Gammagard – Immune Globulin Intravenous (ivig)

Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041

WARNING Intravenous immune globulin has been reported to be associated with kidney disease, kidney failure and death. Patients at risk for these conditions include any amount of pre-existing kidney disease, diabetes mellitus, age > 65, volume depletion, infection and patients receiving medications that can damage the kidneys.

Uses For This Medication

  • Immune globulin (IVIG) is used to prevent and/or treat certain illnesses, or disorders of the immune system, that can occur when your body does not produce enough of its own immune globulin antibodies to prevent those diseases or infections. These diseases include but are not limited to congenital X-linked agammaglobulinemia, common variable immunodeficiency, Wiskott-Aldrich syndrome, and severe combined immunodeficiencies.
  • IVIG is also used for treatment of idiopathic thrombocytopenic purpura (ITP), a condition that occurs when the body destroys its own platelets, resulting in low platelet levels.
  • IVIG is also used to treat other diseases such as chronic parvovirus B19 infection, chronic inflammatory demyelinating polyneuropathies, dermatomyositis, Kawasaki disease, Guillain-Barré syndrome, hyperimmunoglobulinemia E syndrome, multiple sclerosis, Lambert-Eaton myasthenic syndrome, and multifocal motor neuropathy.
  • This medication may also be given for other conditions as determined by your doctor.
  How This Medication Works IVIG belongs to a group of medications known as immunizing agents. IVIG is a solution that contains immunoglobulins (also known as antibodies) to help protect the body against infectious agents, such as viruses or bacteria, that can cause disease or infection. When IVIG is used, it provides a person with additional antibodies from an outside source (other than their own body) to help fight off or prevent disease or infection.   Benefits Of This Medication IVIG can provide a source of immunoglobulin G (IgG) antibodies to patients with immunodeficiency disorders who do not produce enough immunoglobulin. Since IVIG is replacing antibodies within the body, it can prevent bacterial infections and can make infections less severe in some patients. In patients with idiopathic thrombocytopenic purpura (ITP), IVIG can decrease the risk of serious bleeding by temporarily preventing the further destruction of platelets. In children who have Kawasaki disease, IVIG can prevent the development of serious heart problems.   Who Should Not Take This Medication You should not take this medication if you:
  • Are allergic to immune globulin. 
  • Have a severe immunoglobulin A (IgA) deficiency.
  Precautions to be Aware of Before Taking This Medication

Allergy related precautions

IVIG may cause allergic reactions, including anaphylaxis, a severe form of allergic reaction that can be life threatening. These allergic reactions can cause shortness of breath, difficulty breathing, and a decrease in blood pressure. Your doctor or healthcare provider will watch you carefully during and after the administration of immune globulin to make sure that you do not experience any allergic reactions. If an allergic reaction occurs it is treatable with medications.

Blood related precautions

IVIG can cause a serious blood condition called hemolytic anemia. This condition can lead to very low red blood cell levels. Your doctor or healthcare provider will check your red blood cell levels regularly through blood tests while you are on this medication to make sure that you do not develop this condition.  

Infection related precautions

  • Rarely, a syndrome called aseptic meningitis syndrome (AMS) has been reported in patients receiving treatment with IVIG. The syndrome usually starts within several hours to two days following IVIG treatment and symptoms include severe headache, stiffness of the neck, drowsiness, fever, intolerance to light, painful eye movements, and nausea and vomiting. Symptoms usually disappear within several days of stopping IVIG treatment. If you develop any of these symptoms, let your doctor or healthcare provider know right away.
  • IVIG is made from human blood products. Although unlikely, these blood products can contain infectious agents, such as viruses, that can cause disease. All blood products are carefully screened to make sure that they do not contain viruses or bacteria. However, since screening processes are not perfect, the risk of transmitting infectious agents in blood products is still present.
 

Organ related precautions

  • This medication can cause changes in the ability of your kidneys to work normally. These changes can be serious and have led to kidney failure in some patients. You may be more likely to develop kidney problems with IVIG if you already have kidney problems, have diabetes, are over the age of 65, or are already receiving medications that can damage the kidneys. Your doctor or healthcare provider will check your kidneys regularly, usually through blood tests, while you are on this medication to make sure that your kidneys are working properly. If you have any kidney problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects. In addition, if you notice a decrease in urine output, sudden weight gain, retaining of fluids (swelling in the feet or hands), or shortness of breath, let your doctor know right away as these may be symptoms of kidney problems.
  • Rarely, a condition called Transfusion Related Acute Lung Injury (TRALI) has been reported in patients receiving treatment with IVIG. This condition usually occurs within 1-6 hours of receiving IVIG. Signs and symptoms of TRALI include problems breathing, swelling of the lungs, low blood oxygen levels, and fever. Your doctor or healthcare provider will monitor you carefully to make sure that you do not develop this condition.
 

Miscellaneous precautions

  • Blood clots have been reported in patients receiving IVIG. Contact your doctor or healthcare provider immediately if you experience pain or swelling in your leg(s) or if you experience sudden shortness of breath or difficulty breathing, sharp chest pain, sudden and severe headache, or pain that radiates down the shoulder and arm. In addition, if you have a history of blood clots, stroke or heart disease, you should let your doctor or healthcare provider know.
  • Do not receive any immunizations (vaccinations) while on this medication without your doctor or healthcare provider’s approval. This medication can increase your risk of infection. For certain immunizations, you may develop the infection that the immunization is intended to prevent. Generally, it is recommended that patients receiving IVIG should not receive immunizations for at least 14 days before, and up until at least three months after receiving IVIG.
 

Patient specific precautions

• IVIG is commonly used in children for the treatment of Kawasaki disease and appears to be safe and effective.  

Pregnancy and breastfeeding precautions

  • When taking this medication, you should use effective birth control to prevent pregnancy. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant since this medication may cause fetal harm.
  • It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided.
 

Medication and Food Interactions

Before using this medication, tell your doctor or healthcare provider of all prescription or over-the-counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval. Possible interactions can occur with IVIG and the following medications:
  • Live vaccines, such as measles, mumps, and rubella
 

Side Effects

  • All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
  • You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
  • Side effects can occur when immune globulin is given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who were treated with IVIG alone.
 

More common side effects

  • Headache
  • Fever
 

Less common side effects

  • Fatigue
  • Nausea, vomiting
  • Chills, flushing
 

Rare side effects

This is not a complete list of the rare side effects reported with IVIG. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
  • Allergic reactions, including anaphylaxis (see Precautions To Be Aware Of Before Taking This Medication) 
  • Kidney problems (see Precautions To Be Aware Of Before Taking This Medication) 
  • Blood clots (see Precautions To Be Aware Of Before Taking This Medication) 
  • Dizziness
  • Wheezing, chest tightness, cough
  • Meningitis
  • Hives,rashes, skin conditions 
  • Back pain
  • Chest pain
  • Muscle cramps
  • Changes in blood pressure 
  • Seizures (convulsions), tremor (shaking), loss of consciousness 
  • Abnormal destruction, or breaking, of red blood cells 
  • Liver problems
 

How To Take This Medication

  • This medication is usually given by injection into a vein by a healthcare professional. This medication can be given in different doses depending on your weight and your type of condition.
  • In the unlikely event of an overdose of this medication contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.
 

Proper Storage

  • It is unlikely that you will need to store this medication.
  • Keep this medication out of the reach of children or pets.
  • Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.