Normal immunoglobulin (IVIG / SCIG)

How it works

As replacement therapy it restores protective IgG antibody levels, while at higher immunomodulatory exposure it modifies immune and inflammatory responses through several mechanisms including Fc-receptor and complement effects.

Prescribing in practice

• Thromboembolic events, acute kidney injury, aseptic meningitis and haemolysis can occur, so ensure adequate hydration and assess thrombotic and renal risk, infusing at the recommended rate.
• It is a blood-derived product, so batch and product details must be recorded for traceability and use follows national demand-management guidance.
• Anaphylactic reactions can occur, particularly in patients with IgA deficiency and anti-IgA antibodies.

Monitoring

Monitor renal function, haemoglobin and infusion-related reactions, and in replacement therapy review trough IgG levels and infection frequency.

Counselling the patient

• This medicine is made from human plasma and replaces or modulates antibodies.
• Report headache, dark urine, reduced urine output or any reaction during or after the infusion.

Evidence & guidelines

Its use is governed by national immunoglobulin demand-management guidance, which defines accepted clinical indications in the UK.