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immune globulin intravenous and subcutaneous

immune globulin intravenous and subcutaneous
Drug Name Form Strength Ambulatory Use Only Ambulatory Restrictions Inpatient Restrictions Non-Formulary
Gammagard SOLUTION, INJECTABLE 10%        
Gamunex-C SOLUTION, INJECTABLE 10%        
VIEW MORE immune globulins, immunologic agents

HFHS approved uses for Intravenous Immune Globulin (IVIG)

Disease

Recommendation
CIDP where plasmapheresis, corticosteroids, or other immune-modulating agents are not clinically appropriate 0.4 g/kg/day x 5 days, or 1 g/kg x 2 days
Guillain-Barre’ Syndrome where plasmapharesis is not clinically appropriate 0.4 g/kg/day x 5 days
HCT recipients, patient with multiple myeloma or CLL with recurrent (>/=3 /year) bacterial, sino-pulmonary infections with documented IgG<400mg/dL.

0.4 g/kg Q 3-4 weeks

Give monthly IVIG to keep IgG > 400-500 mg/dL.
Idiopathic Thrombocytopenic Purpura with Active Bleeding 0.4 g/kg/day x 5 days, or 1 g/kg x 1-2 days
Myasthenia gravis Crisis where plasmapheresis is not clinically appropriate 0.4 g/kg/day for 5 days, or 1 g/kg x 2 days
Multifocal Motor Neuropathy (MMN) 0.4 g/kg x 5 days, or 1 g/kg x 2 days
PANDAS [or post-infectious encephalitis or disseminated encephalomyelitis] in current & established HFHS pediatric patients Initial dose: 2 g/kg over 5 days, then 1-2 g/kg every month x 3-6 months, and then once every 3-6 months thereafter. Dosing and frequency after initial dose is lower and individualized
Primary Immunodeficiency Diseases with documented IgG<400mg/dL and documented severe lung disease(s) 0.4-0.6 g/kg Q 21-28 days [titrated to response]

Solid Organ Transplant:

Antibody mediated rejection – All organs, biopsy positive and diagnosed early in the rejection process 		0.1 – 0.5 g/kg for all organs
Last updated: Feb. 15, 2021
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