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IVIG Administration

When you’re undergoing IVIG treatment, it’s important to understand IVIG administration and each step of the process. If you know what to IVIG Administrationexpect ahead of time, it will eliminate a lot of stress and allow things to go as smoothly as possible. Your doctor may follow slightly different procedures, but below are some of the most common situations and suggestions for dealing with them.

Your Responsibilities as a Patient

Before everything else, you should understand your responsibilities before, during, and after the procedure. You are, after all, the one in control. Exactly how the IVIG treatment process proceeds will be dictated by how you feel. As the patient, it will be up to you maintain a close and honest relationship with your doctor and other caregivers.

Your main responsibilities will be to cooperate as best you can, follow their instructions, and maintain an open and honest line of communication. Always let them know if there is anything you need or don’t understand. You should tell them immediately about any problems or issues that arise, especially those that might affect the course of your treatment.

Doctor or Nurse Responsibilities

Above all, safety should be the priority for any doctor or nurse whether they are administering IVIG treatment or educating a patient about infusions. The prescriber’s orders should be followed carefully, with any problems addressed and fully resolved before the infusion.

Assessments Before IVIG Administration

Before beginning the IVIG infusion, your nurse will look at several factors to help minimize any problems, discomfort or adverse effects and make sure you have a successful IVIG infusion experience.

  • Assess whether the IVIG product is appropriate for the patient. There are different types of IVIG products, which are NOT interchangeable. Your nurse will first check to make sure the present product is suitable for your particular case.
  • Assess the integrity of the IVIG product. Like any other medication, the nurse will check to make sure that the product is fully intact, no seals have been broken, and it has not been tampered with.
  • Check that the IVIG product is at the right temperature. The immunoglobulin solution should be at room temperature when it is administered.
  • Check that the patient understands IVIG therapy. The nurse will check with the patient to make sure they understand the purpose of the therapy and what will be involved in the process.
  • Check the patient’s general health and hydration level. The nurse should assess whether or not the patient is in a healthy state and properly hydrated. Any problems with health should be communicated to the prescriber. If the patient does not seem to be fully hydrated, this should be remedied before the infusion begins.
  • Check for any variation in weight. IVIG therapy prescriptions are based on the weight of the patient. Any significant change in weight could mean that the prescription would need to be adjusted.
  • Check heart rate and respiratory status. IVIG therapy can cause a fluid overload in patients with congestive heart failure. Their heart and respiratory status must be checked before and during infusion to avoid potential problems.
  • Check the patient for signs of fever. If a patient has a fever, the prescriber should be contacted and consulted for instructions. Depending on condition, the infusion may need to be postponed until the fever subsides.
  • Assess the need for pre-medications. If a patient has had any issues during previous infusions, the prescriber should be consulted for instructions to see if pre-medications may be necessary to help ensure a successful infusion.
  • Determine if there is a need for anesthesia. Some patients, especially children, may wish to receive local anesthesia to numb the sites where needles or catheters will be placed.
  • Assess emergency preparedness. The nurse will make sure that all emergency equipment is functional and nearby as well as make sure there are clear communication channels for reaching both the prescribing doctor as well as emergency services such as 911.
  • Assess the need for blood work before starting the infusion. Blood must be drawn prior to an IVIG infusion if it is needed for monitoring purposes. The nurse should go over any previous blood work with the patient as well as make sure that regular blood tests are being carried out as expected.
  • Assess the patient’s experience with prior IVIG infusions. Last, but not least, the nurse should ask the patient about previous experiences and what they expect to happen. Patients, children especially, may have routines they are used to that help them get through the experience with fewer issues. Nurses should try to follow these routines whenever possible.ivig administration

Assessment During IVIG Administration

During the administration of the IVIG therapy, infusion, the nurse will monitor the patient’s general status and make sure that the infusion is being tolerated. This will involve asking basic questions about how you feel as well as monitoring vital signs for any changes. At this point, as the patient, there isn’t much more to do other than wait for the process to finish.

Assessments After IVIG Administration

After the infusion has been completed, the nurse will generally check on a few things that will allow him or her to assess how well you’ve tolerated the infusion and what could be done to improve your experience during the next one.

  • Check for problems related to the infusion. The nurse will check for any problems occurring immediately after the infusion that may have been caused by it, such as headaches, fever or rashes. In some cases, changes to the infusion protocols might be suggested to provide some relief in the future.
  • Assess the need for future infusions and discuss with the patient. The nurse should inform the patient of upcoming IVIG therapy sessions and their responsibility according to what has been ordered by the prescribing doctor.ivig administration after

The Typical IVIG Infusion

IVIG therapy typically consists of a dose between 400 and 500 milligrams per kilogram of weight, given every three to four weeks. The majority of patients tolerate the procedure well and experience little to no adverse effects.

