Preparing for Intravenous Immunoglobulin (IVIG) Infusion Therapy

Preparing for Intravenous Immunoglobulin (IVIG) Infusion TherapyWhat is infusion therapy?
Infusion therapy involves the administration of medication through a needle or catheter. It is given when a patient’s condition cannot be treated with oral medicine. Typically, infusion therapy means that a drug is given intravenously (IV) in a catheter that is in your vein, but the term also may refer to situations where drug is being administered subcutaneously under the skin.

Why do I need infusion therapy?
Some people have a disease that may need intermittent or long-term treatment. Infusion therapy can enhance your overall health and can provide you with treatment that can be life-sustaining.  

What medications might be given with infusion therapy?
Patients with a Primary Immunodeficiency Disease (PIDD) may need to be treated with intravenous immunoglobulin (IVIG). Many different preparations of IVIG are available from different companies.  You should work with your doctor to identify which product will work best for you.  

Many patients can receive immunoglobulin replacement in other ways, such as subcutaneously under the skin, instead of in the vein. Some patients begin with IVIG therapy and switch to other methods so that they can administer immunoglobulin at their convenience at home. If you are interested in such options, you should talk to your doctor.

Many other medications, such as antibiotics, steroids, and IV fluids, can be given intravenously.

How are immunoglobulin preparations made?
Immunoglobulin therapy products consist of sterile solutions of concentrated antibody proteins extracted from healthy blood donors. It takes thousands of pooled plasma donations to extract the immunoglobulins needed. The solutions are highly purified, treated to minimize the transmission of known pathogens, and sterilely packaged for use.

How long do infusions take?
The length of the infusion depends on a few factors. IVIG generally takes about 3 hours for the infusion to be completed. This estimate only includes the time that it takes for the medication to go into your body; it will take additional time to prepare supplies and medications and to place the IV catheter. If your body reacts to the infusion, it will take longer.

The infusion times for other medications vary widely according to what is being given and how your body tolerates it. You should ask your doctor how long these other medications will take.

How often are infusions given?
Intervals between infusions often range between days to weeks. The frequency of infusions depends upon many factors and will need to be determined by your doctor. Please discuss your anticipated therapy plan with him or her.

Are infusions painful?
Most infusion medications are not painful to receive. The placement of the IV catheter may feel painful to some people. Providers often have many ways to decrease the pain of inserting an IV catheter, including using numbing creams and sprays, distraction techniques and devices which provide physical pain blocking using cold and vibration. Check with your doctor to see which pain control plan might work best for you.

Are there any side effects to infusions?
Side effects can develop with any intravenous infusion. Severe adverse events can occur but are rare. Some side effects can be reduced by premedication with certain medicines. Please check with your doctor to receive a complete list of the side effects of the medications that have been prescribed for you. He or she will choose treatments to minimize your risk.

With IVIG, you may develop a headache during or after your infusion. Some people also feel cold during the infusion and often ask for a blanket. You may also feel more tired or have muscle aches or fever after your infusion and need to rest for a day before feeling like your usual self. Other potential side effects exist, but these events represent the most common ones. Please talk to your doctor about any side effects that you may experience from your infusion.

What happens if this treatment does not work for me?
All forms of immunoglobulin therapy are effective, but an individual may tolerate one better than another. Many forms of IVIG are available. Talk with your doctor, and together you can try to find a product that works best for you.

Where are infusions performed?
Infusions can occur in the hospital or in an outpatient setting, in an infusion center or doctor’s office. Complex infusions or infusions that have a high potential for creating a reaction should be given in your doctor’s office or in an infusion center. These infusion centers are prepared to handle complex infusions and often have the personnel and medication on hand to treat a severe infusion reaction.

Do insurance companies cover infusion therapy?
A wide range of variables impact what services will be covered by your insurance company. You, your infusion therapy provider and your physician will work with your insurance company to determine coverage for your infusions.

Find out more about PIDD.

This article has been reviewed by Thanai Pongdee, MD, FAAAAI

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