Privigen
Privigen is an immunoglobulin (antibody) therapy known as intravenous immunoglobulin (IVIG). It's used to treat certain immune-related conditions like primary humoral immunodeficiency (PI), chronic immune thrombocytopenic purpura) (ITP), and chronic inflammatory demyelinating polyneuropathy (CIDP). It’s given by infusion into a vein (IV), typically in a clinic or infusion center. Common side effects include headache, nausea, and tiredness.
What is Privigen?
What is Privigen used for?
- Primary humoral immunodeficiency (PI) - adults and children 3 years and older
- To raise platelet counts in people with immune thrombocytopenia (ITP) - adults and teens 15 years and older
- Chronic inflammatory demyelinating polyneuropathy (CIDP) - adults
How Privigen works
Privigen is a type of intravenous immune globulin (IVIG). It contains immunoglobulin G (IgG), which is a type of antibody your immune system normally makes to help fight infections.
People with primary immunodeficiency (PI) don't have enough IgG in their bodies, which raises the risk of serious infections. Privigen helps replace the missing IgG, which lowers the chance of getting sick.
People with immune thrombocytopenia (ITP) or chronic inflammatory demyelinating polyneuropathy (CIDP) have immune systems that attack their platelets or nerves by mistake. It’s not fully known how Privigen works for these conditions, but it's thought to help by calming the immune system.
Drug facts
| Common Brands | Privigen |
|---|---|
| Drug Class | Immune globulin |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Privigen
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
PI
- Headache (45%)
- Fatigue (16%)
- Nausea (14%)
- Chills (11%)
- Vomiting (11%)
- Back pain (10%)
- Pain (9%)
- Fever (9%)
- Diarrhea (8%)
ITP
- Headache (65%)
- Fever (37%)
- Low red blood cells (11%)
- Nausea (11%)
- Nosebleed (11%)
- Vomiting (11%)
CIDP
- Headache (29%)
- Low energy (14%)
- High blood pressure (14%)
- Nausea (11%)
- Pain in arms or legs (11%)
Less Common Side Effects
PI
- Cough
- Stomach discomfort
- Stomach pain
- Chest pain
- Joint swelling
- Flu-like symptoms
- Sore throat
- Hives
- Dizziness
ITP
- Changes in bilirubin levels
CIDP
- Flu-like symptoms
- Rash
Privigen serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Kidney problems: tiredness, trouble sleeping, dry and itchy skin, low appetite, urinating less, foamy urine, bloody urine, muscle cramps
- Blood clots: lungs (cough, difficulty breathing, chest pain), legs (redness, pain, tenderness, swelling of the skin), heart attack (chest pain, pain in the arms or shoulders, pain in the neck or jaw), stroke (difficulty speaking, numbness on one side of the body, confusion)
- Serious allergic reaction (anaphylaxis): difficulty breathing, hives, itching, fast heartbeat, tightness in the throat, nausea, stomach pain, dizziness, lightheadedness, swelling in the face or tongue
- Swelling and inflammation of the brain: severe headache, neck stiffness, sleepiness, fever, sensitivity to light, painful eye movements, nausea, vomiting
- Hemolytic anemia (low red blood cell count): tiredness, dizziness, weakness, high heart rate, yellowing of the skin or eyes, dark-colored urine
- Lung problems (TRALI): difficulty breathing, fluid in lungs (wheezing or rattling while breathing), low blood oxygen levels (headaches, feeling confused, or chest pain), fever
- High blood pressure during or shortly after infusion: severe headache, vision changes, chest pain
The following Privigen 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
- Hemolytic anemia—unusual weakness or fatigue, dizziness, headache, trouble breathing, dark urine, yellowing skin or eyes
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Low sodium level—muscle weakness, fatigue, dizziness, headache, confusion
- Shortness of breath or trouble breathing, cough, unusual weakness or fatigue, blue skin or lips
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 Privigen
Pros
- Approved to treat PI, ITP, and CIDP
- Flexible dosing schedules for different conditions
- Could be given at home by trained healthcare professionals in some cases
Cons
- Requires IV access and monitored infusions
- Risk of blood clots and kidney problems
- Can interfere with live vaccines
- Headache, nausea, and flu-like symptoms are common after infusions
Pharmacist tips for Privigen
- Make sure to mark your appointments on your calendar for when you need to receive Privigen or get any blood tests done. If you accidentally miss a dose, talk with your prescriber right away about rescheduling your appointment.
- Drink plenty of water the day before and the day of your Privigen infusion. Staying hydrated lowers the chance of blood clots and kidney problems.
- Most Privigen infusions take several hours. Bring a book or some music to help pass the time.
- Privigen can raise your risk for blood clots. Get medical help right away if you have chest pain, trouble breathing, coughing, headache, trouble speaking, or weakness on one side of your body.
- Privigen can cause serious kidney problems. Contact your prescriber right away if you experience symptoms like trouble urinating, sudden weight gain, swelling, or shortness of breath.