Individual patients may get better results with a more personalized infusion regimen, just as some people respond better to one IVIG product over another. Once you and your doctor have decided on an infusion regimen that works for you, it’s important to stick with it and follow your doctor’s orders. If you have questions about IVIG administration, IVIG therapy, or the IVIG infusion process, you should talk with your doctor.

What Is IVIG?

What is IVIG?

What Is IVIG? IVIG stands for IntraVenous ImmunoGlobulin. IVIG is a preparation made by pooling immunoglobulin G (IgG) from the plasma of healthy blood donors. Generally, it’s used for the treatment of patients suffering from immunodeficiency disorders.

This type of preparation first became widely available during the second world war and was used to help prevent diseases such as polio, measles, and hepatitis. It was first used as a replacement therapy for people with primary immunodeficiency disorders in 1952 and administered through intramuscular injections. This method of administration limited the doses that could be given because of the small volumes involved and also proved to be painful for patients. This is no longer the case.

The U.S. licensed preparations that could be safely administered intravenously in the early 1980s. Larger doses could be given through the intravenous route and more closely matched the body’s own antibody production. Most patients tolerated this type of treatment well, and it soon became the standard treatment for patients suffering from primary immunodeficiencies with antibody deficiency.

what is ivig

What is IVIG Made Of?

IVIG is manufactured using donor pools from 10,000 to 60,000 units of donated human plasma. They contain immunoglobulin G (IgG) antibodies which fight off a wide variety of infectious agents. There are differences in the exact processes and stabilizing agents that are used from one manufacturer to another, but all IVIG preparations contain more than 96% IgG. Most products also contain some immunoglobulin A and trace amounts of other plasma proteins.

What is IVIG Used for?

Immunoglobulin preparations are currently approved by the FDA to be marketed for the following conditions:

All IVIG products carry an indication for one of the above disorders, but none of them are indicated for all five.

Off-Label Uses of IVIG

Using a drug for an “off-label” purpose means to use it for something other than what it has been approved for. For example, aspirin is approved to relieve pain or reduce fever, but, because of other properties that aspirin has, many doctors suggest taking one aspirin per day to reduce the risk of heart attack. This would be an off-label use of aspirin.

Immunoglobulin therapy is often used for many different off-label conditions such as:

  • Guillain-barré Syndrome
  • Polymyositis
  • Dermatomyositis
  • Multifocal Motor Neuropathy
  • Stiff Person Syndrome
  • Relapsing-remitting Multiple Sclerosis
  • Pemphigus

IVIG has also been used to treat other immune disorders, but results have not been proven on a large enough scale to earn the full acceptance of the medical community at this time.

Healthy after ivig

What Is an Immunodeficiency Disorder?

An immunodeficiency disorder is when the body is unable to properly defend itself against infections and diseases. Someone suffering from this type of disorder is more susceptible to illness and disease than an average person. There are two type of immunodeficiency disorders, primary and secondary.

A primary disorder is one in which the immunodeficiency is caused by something congenital. The deficiency may or may not be present at birth, but it develops as the result of something the person was born with. There are more than 100 known types of primary immunodeficiency disorders.

Secondary disorders, sometimes called acquired disorders, develop later in life. They are caused by environmental factors that weaken the immune system. Some examples of secondary immunodeficiency causes are HIV, chemotherapy, malnutrition, and severe burns.

 What is IVIG Treatment for an Immunodeficiency Disorder?

Treatment for immunodeficiency disorders focuses on three main points, regardless of whether it is a primary or secondary disorder:

  • Treating and preventing infections
  • Boosting the weakened immune system
  • Treating the underlying cause of the deficiency

For managing infections, patients may be given antibiotics to fight pathogens as well as other medications to relieve the resulting symptoms, such as decongestants, expectorants, and ibuprofen to reduce pain and fever.

To boost the immune system, IVIG therapy is often used, but treatment may also include gamma interferon therapy and growth factor therapy.

If the immunodeficiency is caused by an underlying serious illness, such as cancer, for example, additional treatment would be specific to that illness.

talk to your doctor about ivig

Talk Your Doctor

What is IVIG? Still want to know more? If your doctor has recommended IVIG treatment, it’s important to follow through with the advice. Speak to your doctor for more information about immunodeficiency disorders, IVIG therapy, and qualified treatment centers near you.

