeurologicalSci. 2023;31:100468. doi:10.1016/j.ensci.2023.100468Shrestha P, Karmacharya P, et al.Impact of IVIG vs. SCIG on IgG trough level and infection incidence in primary immunodeficiency diseases: A systematic review and meta-analysis of clinical studies.World Allergy Organ J. 2019;12(10):100068. doi:10.1016/j.waojou.2019.100068
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.UpToDate.Patient education: intravenous immune globulin (IVIG) (beyond the basics). February 13, 2023.MedlinePlus.Immune response. January 23, 2022.Hooper JA.Intravenous immunoglobulins: evolution of commercial IVIG preparations.Immunol Allergy Clin North Am. 2008;28(4):765-778. doi:10.1016/j.iac.2008.06.002Perez EE, Orange JS, Bonilla F, et al.Update on the use of immunoglobulin in human disease: a review of evidence.J Allergy Clin Immunol. 2017;139(3S):S1-S46. doi:10.1016/j.jaci.2016.09.023CDC.Primary Immunodeficiency (PI).Jusufović E, Sinanović O, et al.Multifocal motor neuropathy: case reports.Acta Clin Croat. 2018 Sep;57(3):581-587.Guo Y, Tian X, et al.Adverse effects of immunoglobulin therapy.Front Immunol. 2018;9:1299. doi:10.3389/fimmu.2018.01299Kaveri SV, Maddur MS, et al.Intravenous immunoglobulins in immunodeficiencies: more than mere replacement therapy.Clin Exp Immunol. 2011;164 Suppl 2(Suppl 2):2-5. doi:10.1111/j.1365-2249.2011.04387.xPerez EE, Hébert J, et al.Efficacy, safety and tolerability of a new 10% intravenous immunoglobulin for the treatment of primary immunodeficiencies.Front Immunol. 2021;12:707463. doi:10.3389/fimmu.2021.707463Allen JA, Gelinas DF, et al.Immunoglobulin administration for the treatment of CIDP: IVIG or SCIG?J Neurol Sci. 2020;408:116497. doi:10.1016/j.jns.2019.116497Zahavi D, Weiner L.Monoclonal antibodies in cancer therapy.Antibodies (Basel). 2020;9(3):34. doi:10.3390/antib9030034Castagnoli R, Delmonte OM, et al.Hematopoietic Stem Cell Transplantation in Primary Immunodeficiency Diseases: Current Status and Future Perspectives. Front Pediatr. 2019 Aug 8;7:295.Zaki HA, Iftikhar H, et al.Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barré syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysis.eNeurologicalSci. 2023;31:100468. doi:10.1016/j.ensci.2023.100468Shrestha P, Karmacharya P, et al.Impact of IVIG vs. SCIG on IgG trough level and infection incidence in primary immunodeficiency diseases: A systematic review and meta-analysis of clinical studies.World Allergy Organ J. 2019;12(10):100068. doi:10.1016/j.waojou.2019.100068
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
UpToDate.Patient education: intravenous immune globulin (IVIG) (beyond the basics). February 13, 2023.MedlinePlus.Immune response. January 23, 2022.Hooper JA.Intravenous immunoglobulins: evolution of commercial IVIG preparations.Immunol Allergy Clin North Am. 2008;28(4):765-778. doi:10.1016/j.iac.2008.06.002Perez EE, Orange JS, Bonilla F, et al.Update on the use of immunoglobulin in human disease: a review of evidence.J Allergy Clin Immunol. 2017;139(3S):S1-S46. doi:10.1016/j.jaci.2016.09.023CDC.Primary Immunodeficiency (PI).Jusufović E, Sinanović O, et al.Multifocal motor neuropathy: case reports.Acta Clin Croat. 2018 Sep;57(3):581-587.Guo Y, Tian X, et al.Adverse effects of immunoglobulin therapy.Front Immunol. 2018;9:1299. doi:10.3389/fimmu.2018.01299Kaveri SV, Maddur MS, et al.Intravenous immunoglobulins in immunodeficiencies: more than mere replacement therapy.Clin Exp Immunol. 