A Patient Guide to Immunoglobulin Therapy

Stephanie Bruce, Option Care

Intravenous immunoglobulin (IVIG) is a safe, effective, and common therapy prescribed by many physicians to treat Myasthenia Gravis. Once your physician has prescribed IVIG therapy, you have the option of receiving this treatment at the hospital infusion center or at home. Both locations are a safe way to receive this therapy, and you and your physician can make this decision together.

The first step towards receiving IVIG therapy is to ensure that your insurance company has authorized it. The authorization process is a critical step to receiving your treatment because IG is an expensive therapy. Whether you are receiving your infusions at home or in the hospital infusion center, your physician's office staff will provide assistance with obtaining a written insurance authorization. Authorizations can sometimes take up to a few months to obtain and typically last six months to one year.

IVIG therapy is predominantly administered intravenously (when a needle is placed directly into a vein). The needle will be placed by a nurse, who will be in attendance during your whole infusion. The length of your infusion will depend on a few factors: the dose and the infusion rate. Because immunoglobulin is dosed according to the patient's body weight, the amount received as well as the rate of the infusion will determine how long the infusion will last. Your doctor, pharmacist, and nurse will determine the infusion rate for you, via an infusion pump, and infusions typically last from 2 to 5 or more hours.

While IVIG is extremely safe, several side effects can occur, and these side effects are usually related to the rate of the infusion. Most will occur within the first 30 to 60 minutes of the start of the infusion. The severity of reactions can range from mild to severe, however most side effects are very mild and transitory. The most common side effects are headache, nausea/vomiting, and fever/chills. Your physician and also your IG provider will review your medical information to ensure that your IG therapy is appropriate for you, minimizing side effects. Taking premedication such as Benadryl and prednisone may help to avoid side effects, and will also be prescribed by your doctor. Drinking plenty of water (6-8 8oz. glasses per day) the day before, during, and the day after your infusion is also important. Also try to avoid caffeinated beverages.

During your infusion, whether at home or at an infusion center, your nurse will stay with you during the whole infusion, periodically monitoring your vital signs and progress. Make sure to tell her immediately if you are starting to experience any type of side effect. Be prepared with a book or something else to do to pass the time. Also, remember to eat well balanced meals and continue your normal daily activities on the day of and surrounding your infusions.

IVIG therapy is mostly prescribed on a monthly basis, however each patient may respond a little differently to treatment, and your schedule may differ. Your doctor will evaluate your response and can customize your treatment plan to optimize your outcome. Remember, feeling the benefits of your IVIG infusion can take a little time. Make sure to communicate with your doctor, and together you can customize your treatment plan with IVIG and live life to the fullest.