IVIG Side Effects – Best-Practices to Avoid Them

Adverse drug reactions, commonly referred to as IVIG side effects, are the known, but undesired effects of medications and medical procedures. For example, you might take an analgesic for its intended effect of relieving a headache or sore muscle pain. As a side effect, you might also experience an upset stomach.

Just as with any other type of treatment or medication, there is a possibility of encountering side effects when undergoing IVIG treatment. The good news is that a majority of patients who receive intravenous immunoglobulin therapy don’t experience any side effects at all. It is, however, important for both patient and caregiver(s) to be prepared. If side effects do arise, they are generally easier to control or eliminate if everyone involved plans ahead.

Classification of IVIG Side Effects

IVIG Side Effects

Some side effects of IVIG therapy are more common than others. Overall, side effects are generally categorized as either severe or mild. Severe side effects should be reported immediately to a medical professional and may require extra medical attention. Mild, sometimes called minor, side effects are generally easy to treat and/or control and may even disappear on their own as the body becomes accustomed to the treatment.

Best-practices to Avoid Mild IVIG Side Effects

Mild to moderate side effects of IVIG therapy can often be controlled, or even avoided altogether, with simple, easy to implement treatments. Some of the most common mild side effects include:

  • Headache
  • Chills
  • Myalgia
  • Increased heart rate/pulse
  • Nausea
  • Lower back pain
  • Hypotension

Headaches and migraines tend to be the most commonly experienced side effects of IVIG. In most cases, patients can control or eliminate these and other side effects through the use of NSAIDS, steroids, and antihistamines before and after an IVIG infusion. In some cases, simply changing IVIG dosage or adjusting the administration schedule can reduce or remove side effects. Additionally, patients have also reported much less discomfort due to side effects when they take steps to make sure they are fully hydrated before, during, and after an infusion.

ivig side effects

Best-practices to Treat Severe IVIG Side Effects

Severe side effects from IVIG therapy are rare. They can often be reduced or avoided by screening patients for factors that would indicate they are predisposed to complications with this type of treatment.

Severe side effects of IVIG therapy can include:

  • Thrombosis
  • Acute renal failure
  • Serum sickness
  • Stevens-Johnson Syndrome
  • Aseptic Meningitis
  • Anaphylaxis

The patient may experience these conditions as labored breathing, difficulty swallowing, severe headache, tightness in the chest, fatigue or weakness, reddening of the skin, or severe itching, especially on the feet and hands.

Treatment for these side effects usually involves administration of antihistamines, steroids, and NSAIDS. In cases of a severe reaction, epinephrine may also be administered. Doctors have had success in eliminating these kinds of side effects for some patients by switching from an intravenous to a subcutaneous IG infusion method.

The Benefits Often Outweigh the Risks

Even though the possibility of experiencing side effects exists, the benefits of IVIG therapy outweigh the risks in the vast majority of cases. If a patient experiences side effects at all, they are usually easily treatable and end up being nothing more than a mild annoyance.

IVIG infusion treatments can provide significant help to patients with an immune deficiency, allowing their bodies to fight off illness and infections that could otherwise be dangerous or even life-threatening.

It has also been shown to be an effective treatment for many autoimmune diseases — when the immune system attacks some part of the body. It has been successfully used as part of the treatment for Chronic Inflammatory Demyelinating Polyneuropathy, Multiple Sclerosis, Multifocal Acquired Sensory and Motor Neuropathy, Dermatomyositis, Polymyositis and others.

ivig side effects - benefitsIf you think you might be experiencing side effects as a result of your IVIG therapy, during or after an infusion, let your doctor know right away. Together, you’ll be able to decide the best course of action to help you reduce or eliminate any discomfort and get the best possible benefit from your treatment.

IVIG Patient Information – A Comprehensive Guide to IVIG Treatment

Our IVIG patient information article is designed for you and others who may be in your circle of care. Questions about your IVIG treatment plan should be addressed by your doctor.  The IVIG patient information provided on our Website, including text, images, audio, video, or other formats are for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

What is IVIG?

IVIG stands for Intravenous immune globulin (“IVIG”). It’s a product made up of antibodies that can be given through a vein. It is prepared from the blood donated by thousands of people, to make a super-concentrated collection of antibodies. Antibodies are proteins that your body makes to help you fight infections.

Over the course of your life, your body makes thousands of different antibodies. Each antibody made by your body is slightly different because it fits like a lock and key to every foreign substance (such as a virus) that gets into your body. This is why you need a new flu shot every year; each year the flu virus is slightly different, and different antibodies (which the vaccine causes your body to produce) are required to protect you.

Why Do I Need IVIG?

