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Managing IG’s Side Effects
Side effects are a part of many drug treatments which usually range from mild to
moderate reactions that are expected although undesired. IVIG’s side effects may
include headache, flushing, chills, muscle pain, wheezing, rapid heart rate, lower back
pain, nausea and low blood pressure. Headaches, and the more severe migraine, are
typically more common side effects. Fortunately both forms can be overcome by
treating with antihistamines, NSAIDS and steroids both before and after an infusion.
Proper hydration also plays a role in managing this particular side effect. Changing the
form of treatment can also help alleviate this discomfort. Different formulations of IVIG
5% and 10% can make a difference as can switching to subcutaneous IG (SCIG).
For SCIG patients, the most common side effects include headaches and local
irritation at the needle site causing redness, swelling, itching and blanching. Fortunately,
most reactions decrease with time as the body becomes accustomed to the therapy.
Patients bothered by these reactions can also help by using ice or heat at the needle
site or applying a topical anesthetic cream thirty- to sixty-minutes prior to the infusion.
Needle placement can also be a cause for these reactions which can be discussed and
changed with the provider’s assistance.
Occasionally serious side effects do occur in patients treated with IVIG but most
can be reduced by screening the patient for predisposing factors that may lead to
complications. Serious side effects may include acute kidney failure, blood clots,
Stevens-Johnson syndrome, serum sickness, aseptic meningitis and anaphylaxis.
Treatment with epinephrine (epi-pen), benadryl and other therapies can often mediate
these severe reactions immediately.
In order to better understand these reactions and protect patients the FDA
encourages both patients and healthcare professionals to report any adverse drug
reactions. The FDA is particularly interested in suspected adverse drug reactions in new
drugs and suspected severe adverse drug reactions for any drug, no matter when the
drug entered the market. Manufacturers of newly licensed drugs are also required by
the FDA to perform post-marketing risk management collecting information on adverse
reactions in a more proactive manner.
Many patients are fortunate to receive therapy through IVIG for their particular
disease as it is one of the safest biological products available. Although severe side
effects have been reported they are certainly rare. Luckily, almost all side effects can
either be safely controlled or eliminated altogether.
For more information on this topic see the April/May 2010 issue of IGLiving Magazine
online at http://www.igliving.com under Feature Articles.