Do you know what the “expected” and “unexpected” side effects of intravenous immune globulin (IVIG) therapy are? More importantly, do you know how to manage them?
When undergoing IVIG therapy, some mild side effects are expected. An infusion consists of large amounts of antibodies being infused at once. When infused at a higher concentration, you can exhibit an immune system response to those concentrated antibodies. That’s why premedications are ordered before your infusion and why increased oral hydration is very important.
It is important to always take premedications as ordered. In general, acetaminophen and diphenhydramine are ordered and can be taken around the clock before and after your infusion to help minimize side effects. Of course, even with premedication, you can still expect to see some mild side effects. But, the degree of side effects varies from person to person, and is often influenced by the IG dosage and frequency.
Expected mild side effects and management:
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Headache: This should be alleviated with your premedication and with good hydration. A severe headache is not an expected side effect.
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Fatigue: Try to rest and listen to your body.
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Body aches, or feeling “flu-like”: Most people report this side effect the day after therapy.
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Chills and/or low-grade fever: A low-grade fever is below 100.5° Fahrenheit. If your fever is greater than 100.5° Fahrenheit, always call your doctor.
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Dizziness: Proper hydration and a repeat of premedications may help prevent this.
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Nausea: Your doctor may prescribe a medication to help nausea.
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Blood pressure changes: A nurse should be monitoring your blood pressure during the infusion. If you have any changes (high or low), the nurse will stop your infusion and recheck your blood pressure. After the nurse’s assessment, the nurse may continue the infusion or may call the doctor.
Note: Always make sure to take your prescribed blood pressure medication prior to your infusion.
Unexpected side effects and management:
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Impaired kidney function: This is indicated by dark colored urine during or after your infusion, difficulty urinating and/or a decrease in urine output. Immediately report this side effect to your doctor.
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Thrombolytic events (formation of clots): IVIG can sometimes increase this risk. If you experience chest pain, tightness or anything out of the ordinary, always report this to your doctor; this means you need immediate medical attention.
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Aseptic meningitis syndrome: Sometimes IVIG can irritate the lining of the brain causing severe headache. Symptoms of aseptic meningitis syndrome include neck rigidity, severe headache with sensitivity to light, and sometimes vomiting. Immediate medical attention is required.
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Anaphylaxis: This is a true allergic reaction. Symptoms include chest tightness, difficulty breathing, angioedema and swelling of the eyes, eye lids or lips. Always know where your anaphylaxis kit is and how to administer an EpiPen. Should this occur, you must call 911.
IVIG therapy has its fair share of side effects, but most patients agree the benefits outweigh the discomfort. Understanding what the expected and unexpected side effects are is a very important part of managing your ongoing treatment plan.
What side effects have you experienced?