IVIG is used primarily in two situations, Primary Immunodeficiency or autoimmune or immune-mediated syndromes. Be sure to ask your doctor if you have specific questions about your treatment plan.

Primary Immunodeficiency occurs when your body does not make enough antibodies.  The IVIG simply provides extra antibodies that your body cannot make on its own. The antibodies usually last for several weeks and help your body fight off a large variety of infections.

A second reason you might need IVIG is if your immune system has started attacking your body’s normal cells. These are conditions known as autoimmune or immune-mediated diseases. Some common autoimmune or immune-mediated diseases include multiple sclerosis, myasthenia gravis, chronic inflammatory demyelinating polyneuropathy, polymyositis, dermatomyositis, rheumatoid arthritis, and systemic lupus erythematosus.

How is IVIG Given?

IVIG is given into a vein (“intravenously”) in a physician monitored infusion suite. The specific dose ordered by your physician, as well as your tolerance to the medication, will determine your length of stay at the infusion center. Infusion rates are unique to each individual.

The amount of IVIG you need for each dose depends on your weight as well as the reason you are getting the IVIG (your diagnosis). The length of time it takes for an IVIG infusion will vary for each person. On average, it is between 4 to 6 hours.  Larger doses are often divided over multiple days for patient tolerability.

Why Do I Have to Have Regular Infusions?

IVIG increases the antibody level within your body. Antibodies, whether those produced naturally by your body or those administered through IV, are eventually metabolized and eliminated by your body within 3-4 weeks. Regular infusions are necessary to maintain immune globulin levels within the desired range.

When Will I Notice the Benefits of IVIG?IVIG Patient Information

Your response will vary depending on your diagnosis (Primary Immunodeficiency or autoimmune or immune-mediated syndromes). Every patient is individual, and your response will be just as individualized. It is important to give the IVIG enough time for your nurses and your physician to evaluate your response

If you are experiencing a Primary Immunodeficiency, your response should be fewer infections, particularly bacterial-type infections. If you continue to get infections while on IVIG you should notify your physician immediately. Your dose may need to be adjusted.

If you are experiencing an autoimmune or immune-mediated disease process, your response is usually determined by the severity of the symptoms you are experiencing, such as pain, mobility, and fatigue. Generally, it will take 3-6 months to fully realize the benefits, but some patients may feel better in a shorter period. Sometimes the benefit that you experience is stability. In other words, your no symptoms don’t get worse.

IVIG Side Effects

IVIG is one of the safest biological products available, and many people do not experience side effects. Some patients may experience mild side effects such as chills, fever, flu-like muscle/joint pain, fatigue, headache, and nausea.

The good news is that almost all side effects can be safely controlled and often eliminated. These side effects are easily managed by doing the following:

  • Hydrate: It’s critical to properly hydrate beginning 3-5 days before your infusion. Just like combatting the flu, you always want to get plenty of fluids to alleviate side effects. These fluids are increased either orally or in some cases, intravenously before or after your IVIG infusion.
  • Rate of Infusion: Giving the infusion more slowly; each patient tolerates IVIG infusion rates differently, and your nurses will tailor your infusion to your needs and tolerability.
  • Smaller Doses: Dividing a large dose into several smaller doses that are given over several days
  • NSAIDS: Taking NSAIDS like Tylenol, Aleve or Motrin to prevent the fever and flu-like symptoms and taking antihistamines like Benadryl, Claritin or Zyrtec to prevent allergic reactions. Some patients may also take medications like Excedrin Migraine if they have a history of headaches.

What Happens If This Treatment Does Not Work for Me?

All forms of IVIG therapy are effective, but an individual may tolerate one better than another. Many forms of IVIG are available. Talk with your doctor and infusion nurse, and together you can try to find a product or different therapy that works best for you.

Will Insurance Cover My IVIG Infusions?

IVIG Patient Information

Most commercial insurance carriers require prior authorization for IVIG, and medical policies outlining how IVIG is approved. If your doctor partners with Corinthian Health Services,  An RN Care Manager will contact you to review your benefits and discuss patient financial responsibility before your infusion. Your RN Care Manager can also recommend patient assistance programs that you may qualify for to help with the out-of-pocket expenses.

What’s Unique About Corinthian Health Services?

Corinthian Health Services requires ALL of our IVIG Infusion Nurses to be nationally board certified in Ig therapy. This distinction is unique among infusion providers and is known as the IgCN certification (Immune globulin Certified Nurse).ivig patient information

Your infusion will occur in a physician-supervised setting, within the physician’s office. This ensures the highest level of safety and care in the industry.

