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immune globulin (intravenous)

Generic Name: immune globulin (intravenous) (IGIV) (im MYOON GLOB yoo lin)
Brand Name: Carimune, Flebogamma, Gammaplex, Octagam, Privigen, ...show all 21 brand names

What is immune globulin intravenous (IGIV)?

Immune globulin intravenous (IGIV) is a sterilized solution made from human plasma. It contains the antibodies to help your body protect itself against infection from various diseases.

IGIV is used to treat primary immunodeficiency (PI), and to reduce the risk of infection in individuals with poorly functioning immune systems such as those with chronic lymphocytic leukemia (CLL). IGIV is also used to increase platelets (blood clotting cells) in people with idiopathic thrombocytopenic purpura (ITP) and to prevent aneurysm caused by a weakening of the main artery in the heart associated with Kawasaki syndrome.

IGIV is also used to treat chronic inflammatory demyelinating polyneuropathy (CIDP), a debilitating nerve disorder that causes muscle weakness and can affect daily activities.

IGIV may also be used for purposes not listed in this medication guide.

What is the most important information I should know about immune globulin intravenous?

This medicine can cause blood clots. A blood clot may be more likely if you have risk factors such as heart disease, blood circulation problems, estrogen use, a history of blood clots, if you are 65 years or older, if you have been bed-ridden, or if you are using a catheter.

Stop using immune globulin and call your doctor at once if you have:

  • signs of a blood clot in the brain--sudden numbness or weakness (especially on one side of the body), slurred speech, problems with vision or balance;

    Slideshow: Flashback: FDA Drug Approvals 2013

  • signs of a blood clot in the heart or lung--chest pain, rapid heart rate, sudden cough, wheezing, rapid breathing, coughing up blood; or

  • signs of a blood clot in your leg--pain, swelling, warmth, or redness in one or both legs.

Immune globulin intravenous can also harm your kidneys, especially if you already have kidney disease or if you also use certain other medicines. Many other drugs (including some over-the-counter medicines) can be harmful to the kidneys.

Call your doctor at once if you have signs of a kidney problem, such as swelling, rapid weight gain, and little or no urinating.

Drink plenty of liquids while you are using this medicine to help improve your blood flow and keep your kidneys working properly.

What should I discuss with my health care provider before using IGIV?

You should not use this medication if you have ever had an allergic reaction to an immune globulin or if you have immune globulin A (IgA) deficiency with antibody to IgA.

IGIV can harm your kidneys or cause blood clots. To make sure this medicine is safe for you, tell your doctor if you have:

  • heart disease, blood circulation problems or a blood vessel disorder;

  • a history of stroke or blood clot;

  • if you use estrogens (birth control pills or hormone replacement therapy);

  • kidney disease;

  • diabetes;

  • a serious infection called sepsis;

  • hyperproteinemia (too much protein in the blood);

  • paraproteinemia (abnormal proteins in the blood);

  • if you are dehydrated;

  • if you are 65 years or older;

  • if you have been bed-ridden due to severe illness; or

  • if you are using a catheter.

FDA pregnancy category C. It is not known whether immune globulin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether immune globulin passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Immune globulin is made from human plasma (part of the blood) which may contain viruses and other infectious agents. Donated plasma is tested and treated to reduce the risk of it containing infectious agents, but there is still a small possibility it could transmit disease. Talk with your doctor about the risks and benefits of using this medication.

How is IGIV given?

IGIV is injected into a vein through an IV. You may be shown how to use an IV at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

IGIV should not be injected into a muscle or under the skin.

IGIV is usually given every 3 to 4 weeks. Your dosing schedule may be different. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Do not use IGIV if it has changed colors or has particles in it. Call your pharmacist for new medication. Throw away any unused medicine that is left over after injecting your dose.

Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

While using IGIV, you may need frequent blood tests. Your kidney function may also need to be checked.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using IGIV.

Some brands of IGIV should be stored in a refrigerator, while others can be kept at room temperature. Follow the storage instructions on your prescription label or ask your pharmacist if you have questions about how to store the medication. Do not allow the medicine to freeze.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of this medication.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using IGIV?

Do not receive a "live" vaccine while using IGIV. The vaccine may not work as well during this time, and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

IGIV side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; wheezing, difficult breathing; dizziness, feeling like you might pass out; swelling of your face, lips, tongue, or throat.

