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1. What is IVIG or Intravenous Immune Globulin?
IVIg is a collection of Y shaped antibodies called IgG as shown in the above cartoon.
IVIg is a plasma product formed by taking antibodies from about 20,000 donors and mixing them together. IVIg
has proven effective in several immune system disorders,
including nearly all autoimmune conditions like CIDP & GBS.
The sooner you treat the patient with IVIg the better the
results. The window of opportunity usually within the first 18 months during which IVIg administration is ideal. The longer you wait the longer it will take for IVIg to work.
After being exposed to toxins and poisonous chemicals including
carbon monoxide the body's immune system may mount a attack on
the body. This autoimmune attack can be reversed by IVIG.
2. How does IVIG work?
For immune deficiency where the body does not make enough antibodies, IVIG supplies them. For autoimmune disorders like GBS & CIDP, there is a abnormal autoantibody being formed which is inactivated by IVIG.
Patients with autoimmune disorders like CIDP also are deficient in antiidotype antibodies. IVIG has antiidotype antibodies & improve the patients condition. IVIg has a higher concentration of antiidotype antibodies.
3. How long does it take to a IVIG treatment to have a effect?
After IVIg infusion, patients may see a response in their disease within 24- 48 hours. Some patients will have to wait 3-4 weeks to see an effect after IVIg. In a few no effect may be seen following IVIg infusion. If 4-5 cycles of IVIg do not show any response then change the brand or increase the dose . The NIH recommends that if no response is seen with IVIg infusions, then add steroids to the treatment plan.
Everyone is slightly different as it depends on how long has the disease process been going on.
4. Why is IVIG so expensive?
IVIg is obtained from plasma, donors are paid then the plasma is sent to a processing centers for mixing, antibody removal, chemical treatment and filtration to remove viruses. This is followed by the products to be freeze dried. All this ends up for IVIG to be priced at $ 48 to $ 68 a gram. A single IVIg infusion costs about $3000 for a child and 10,000 for an adult. For a child the cost of IVIg is low because only a few grams are used. The price of IVIg in India is $25 a gram. In Pakistan IVIg costs 20 a gram. IVIg can be bought from China at 45-10 A Gram. Lowest price is in Bangladesh Baygam from Germany for $10 a gram. This low price is due to expired bottles brought form Saudia Arabia.
5. How is IVIG administered?
IVIG is mixed in a bag and a tube runs from it to a vein usually in the arm. The recommended way to infuse IVIg includes a pump. Usually IVIg is given at a rate of 100 cc/ hour to 200 cc/ hour.
The rate is of IVIg is reduced for any problems such as headaches, rash, fatigue, hypertension or hypotension. For an adult's infusion of IVIg is usually given over 5 to 6 hours. Dr Engle at USC recommends a rate of 100cc/hr of a 7.5% solution.
6. What are the common side effects OF IVIG?
Women with history of Migraines or SLE may get a headache after IVIg . Fatigue similar to getting a Flu, which is due to antibodies interaction. Rash is seen after IVIg and it is recommended they take Benadryl or even steroids to avoid this. There are a lot of antibodies in IVIg and some may result in odd reactions. After IVIg if odd symptoms are seen then use of steroids usually helps. Blood pressure changes are also seen.
7. How can one reduce the side effects of IVIG?
Remember to drink 7 glasses of wateror juice a day for hydration before starting the IVIG treatment and continuing this a month after the last IVIg infusion. Remember to take a baby aspirin to prevent thrombophelebitis after IVIg. Check with their doctors if they can use aspirin and should not take this if they are on coumadine or have bleeding disorders. Do not use asprin if you have stomach ulcers. Low dose prednisone will reduce side effects like headaches.
8. Where is the IVIG treatment given?
IVIg can be given at home, in a doctors clinic or a hospital outpatient unit. Some patients have even taken this at work.
9. What is the frequency of the IVIG treatment given?
Usually a dose of IVIg is 2 grams per kilogram is divided into five doses and 400mg/kg is infused daily for 5 days. (For the first time only) Some patient can tolerate consecutive days of IVIg. It is recommended that young women take this on alternate days.
Please continue to next page for diseases treated and brand information of IVIg
For CIDPUSA Foundation
IVIG is used in neurology .IVIG is used for alzheimers. IVIg is used for asthma. IVIg is used for pemphigus. IVIg is used to treat vasculitis. IVIg is used in arthritis. IVIg is used for polyneuropathy. IVIg is used to treat renal disease. IVIg is used for gastrointestinal problems. IVIg can be used for almost 101 diseases. In immune deficiency IVIG is used to make the immune system stronger. So IVIg is used in cancer, IVIg can treat thrombocytopenia. IVIg is used in Kawasaki disease and low platelet count will increase the platelet count with Rx.