Hyqvia
HyQvia is a type of antibody called immunoglobulin G. It's used to treat primary immunodeficiency (PI) in adults and children age 2 years and older. This medication is also used to help with nerve damage in adults with chronic inflammatory demyelinating polyneuropathy (CIDP). HyQvia is given as an injection under the skin using an infusion pump about every month. The dosing is typically adjusted based on your weight and immunoglobulin G levels. Common side effects include reactions at the infusion site and headache.
What is HyQvia?
What is HyQvia used for?
Primary humoral immunodeficiency or PI (a condition that makes you have trouble fighting infections) in people 2 years and older
Chronic inflammatory demyelinating polyneuropathy or CIDP (a condition that causes nerve damage) in adults
How HyQvia works
HyQvia contains two components.
Immunoglobulin G (IgG) — the main component of the medication — is a type of antibody that your immune system makes to help you fight off things that can make you sick (e.g., viruses, bacteria). With PI or CIDP, part of your immune system is either missing or isn't working like it should.
For PI, problems with the immune system can lead to frequent infections. HyQvia is thought to replace IgG and boost your immune system to help prevent infections.
For CIDP, a dysfunctional immune system can lead to nerve damage. HyQvia thought to prevent an overly active immune system from attacking your nerves.
Recombinant human hyaluronidase (HY) is a protein that helps your body absorb the medication better when it's injected under the skin.
Drug Facts
What are the side effects of HyQvia?
Common Side Effects
- Infusion-site reactions (e.g., pain, redness, swelling, itching; 52%)
- Headache (21%)
- Feeling tired (11%)
- Fever (7%)
- Infusion-site reactions (24%)
- Headache (20%)
- Fever (15%)
- Feeling tired (8%)
Other Side Effects
- Nausea
- Vomiting
- Itching
- Back pain
- Stomach pain
- Pain in arm or leg
Serious Side Effects
- Blood clots: in the lungs (cough, difficulty breathing, chest pain); in the leg (redness, pain, tenderness, swelling of the skin); near the heart (chest pain, pain in the arms or shoulders, pain in the neck or jaw); in the brain (difficulty speaking, numbness on one side of the body, confusion)
- Serious allergic reaction: difficulty breathing, tightness in the throat, hives, fast heartbeat, dizziness, lightheadedness, swelling in the face or tongue
- Brain inflammation: severe headache, neck stiffness, sensitivity to light, painful eye movements
- Kidney problems: tiredness, dry and itchy skin, low appetite, urinating less than usual, foamy or bloody urine, muscle cramps
- Breakdown of red blood cells: tiredness, dizziness, weakness, yellowing of the skin or eyes, dark-colored urine
- Lung problems: severe breathing problems, wheezing or rattling while breathing, chest pain, fever
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
- Fever, neck pain or stiffness, sensitivity to light, headache, nausea, vomiting, confusion, which may be signs of meningitis
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Lung injury—shortness of breath or trouble breathing, cough, spitting up blood, chest pain, fever
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of HyQvia
Pros
Works well to prevent infections in people 2 years and older with PI
Can give at home after you get trained
Given every 3 to 4 weeks (after the ramp-up period at the beginning of treatment)
Possible to store at room temperature for up to 3 months, making it convenient for travel
Cons
Must be given as an injection under the skin
Might be hard for some people to administer properly
Has some potential risks, such as kidney and lung problems
Available as brand-name only
Pharmacist tips for HyQvia
Mark on your calendar to get your HyQvia infusions at the clinic or infusion center (or even at home if your provider has trained you and decided to let you do so). Writing down when your infusions are helps make sure you don't miss any doses. Talk with your provider right away if you accidentally miss a dose.
HyQvia infusions can commonly cause redness or swelling at the infusion site. They're usually mild to moderate in severity. But contact your provider if you have a severe or worsening reaction or if a reaction lasts for more than a few days. Your care team can tell you how to adjust your infusion. Call 911 if you're having difficulty breathing or feel your throat or tongue start to swell up.
HyQvia can raise your risk of blood clots. Stay well hydrated before each HyQvia infusion to help prevent blood clots. Get medical help right away if you have symptoms of a blood clot, such as swelling, pain, tenderness, difficulty breathing, or chest pain.
Before you get any vaccines, let your provider or pharmacist know that you're taking HyQvia. This medication can interfere with your response to live vaccines like Varivax (varicella vaccine) and MMR (measles, mumps, and rubella vaccine). Your providers can check to make sure the vaccine is safe for you to get.
How to take HyQvia infusions at home:
Carefully review the instructions on how to infuse HyQvia infusions using either a peristaltic infusion pump or syringe driver pump. Your provider will determine which infusion pump is right for you. Following instructions carefully can help avoid hurting yourself or accidentally wasting any medication. Let your provider or pharmacist know if you have any questions.
HyQvia comes as a dual vial unit (one vial of HY and one vial of IgG). The order that you infuse HyQvia is important to help your body absorb the medication. First, infuse HY; then infuse IgG within 10 minutes.
