Nursing Notes
By Nufactor

Infusion Nursing Notes by Nufactor provides education, resources and support to promote successful patient therapy within the infusion nursing community.

IVIG Side Effects

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:

  • Headache: This should be alleviated with your premedication and with good hydration. A severe headache is not an expected side effect.

  • Fatigue: Try to rest and listen to your body.

  • Body aches, or feeling “flu-like”: Most people report this side effect the day after therapy.

  • 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.

  • Dizziness: Proper hydration and a repeat of premedications may help prevent this.

  • Nausea: Your doctor may prescribe a medication to help nausea.

  • 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:


  • 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.

  • 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.

  • 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.

  • 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?

Comments (5) -

  • Reid Carlson

    2/28/2014 8:36:27 AM |

    Your listing of side effects is a great help. A lot of care givers don't share this info or don't know. A person receiving IVIG is scared,apprehensive, and asking themselves am I doing the right thing? The adverse reactions or complications can cause anxiety or fear until you have been there.Each time is different.After 1 dose I had a itchy rash on both forearms as well as other common side effects. The disease is so rare most Dr.'s don't know the answer.
    The benefits outweigh the side effects in my case,as I now have a return of equilibrium and some memory, which is better than flu symptoms or the headache and fatigue.

  • Cindi Vokey, RN, BSN

    3/5/2014 8:52:55 AM |

    Good Morning Reid,
    Thank you for your comment!  We are very happy to hear our blog has been helpful to you.  It is our goal to provide help and education to patients and families who are navigating their way through therapy or a diagnosis.  
    I'm happy to hear the benefits of IVIG outweigh your side effects.  Hopefully you have been able to minimize side effects during and after treatment.
    Please feel free to reach out to NuFACOTR onthis blog if you have any questions or concerns about your diagnosis or treatment.  We are here every step of the way!

  • SC

    8/5/2014 9:02:49 AM |

    My son was treated with IVIG for ITP at 16 months of age ... as a 19 year old adult, he has had two Staph infections that required lancing, as well as 3 post-op infections following removal of wisdom teeth. Is there any correlation between IVIG and long term effects on the immune system?

  • Graham Somerville

    2/2/2015 12:51:57 AM |

    Really glad I found this site and the information within. I have been undergoing IVIG over the last 6 years without any premeds but after the latest dose I did really wonder whether the benefits of having treatment every 12 weeks outweighed feeling rotten for almost a week after the infusion. I have been booked in for premeds before my next dose so hopefully that might do the trick. I will report the findings back here when available.

  • Lauren

    5/7/2015 4:23:29 AM |

    Yesterday I had my first IVIG infusion. I was extremely nervous. The anticipation was much worse than the treatment itself. One thing I read prior to my first infusion was to stay hydrated. Personally I think this is the best advice I could both give and receive. I drank 32 oz prior and 16 oz every hour (4 hours total).

    The nurse informed me that many times because of our low immunoglobulins we often times have weak vains. That said, the ONLY problem I personally encountered was a collapsed vain the first hour. Immediately my arm went numb and was swollen a great deal, but after apply heat it went down almost 100%... Luckily my other arm took the vain and I made sure to sit still and did not move around too much. (The hardest part is keeping still for 4 hours straight). The Benadryl drip will make you so tired though which will help in terms of arm movement.

    After the fusion I felt fine. I noticed I was a bit gaseous and very sleepy. Last night, into today I noticed I've been sweating a lot, and shortly thereafter get a bit chilly. As said in the post before the good outweighs the bad for me this far. Personally none of these side effects can possibly be worse than being sick ALL the time. I am blessed to have finally figured out what is wrong with me.

    As hard as it is STAY POSITIVE. Treatments may or may not get harder for me overtime but I know I'm on my way to a healthier happy me. Best of luck to everyone you will be OK!

Pingbacks and trackbacks (1)+