- You can get some vaccines while taking Privigen, but you should avoid live vaccines because the medication can affect how well those vaccines work. Tell the healthcare professional giving your vaccines if you’ve recently received Privigen.
Risks and warnings for Privigen
Privigen 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.
Kidney failure
- Risk factors: Age greater than 65 years | Kidney problems | Type 2 diabetes | Sepsis | Having high amounts of certain proteins in blood (Paraproteinemia) | Not having enough fluids | Taking medications that can cause kidney problems
Privigen can cause severe and life-threatening kidney problems. Your risk is higher if you're an older adult or if you're dehydrated. Drink plenty of water the day before and the day of your infusion to help lower the risk of kidney problems.
To keep you safe, your prescriber will order labs to check your kidney health as needed before and during treatment with Privigen. If your kidney health worsens, your care team might slow down or stop your infusion. Contact your prescriber right away if you have symptoms like reduced urination, swelling, sudden weight gain, or shortness of breath.
Blood clots
- Risk factors: Older age | Not moving much or on bed rest | History of blood clots | Having other medical conditions that raise your risk of clots | Taking medications that contain estrogen | Central IV lines | High plasma viscosity (having thick plasma) | Heart problems
Privigen can form blood clots during or after treatment, sometimes without known risks. This medication can make blood flow more slowly, so staying well hydrated before treatment is important. Your care team will watch you closely during treatment and might adjust your dose or stop the medication if needed.
Get emergency help right away if you have signs of a blood clot, such as chest pain, trouble breathing, swelling or warmth in a leg, or sudden weakness in your face, arm, or leg. These symptoms can be different depending on where the clot is, but all are medical emergencies.
Serious allergic reactions
Serious allergic reactions to Privigen are possible, including life-threatening reactions like anaphylaxis (closing of the throat). If you notice dizziness, a choking sensation, sweating, dizziness, nausea, swelling around your eyes, swelling of the lips or tongue, or difficulty breathing after using Privigen, get medical attention right away.
High protein levels, thick blood, and low sodium
After treatment with IVIG products like Privigen, some people might develop high protein levels in the blood, thicker blood, or low sodium levels. Your prescriber will check your lab results to monitor for these side effects and may adjust your dose if needed.
Swelling in the brain
- Risk factors: Doses of 2 grams/kg or higher | Receiving Privigen too quickly
Although rare, Privigen can cause swelling and inflammation of the brain, called aseptic meningitis. Symptoms can start within a few hours to 2 days after your infusion and usually go away within a few days after stopping the medication. Contact your prescriber right away if you have a severe headache, stiff neck, sleepiness, fever, light sensitivity, eye pain, nausea, or vomiting.
Breakdown of red blood cells
- Risk factors: Doses of 2 grams/kg or higher | Non-O blood group | History of anemia | History of lung or heart problems
Privigen can cause hemolytic, which means your red blood cells break down. Your prescriber will check your blood cell counts before and during treatment. Contact your care team right away if you feel unusually tired, have shortness of breath, dark urine, or pale skin.
High blood pressure
- Risk factors: History of high blood pressure
Blood pressure can rise during or shortly after a Privigen infusion and, in rare cases, become very high. This is more likely if you already have high blood pressure. Tell your prescriber if you have a history of high blood pressure or take blood pressure medications, and your care team will monitor your blood pressure before, during, and after your infusion. Contact your care team right away if you have a severe headache, chest pain, or vision changes.
Serious lung problem
Privigen can cause a rare but serious lung problem called transfusion-related acute lung injury (TRALI). TRALI happens when fluid builds up in your lungs after you receive this medication, usually within 1 to 6 hours of your infusion. Tell your prescriber right away if you have severe trouble breathing, signs of fluid in your lungs, low oxygen levels, or a fever.
Risk of infection
Because Privigen is made from donated human blood, there's a small risk it could contain viruses that make you sick. This risk is very low because donors are carefully screened and the medication goes through strict steps to remove or kill viruses. Still, contact your prescriber right away if you feel sick or notice symptoms like confusion, anxiety, or trouble with balance.
Privigen dosage
Typical dosage for Privigen
Your dose is based on your body weight.
-
Primary immunodeficiency (PI):
-
Idiopathic thrombocytopenic purpura (ITP):
- People ages 15 years and older: The typical dose is 1 gram/kg infused IV daily for 2 days.
-
Chronic inflammatory demyelinating polyneuropathy (CIDP):
- Adults: The typical starting dose is 2 grams/kg, split into smaller doses and infused IV over 2 to 5 days. The typical maintenance dose is 1 gram/kg infused over 1 to 2 days, once every 3 weeks.
Privigen contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Privigen will not be safe for you to take.
- Severe allergy to human immune globulin
- History of hyperprolinemia
- People with low immunoglobulin A who also have anti-IgA antibodies and history of an allergic reaction