2011;164 Suppl 2(Suppl 2):2-5. doi:10.1111/j.1365-2249.2011.04387.xPerez EE, Hébert J, et al.Efficacy, safety and tolerability of a new 10% intravenous immunoglobulin for the treatment of primary immunodeficiencies.Front Immunol. 2021;12:707463. doi:10.3389/fimmu.2021.707463Allen JA, Gelinas DF, et al.Immunoglobulin administration for the treatment of CIDP: IVIG or SCIG?J Neurol Sci. 2020;408:116497. doi:10.1016/j.jns.2019.116497Zahavi D, Weiner L.Monoclonal antibodies in cancer therapy.Antibodies (Basel). 2020;9(3):34. doi:10.3390/antib9030034Castagnoli R, Delmonte OM, et al.Hematopoietic Stem Cell Transplantation in Primary Immunodeficiency Diseases: Current Status and Future Perspectives. Front Pediatr. 2019 Aug 8;7:295.Zaki HA, Iftikhar H, et al.Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barré syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysis.eNeurologicalSci. 2023;31:100468. doi:10.1016/j.ensci.2023.100468Shrestha P, Karmacharya P, et al.Impact of IVIG vs. SCIG on IgG trough level and infection incidence in primary immunodeficiency diseases: A systematic review and meta-analysis of clinical studies.World Allergy Organ J. 2019;12(10):100068. doi:10.1016/j.waojou.2019.100068
UpToDate.Patient education: intravenous immune globulin (IVIG) (beyond the basics). February 13, 2023.
MedlinePlus.Immune response. January 23, 2022.
Hooper JA.Intravenous immunoglobulins: evolution of commercial IVIG preparations.Immunol Allergy Clin North Am. 2008;28(4):765-778. doi:10.1016/j.iac.2008.06.002
Perez EE, Orange JS, Bonilla F, et al.Update on the use of immunoglobulin in human disease: a review of evidence.J Allergy Clin Immunol. 2017;139(3S):S1-S46. doi:10.1016/j.jaci.2016.09.023
CDC.Primary Immunodeficiency (PI).
Jusufović E, Sinanović O, et al.Multifocal motor neuropathy: case reports.Acta Clin Croat. 2018 Sep;57(3):581-587.
Guo Y, Tian X, et al.Adverse effects of immunoglobulin therapy.Front Immunol. 2018;9:1299. doi:10.3389/fimmu.2018.01299
Kaveri SV, Maddur MS, et al.Intravenous immunoglobulins in immunodeficiencies: more than mere replacement therapy.Clin Exp Immunol. 2011;164 Suppl 2(Suppl 2):2-5. doi:10.1111/j.1365-2249.2011.04387.x
Perez EE, Hébert J, et al.Efficacy, safety and tolerability of a new 10% intravenous immunoglobulin for the treatment of primary immunodeficiencies.Front Immunol. 2021;12:707463. doi:10.3389/fimmu.2021.707463
Allen JA, Gelinas DF, et al.Immunoglobulin administration for the treatment of CIDP: IVIG or SCIG?J Neurol Sci. 2020;408:116497. doi:10.1016/j.jns.2019.116497
Zahavi D, Weiner L.Monoclonal antibodies in cancer therapy.Antibodies (Basel). 2020;9(3):34. doi:10.3390/antib9030034
Castagnoli R, Delmonte OM, et al.Hematopoietic Stem Cell Transplantation in Primary Immunodeficiency Diseases: Current Status and Future Perspectives. Front Pediatr. 2019 Aug 8;7:295.
Zaki HA, Iftikhar H, et al.Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barré syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysis.eNeurologicalSci. 2023;31:100468. doi:10.1016/j.ensci.2023.100468
Shrestha P, Karmacharya P, et al.Impact of IVIG vs. SCIG on IgG trough level and infection incidence in primary immunodeficiency diseases: A systematic review and meta-analysis of clinical studies.World Allergy Organ J. 2019;12(10):100068. doi:10.1016/j.waojou.2019.100068
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