Key takeaways:
Your body makes antibodies to fight infection. But if your immune system can’t make antibodies, an immunoglobulin infusion can provide protection.
Immunoglobulin infusions are helpful treatment options for people with autoimmune conditions or immunodeficiencies.
Side effects from immunoglobulin infusions include headache, nausea, and vomiting. Rare side effects, like allergic reactions, can happen, too.
Antibodies — also known as immunoglobulins — work by neutralizing bacteria or viruses so these bugs can’t cause illness. Over the course of a lifetime, our bodies make thousands of different antibodies. Each antibody fights off a specific infection, like how only a specific key fits into a lock. Immunoglobulins can also help calm inflammation from autoimmune and neurological conditions. But some people can’t make enough antibodies or need help calming an inflammatory process. In these situations, immunoglobulin infusions can be a big help.
If you’ve been told you need an immunoglobulin infusion, you might have some questions about how it works. Here’s everything you can expect from your infusion.
What are the different types of Immunoglobulins?
There are five types of antibodies (or immunoglobulins):
Immunoglobulin G (IgG)
Immunoglobulin M (IgM)
Immunoglobulin E (IgE)
Immunoglobulin A (IgA)
Immunoglobulin D (IgD)
IgG is the most common type of antibody. About 75% to 80% of all antibodies a person makes are IgG. IgG can protect the body against infections and calm inflammatory responses.
What is intravenous immune globulin?
Intravenous immunoglobulin — also called IVIG — is a medicine that is given through the vein. It’s made up mostly of immunoglobulin IgG.
IVIG is a blood product. When people donate their blood, the antibodies in their blood are removed and then pooled together to make IVIG. When someone gets an IVIG infusion, they receive a concentrated collection of antibodies from hundreds or even thousands of people. This means that the person receiving the IVIG has the benefit of getting more antibodies than they could make on their own.
Who might need an immunoglobulin infusion?
IVIG is a treatment option for people with:
Immunodeficiencies and immune compromise, including people recovering from chemotherapy or stem cell transplants
Inflammatory conditions like Kawasaki disease and immune thrombocytopenia (ITP)
Neurologic conditions like myasthenia gravis and Guillain-Barré syndrome
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Some people only need IVIG treatments once, while others need multiple infusions.
Healthcare teams are still finding new ways to use IVIG. As time goes on, IVIG might be a treatment option for other conditions, too.
How do I prepare for an immunoglobulin infusion?
IVIG infusions can be done at a doctor’s office, infusion center, or hospital. There’s nothing specific you need to do to prepare for your infusion. And the good news is that IVIG infusions aren’t painful (except for the pinch from the IV placement). But here are some helpful tips that can make the process go more smoothly:
Bring layers: Many people say the IVIG infusion makes them feel cold. Bring an extra sweater, some cozy socks, or a blanket to keep yourself comfortable.
Bring something to do: IVIG infusions can last between 2 to 4 hours, depending on your dose. You’ll want to bring something to keep yourself occupied. Most centers have Wi-Fi access and outlets, so it can be a good time to catch up on movies or TV shows.
Budget for extra time: Even though the infusion itself can take 2 to 4 hours, the entire visit can take longer. You need to budget extra time for before and after the infusion. Before the infusion, you’ll need to get your IV started and fill out your paperwork. Your healthcare team will also want you to stay for observation after your infusion for about 30 to 60 minutes. This is to make sure you don’t have any side effects to the medication.
Take a day (or two) off: Because the process can take up most of your day, you’ll probably need a day off work or school. You may feel tired after the infusion, so, if you can, try to take a day off the day after to recover from the infusion. If you need multiple infusions, consider taking advantage of FMLA.
Touch base with your insurance provider: Check with your insurance provider to make sure your infusion is covered by your plan. In addition to the medication costs, you’ll want to make sure the infusion center’s charges are covered within your network.
Use the same brand: If you need multiple IVIG infusions, your healthcare team should try to use the same brand each time. Make sure you know what type of IVIG you are receiving.
Consider vaccines: IVIG can interfere with vaccine effectiveness. If you aren’t up to date on your vaccines, talk to your healthcare provider about whether you should get your vaccines before your IVIG infusion.
Are there any risks in taking an immunoglobulin infusion?
IVIG is a blood product and a medication, so there are risks, including medication reactions. Up to 50% of people who get IVIG report some kind of reaction. But, fortunately, most of these reactions are mild.
The most common mild reactions are:
Headache
Chills
Muscle pains
Fatigue
Nausea or vomiting
More serious reactions can also happen, though they are much less common. Severe reactions include:
Rapid anemia
Blood clots
Lung injury
Pulmonary edema
Your healthcare provider may do several things to reduce your chance of having an adverse reaction, including:
Checking your blood work beforehand, to ensure you can tolerate the infusion.
Asking you to stay well hydrated before and after the infusion.
Asking you to take anti-nausea medications, benadryl, or acetaminophen before your infusion.
They may also adjust your infusion by:
Giving it over a longer period of time
Dividing the infusion into smaller doses and giving it over several days
Switching brands of IVIG
Using a lower concentration of IVIG
Changing from IVIG to subcutaneous immunoglobulin
What happens after my immunoglobulin infusion?
After your infusion, you’ll be asked to stay at the office or infusion center for about an hour. During this time, the staff will monitor your symptoms and vital signs to make sure you don’t have a reaction to the IVIG treatment. Afterward, you’ll be able to go home.
You may feel tired the rest of the day and the next. You should stay on alert for symptoms that could be a sign of serious reactions. Some symptoms to look out for include:
Headache that doesn’t go away
Pain when moving your neck
Sensitivity to light
Trouble breathing
Chest pain
Feeling lightheaded, or like you’re going to faint
Change in your urine color
Making less urine than normal
If you develop any of these symptoms, you should call your healthcare provider right away.
The bottom line
An immunoglobulin infusion — or IVIG — is a blend of antibodies that comes from donors. Immunoglobulin infusions can help people fight off infections or calm inflammatory processes. IVIG infusions can cause minor reactions. Some people can have more severe reactions, though these are rare. Your healthcare team will monitor you closely after an infusion for signs of a reaction.
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References
American Academy of Allergy, Asthma & Immunology. (2020). Preparing for intravenous immunoglobulin (IVIG) infusion therapy.
Centers for Disease Control and Prevention. (2021). Immunity types.
Kotton, C. N., et al. (2021). Immunocompromised travelers. CDC Yellow Book 2020: Health Information for International Travel.
Perez, E. E., et al. (2017). Update on the use of immunoglobulin in human disease: A review of evidence. The Journal of Allergy and Clinical Immunology.
Wittstock, M, et al. (2003). Therapy with intravenous immunoglobulins: Complications and side-effects. European Neurology.