Store HyQvia vials in the refrigerator for up to 3 years from the date of manufacture written on the carton and vial. Don't freeze the medication because this could damage it. You can also keep the vials at room temperature for up to 3 months during the first 2 years of the manufacturing date. Once the vials are at room temperature, don't place them back in the refrigerator. Keep the vials in the original container away from light.
When it's time for your dose, take HyQvia out of the refrigerator and let it reach room temperature. This can take up to 1 hour. Don't try to warm up the medication any other way (e.g., microwave, under hot water) because you might damage it.
Always check to make sure the HY vial is clear and colorless and the IgG vial is clear and colorless or pale yellow before you use it. Don't use the vials if the liquids seem cloudy or have particles or if the vial cap is missing or broken. Contact your or your child's provider or pharmacist to see if it's possible to get a replacement.
Throw away used syringes and needles in a sharps container or something made of heavy-duty plastic (e.g., empty milk carton, laundry detergent bottle). This helps lower the risk of needle-stick injuries. Don't throw them away in your trash can. Visit the FDA's website for more information on how to throw away your sharps container safely.
After each dose, peel off the removable part of the label on each vial you used; stick it in a journal; and log the date and time of your infusion, the dose, infusion site location, and any infusion-related reactions. This helps keep track of your doses and can be helpful during discussions with your provider at your follow-up appointments.
Frequently asked questions about HyQvia
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What are the risks and warnings for HyQvia?
HyQvia can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of blood clots
Risk factors: Older age | Not moving much or on bed rest | History of blood clots | Medical conditions that raise your risk of blood clots | Taking medications that contain estrogen | Central IV lines | Have thick blood | History or risk of heart problems
HyQvia can raise your risk of getting blood clots in various parts of your body. Anyone can get a blood clot during treatment, but having certain factors can put you at higher risk. Symptoms of a blood clot might be different depending on the location of the clot. They can include swelling, warmth, or tenderness in the legs. But more seriously, clots can lead to breathing problems, heart problems, or stroke and cause chest pain, difficulty breathing, or weakness of the face, legs, or arms. Call 911 if you have any of these symptoms because this is a medical emergency.
Your provider will monitor you closely for blood clot symptoms while you're getting treated with HyQvia. If you're at risk for blood clots, your provider might adjust your dose and infusion rate. Make sure you're well hydrated before using HyQvia to help prevent blood clots from happening.
Serious allergic reactions
Serious allergic reactions to HyQvia are possible, including life-threatening reactions like anaphylaxis (e.g., closing of the throat). Stop the infusion and get medical attention right away if you notice dizziness, nausea, a choking sensation, difficulty breathing, swelling around your eyes, or swelling of the lips or tongue after you use HyQvia.
Swelling of the brain
Although rare, some people who used HyQvia developed swelling or inflammation in the brain (aseptic meningitis). Sometimes, symptoms can start to happen within several hours to 2 days of the infusion. This problem typically goes away within several days after stopping treatment. Contact your provider if you have symptoms of meningitis, including severe headache, neck stiffness, sleepiness, fever, sensitivity to light, painful eye movements, nausea, or vomiting.
Kidney problems
Risk factors: Older than 65 years | History of kidney problems | High blood sugar | Sepsis | Having high amounts of certain proteins in blood (paraproteinemia) | Not enough fluids in the body | Taking medications that can cause kidney problems
People who've taken human immune globulin products that are injected through the vein have had severe and even fatal kidney problems. The risk might be higher if you have certain factors like older age, diabetes, or taking medications that can cause kidney problems.
To be safe, your provider will order lab tests to check your kidney health before and during treatment with HyQvia. Your provider might stop your treatment with the medication if your kidney health worsens. Contact your provider if you have any signs or symptoms of kidney failure, including changes in your need to urinate, tiredness, dry and itchy skin, low appetite, and muscle cramps.
Anemia due to breakdown of red blood cells
HyQvia might cause your body to rapidly destroy your red blood cells, which can lead to anemia. Your provider might check your blood cell counts during treatment to make sure your red blood cell count doesn't drop too low. Contact your provider if you have any symptoms of anemia, such as tiredness, dizziness, and weakness.
Spread of local infection
Don't infuse HyQvia in or around an infected area on your thighs or stomach. Doing so can cause the infection to spread to other parts of your body.
Lung problems
People who've taken human immune globulin products that are injected through the vein have developed a condition called transfusion-related acute lung injury (TRALI). This condition happens when fluid backs up in your lungs, and it has typically occurred within 1 to 6 hours after taking the medication. Symptoms include severe breathing problems, chest pain or tightness, a racing heartbeat, and fever. To be safe, let your provider know right away if you have any of these symptoms while you're getting treated with HyQvia. Your provider will examine your lungs and give you appropriate treatment.