Stop using this medicine and call your doctor at once if you have:

  • signs of a blood clot in the brain--sudden numbness or weakness (especially on one side of the body), slurred speech, problems with vision or balance;

  • signs of a blood clot in the heart or lung--chest pain, rapid heart rate, sudden cough, wheezing, rapid breathing, coughing up blood;

  • signs of a blood clot in your leg--pain, swelling, warmth, or redness in one or both legs;

  • signs of a kidney problem--swelling, rapid weight gain, and little or no urinating;

  • liver problems--fast heart rate, dark urine, jaundice (yellowing of the skin or eyes);

  • lung problems--chest pain, trouble breathing, blue lips, pale or blue colored appearance in your fingers or toes; or

  • signs of new infection--high fever, flu symptoms, mouth sores, severe headache, neck stiffness, increased sensitivity to light, nausea and vomiting.

Common side effects may include:

  • mild headache;

  • dizziness;

  • tired feeling;

  • back pain, muscle cramps;

  • minor chest pain; or

  • flushing (warmth, redness, or tingly feeling).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Immune globulin (intravenous) dosing information

Usual Adult Dose for Bone Marrow Transplantation:

20 years or older: 400 to 500 mg/kg/dose IV, given as an infusion, every week for 3 months, then once a month

Usual Adult Dose for Chronic Lymphocytic Leukemia:

400 mg/kg/dose IV, given as an infusion, every 3 weeks

Usual Adult Dose for Idiopathic (Immune) Thrombocytopenic Purpura:

Initial dose: 400 to 1000 mg/kg/day IV, given as an infusion, for 2 to 5 days
Maintenance: 400 to 1000 mg/kg/dose IV, given as an infusion, every 3 to 6 weeks based on clinical response and platelet count

Usual Adult Dose for Kawasaki Disease:

2000 mg/kg IV, given as an infusion, over 10 to 12 hours
The dose may need to be repeated if response is inadequate.

Usual Adult Dose for Primary Immunodeficiency Syndrome:

300 to 600 mg/kg/dose IV, given as an infusion, once every 3 to 4 weeks

Usual Adult Dose for Chronic Inflammatory Demyelinating Polyradiculoneuropathy:

Loading dose: 2 g/kg IV, given as an infusion, in divided doses over 2 to 4 consecutive days
Maintenance dose: 1 g/kg IV, given as an infusion, over 1 day or 0.5 g/kg IV infusion on 2 consecutive days, every 3 weeks

Usual Adult Dose for Polymyositis/Dermatomyositis:

Study (n=35)
1 g/kg/day IV, given as an infusion, for 2 consecutive days per month, for 4 to 6 months

Usual Pediatric Dose for Chronic Lymphocytic Leukemia:

400 mg/kg/dose IV, given as an infusion, every 3 to 4 weeks

Usual Pediatric Dose for HIV Infection:

400 mg/kg/dose every 2 to 4 weeks in those patients with hypogammaglobulinemia (IgG less than 400 mg/dL). Consider IGIV for HIV-infected children who have recurrent, serious bacterial infections during a 1 year period.

Usual Pediatric Dose for Idiopathic (Immune) Thrombocytopenic Purpura:

Initial dose: 400 to 1000 mg/kg/day IV, given as an infusion, for 2 to 5 consecutive days (total dose: 2 g/kg)

Maintenance: 400 to 1000 mg/kg/dose IV, given as an infusion, every 3 to 6 weeks based on clinical response and platelet count

Usual Pediatric Dose for Kawasaki Disease:

2000 mg/kg IV, given as a single dose, over 10 to 12 hours; should be used in combination with aspirin. If signs and symptoms persist greater than or equal to 36 hours after completion of the infusion, retreatment with a second 2000 mg/kg infusion should be considered.

Usual Pediatric Dose for Primary Immunodeficiency Syndrome:

Primary immunodeficiency disorders: Adjust dose/frequency based on desired IgG concentration and clinical response. Manufacturers dosing recommendations vary based on individual product used.
General dosing range: 200 to 800 mg/kg IV every 3 to 4 weeks; maintain a trough IgG concentration of 500 mg/dL.

Usual Pediatric Dose for Chronic Inflammatory Demyelinating Polyradiculoneuropathy:

400 mg/kg/day for 5 days once each month or 1 g/kg/day for 2 days once each month

What other drugs will affect IGIV?

IGIV can harm your kidneys. This effect is increased when you also use certain other medicines, including: antivirals, chemotherapy, injected antibiotics, medicine for bowel disorders, medicine to prevent organ transplant rejection, injectable osteoporosis medication, and some pain or arthritis medicines (including aspirin, Tylenol, Advil, and Aleve).

Other drugs may interact with immune globulin, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about immune globulin intravenous.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 5.01. Revision Date: 2013-11-14, 9:55:16 AM.

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