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Subcutaneous Immune Globulin

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Subcutaneous Immune Globulin, Subcutaneous Immunoglobulin, Vivaglobulin, Hizentra

  • See Also
  1. Intravenous Immunoglobulin
  • Indications
  1. Primary Immunodeficiency
  • Contraindications
  1. IgA Deficiency
  • Mechanism
  1. Pooled donor plasma extracted for IgG antibodies and administered as an subcutaneous Blood Product
  • Dosing
  1. Precautions
    1. Maintain adequate hydration to reduce the risk of Acute Kidney Injury
  2. Primary Immunodeficiency
    1. Dose 100 to 200 mg/kg SQ weekly
      1. Adjust frequency adjusted based on IgG trough levels
    2. Conversion from prior Intravenous Immunoglobulin dosing (IVIG)
    3. SQ Dose = (prior IV dose) * 1.37 / (nWeeklyDoses)
  3. Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
    1. Maintenance: 0.2 g/kg SQ each week
  • Adverse Effects
  1. Thrombosis (black box warning)
    1. Caution in Hypercoagulable states and cardiovascular disease
  2. Bloodborne Communicable Disease
    1. As with all donor Blood Products, carefully screened in U.S., but risk is not 0%
    2. Potential risk of Creutzfeldt Jakob Disease (or its variant)
  3. Acute Kidney Injury
    1. Caution with concurrent Nephrotoxic Drugs, Chronic Kidney Disease
  4. Transfusion-Related Acute Lung Injury (TRALI)
  5. Aseptic Meningitis syndrome
  6. Bloodborne Communicable Disease
    1. As with all donor Blood Products, carefully screened in U.S., but risk is not 0%
    2. Potential risk of Creutzfeldt Jakob Disease (or its variant)
  7. Other common effects
    1. Headache
    2. Nausea or Vomiting
    3. Fever or chills
  • Safety
  1. Pregnancy Category C
  2. Unknown safety in Lactation
  3. Monitoring
    1. Renal Function tests and Urine Output
  • Resources
  1. Subcutaneous Immune Globulin - Hizentra (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7b58f5ff-0316-49a3-b585-1f6003ddb953
  • References
  1. (2009) P T 34(6):2-21 +PMID: 19572042 [PubMed]