Risk of infection
Because HyQvia is made from human blood products, there's a risk that it might contain viruses and other germs that can make you sick. But your risk of infection is low since the donors of these blood products are carefully screened. Also, there are high manufacturing standards put into place to make sure the germs are killed or removed. To prevent serious infections in the rare case that your doses of HyQvia are affected, let your provider know right away if you start to feel sick or have symptoms, such as feeling confused and anxious or having trouble maintaining your balance.
HyQvia dosage forms
Typical dosing for HyQvia
HyQvia is given as an injection under the skin of the stomach or thighs using an infusion pump.
PI:
Your dose depends on your body weight, the IgG levels in your blood, and whether you were previously using another immune globulin therapy.
You'll start at a low dose, and then ramp up your dose over the first 7 weeks of treatment. You'll typically infuse the medication once during weeks 1, 2, 4, and 7. Then, you'll infuse HyQvia once every 3 to 4 weeks thereafter.
Your provider will adjust your dose based on how well HyQvia is working for you and whether you're having side effects. Your dose might also differ if you've been exposed to measles or if you're at risk of measles exposure (e.g., traveling to certain places).
CIDP:
Your HyQvia dose depends on the dose of your previous intravenous immune globulin (IVIG) therapy.
Your first dose of HyQvia will be 2 weeks after your last IVIG dose. You'll start HyQvia at a low dose and then ramp up your dose over several weeks of treatment (can take up to 9 weeks). Then, you'll infuse HyQvia once every 3 to 4 weeks thereafter.
Your provider will adjust your dose based on how well HyQvia is working for you and whether you're having side effects.
HyQvia contraindications
Severe allergy to immunoglobulin G, hyaluronidase, or human albumin
Immunoglobulin A deficiency with antibodies against IgA and a history of allergic reaction to immune globulin
What are alternatives to HyQvia?
Primary humoral immunodeficiency or PI (a condition that makes you have trouble fighting infections) in people 2 years and older
Chronic inflammatory demyelinating polyneuropathy or CIDP (a condition that causes nerve damage) in adults
Primary humoral immunodeficiency or PI in adults and children ages 2 years and older
Prevent bleeds during surgery in adults and children with immune thrombocytopenia (ITP)
Chronic inflammatory demyelinating polyneuropathy (CIDP) in adults
Primary immunodeficiency (PI) in adults and children ages 2 years and older
Prevention of bacterial infections from a blood and bone marrow cancer called chronic lymphocytic leukemia (CLL)
Prevention and treatment of bleeding from low platelets (idiopathic thrombocytopenic purpura or ITP)
Prevention of widening of coronary arteries (aneurysm) in children with Kawasaki syndrome
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References
Best studies we foundAmerican Society of Hematology. (n.d.). Blood clots.
Centers for Disease Control and Prevention. (2020). Traveling abroad? Check if you’re protected against measles.
Centers for Disease Control and Prevention. (2022). Primary immunodeficiency (PI).
Centers for Disease Control and Prevention. (2023). Know the risks, signs & symptoms of blood clots.
Cho, M. S., et al. (2023). Transfusion-related acute lung injury. StatPearls.
Immune Deficiency Foundation. (n.d.). Selective IgA deficiency.
Immune Deficiency Foundation. (n.d.). What is PI?
Justiz Vaillant, A. A., et al. (2023). Immunoglobulin. StatPearls.
Kaur, H., et al. (2022). Aseptic meningitis. StatPearls.
MedlinePlus. (2022). Immunoglobulins blood test.
Moman, R. N., et al. (2022). Physiology, albumin. StatPearls.
National Heart, Lung, and Blood Institute. (2022). Hemolytic anemia.
National Human Genome Research Institute. (2024). Antibody.
National Institute of Neurological Disorders and Stroke. (2024). Peripheral neuropathy.
National Kidney Foundation. (2020). 10 signs you may have kidney disease.
National Organization for Rare Disorders. (2021). Chronic inflammatory demyelinating polyneuropathy.
Takeda Pharmaceuticals U.S.A., Inc. (2024). HyQvia [immune globulin infusion 10%) (human) with recombinant human hyaluronidase] solution, for subcutaneous administration [package insert]. DailyMed.
Takeda Pharmaceuticals U.S.A., Inc. (n.d.). How to infuse HyQvia with a syringe driver pump.
Takeda Pharmaceuticals U.S.A., Inc. (n.d.). Hyaluronidase, or Hy, is what allows you to infuse IG monthly.
Takeda Pharmaceuticals U.S.A., Inc. (n.d.). HyQvia is infused subcutaneously, or the subQ way.
Takeda Pharmaceuticals U.S.A., Inc. (n.d.). HyQvia step-by-step infusion guide.
Takeda Pharmaceuticals U.S.A., Inc. (n.d.). Meet the only monthly* subQ IG treatment.
U.S. Department of Health and Human Services. (2008). Guidance for industry: Safety, efficacy, and pharmacokinetic studies to support marketing of immune globulin intravenous (human) as replacement therapy for primary humoral immunodeficiency.
U.S. Food and Drug Administration (2021). Safely using sharps (needles and syringes) at home, at work and on travel.
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