Our infusion centers are designed to be a place of relaxation as well as a center of clinical excellence! Corinthian believes that optimal health and the very best infusion experience is realized in a safe and spa-like setting. Corinthian provides healthy snacks and drinks to enjoy during your infusion.

Your infusion experience is also tailored to YOUR needs, whether you need to work on your computer or watch television or just take a nap. We discourage the use of cell phone conversations within the infusion center to provide privacy as well as respecting the relaxing atmosphere we strive to maintain. We do provide areas outside the infusion center where cell phone usage is allowed.

IVIG Patient Information

If your physician has partnered with Corinthian Health Services, your referral is sent to your local Corinthian Infusion Suite. Once the Care Manager has received your paperwork, they will contact you to let you know the approximate time to receive authorization from your insurance carrier (days to weeks depending on insurance provider).

When the Care Manager receives authorization for your IVIG therapy, they will contact you to provide IVIG patient information, discuss benefits, and financial responsibility. Next, you will receive a call from the Corinthian clinical team for scheduling and instruction on how to prepare for your IVIG infusion appointment.

If your physician has not partnered with Corinthian Health Services, your experience will be different. Speak to your physician about your desire to use our services, and he or she may be able to direct you to a local Corinthian Infusion Suite.

IVIG for MS – An Overview of IVIG Benefits for Treatment of Multiple Sclerosis

IVIG for MS may help reduce symptoms of the disease and its progression. Always speak with your doctor regarding the best treatment plan for you.

Multiple Sclerosis, or MS, affects the brain, spinal cord, and optic nerves. It is the result of the body’s immune system attacking a substance called myelin, which wraps around nerve fibers to protect them. Without myelin, exposed nerves can become damaged, often forming scar tissue, which interferes with nervous system functions. This is where multiple sclerosis gets its name, which means “many scars.”

IVIG for MS Benefits

Intravenous immunoglobulin, commonly referred to as IVIG, is generally used to help the body fight off disease by boosting the immune system. A derivative of donated blood, this medicine is made by filtering antibodies from many donors and pooling them together in a liquid suspension.

ivig for ms

IVIG has been shown to be effective for treating some neurological diseases by increasing the functions of some parts of the immune system while decreasing others. As an off-label treatment for MS, IVIG is used to help slow the progression of the disease as well as reduce the symptoms and disabilities it causes. Doctors also believe that it can lengthen the time between relapses for those suffering from relapsing-remitting MS (RRMS).

MS-Specific Uses for IVIG

Currently, IVIG is not a general treatment for multiple sclerosis at this time. However, it is used in more specific areas where it has been shown to be particularly effective.

  • Patients who cannot tolerate common therapies: IVIG use is recommended in cases where patients are unable to tolerate currently common MS therapies such as those that use Copaxone, Betaseron, Avonex, and Rebif.
  • Pregnant women: Some studies have shown that IVIG can reduce the chance of having a relapse during pregnancy.
  • Postpartum women: In about one-third of all cases, women with MS will experience a relapse after childbirth. IVIG has been shown to be effective in preventing these relapses.
  • People with primary progressive MS: A European study showed that IVIG could help to slow the progression of multiple sclerosis in people with primary progressive MS.

How Effective is IVIG for MS?

How Effective is IVIG for MSAt present, the medical community is fairly well divided on the effectiveness of IVIG for treating multiple sclerosis. Some studies seem to show beneficial effects from IVIG treatments while others report that there is no significant difference between patients treated with IVIG and those given a placebo.

In an article published in 2008, Professor Jeffrey A. Cohen discusses the meaning of some of these conflicting reports and stresses that none of the studies conducted so far are considered to be definitive. However, he has indicated that several studies demonstrate the beneficial effects of IVIG in relapsing–remitting multiple sclerosis. The magnitude of the benefits in terms of reductions in relapse rate and MRI lesion activity seemed to be favorable.

Possible Side Effects of IVIG

ivig for msAs with most medical treatments, someone treated with IVIG may experience side effects. Some of the most common side effects include:

  • Headache
  • Fever
  • Joint pain
  • Chest pain
  • Nausea
  • Vomiting
  • Rash

There are also rare, but serious, side effects such as kidney failure or dysfunction, aseptic meningitis or what are known as thrombotic events which include things like stroke, pulmonary embolism, heart attack, or deep vein thrombosis.

For these reasons, IVIG is not to be used on patients with an IgA deficiency or existing kidney problems or failure. For people with heart problems or diabetes, doctors advise using IVIG only with a great deal of caution and careful monitoring.

If you have questions about IVIG for MS or think it might be a good treatment option for you, talk with your doctor. He’ll be able to help you weigh out the potential pros and cons to developing an effective overall MS treatment plan.