IVIg is a solution of IgG antibodies normally present in adult human blood.1 The IgG antibodies are extracted from the combined plasma of more than 1,000 screened donors and treated to eliminate bacterial and viral contaminants. It is used to treat immune deficiency and many other conditions on-label and off-label.1
IVIg temporarily increases the platelet count in about 80% of ITP patients.2 The duration of the response varies and the treatment can be repeated when the platelet count drops.
IVIg is manufactured by different companies and each brand has slightly different features and side effect profiles. See the BioRX and The American Society of Health-System Pharmacists IVIg comparision charts for more information.
Dosage
IVIg is given intravenously for a period of several hours. There are two different dosage options: .4 g/kg per day for 5 days, or infusions of 1 g/kg per day for 1 to 2 days. The higher-dose, shorter-term administration leads to a more rapid rise in platelet count, but higher toxicities 3
Side Effects
The most common side effects of IVIg include headache, fever, chills, nausea or vomiting, muscle pain or chest pain. Slowing down the infusion or premedication can help eliminate these problems or decrease their severity. Fortunately, most patients with these side effects can be helped by slowing down the rate of infusion. Premedication with acetaminophen, antihistamines, or occasionally steroids can also help decrease side effects.4
Rare and more serious side effects include: hemolytic anemia, blood clots, pulmonary edema, and aseptic meningitis syndrome.5
Patients who are IgA deficient have a greater chance of developing anaphylactic shock.1 IVIg can cause renal dysfunction and renal failure, expecially with preparations that are very concentratred or have a high sugar content.5
1. http://en.wikipedia.org/wiki/Intravenous_immunoglobulin
2. http://www.ncbi.nlm.nih.gov/pubmed/11809183
3. http://www.ncbi.nlm.nih.gov/pubmed/14528103
4. http://www.immunedisease.com/patients-and-families/ivig-therapy/ivig-side-effects.html
5. http://www.ashp.org/s_ashp/docs/files/DShort_IVIGsidebysideupdatedDec07.pdf
