Pre-infusion Tips and Tricks for IVIG and SCIG Infusions
By Nufactor - May 27, 2022

It can be overwhelming for anyone to receive a new medical diagnosis. Being prescribed Immune Globulin infusions has the potential to create even more anxiety. In this blog, I will discuss precautions taken by Nufactor as well as tips and tricks for patients receiving IgG through Nufactor. Understanding the nuances associated with any medication is an important aspect of medical care. Pre-planning for Immune Globulin infusion is an essential part of safe and efficient patient-experiences and outcomes.

Intravenous Immune Globulin (IVIG) and Subcutaneous Immune Globulin (SCIG) while different in the route of administration, share some precautions and potential side-effects that may be prevented or minimized through thoughtful pre-infusion precautions.

IVIG and SCIG: ALL PATIENTS

One part of the patient experience that might be deemed overwhelming is clinical intake and ongoing follow-up. Regardless of the route of administration, precautions will be exercised pre-infusion and on an ongoing basis as needed prior to each infusion. You should expect to be asked many questions as well as to receive pre-infusion suggestions

• Minimize distractions in your home when possible. Partition pets in an area away from the infusion area. Arrange childcare, when possible, for at least the first hour of an infusion visit. Limit the number of people in the room being used to infuse.
• Get adequate sleep on infusion days.
• Consider your dietary choices. Avoid overeating, eating spicy or greasy food. Avoid gluten or lactose if intolerant. Avoid any food sensitivities during IgG infusion courses to minimize gastrointestinal (GI) distress such as GERD (gastro-esophageal reflux disorder) , epigastric discomfort, or diarrhea. This will assist your nurse in identifying IgG-related GI sensitivities if other causative factors are limited.
• Headache prevention can be managed in a similar manner. Consider factors known to cause you headaches in a general sense. This would enable your nurse to differentiate an IgG related headache from other causes. Eating small frequent meals and supplementing with snacks will maintain a stable blood sugar. Maintaining 25-30% of daily caffeine intake in addition to the recommended 64 ounces of water-based pre-IgG hydration will minimize the chance of a caffeine-withdrawal headache, particularly for multi-day infusion patients. During allergy season if you are prone to sinus-headaches, discuss an appropriate medication regimen with your physician. Migraine headache sufferers require additional care and coordination. It may be advisable to coordinate a headache-prevention plan with your pain management physician/neurologist and your Nufactor pharmacist.
• You can expect your infusion nurse to call to call you at least one day prior to an infusion visit to review some instructions and ask some questions. This may include:
1. Asking if your medication has arrived and discussing how to handle it
2. Checking to be certain you have your anaphylaxis kit in your home. Please call Nufactor if you cannot locate it.
3. A review of your medications including pre-medications when prescribed by your physician.
4. A reminder to take your regular daily medications i.e. blood pressure pills.
5. Proper oral hydration: 64 ounces of water (e.g., 8 x 8 ounces glasses) starting 1 - 2 days prior to, day of and 1 - 2 days after dose/course.
6. Avoid alcoholic beverages starting 1 - 2 days prior to, day of and 1 - 2 days after dose/course.
7. If your medication is refrigerated, take out to warm to room temperature 1 - 8 hours prior to infusion. IVIG should never be microwaved or heated in any other manner.
8. Report if your temperature is greater than 100.5° F to Nufactor.
9. A review of your status since last infusion, including any side effects, illness, doctors’ visits or hospitalizations.
10. Read your New Patient Packet at your leisure. Your nurse may review some sections with you while in your home.
11. If your doctor has ordered bloodwork, expect your nurse to draw it after inserting your IV.
12. Your nurse will assess baseline vital signs: BP, pulse, respirations and temperature.
13. Nurses carry their own BP cuff and thermometer; if you prefer that your own be used, please have it available.
14. Expect that your nurse is required to stay with you for the entire infusion.

Specific SCIG pre-infusion tips: Prior to the visit, instruct patients to:

• Wear appropriate, comfortable clothing.
1. For abdominal sites, drawstring waisted shorts, pants, or skirt and a stretchy top that will stay up when lifted.
2. For thighs, shorts or skirt.
3. For backs of arms, a short-sleeved shirt with rollable or stretchy/elasticized sleeves.
4. For posterior upper/outer hips, low waisted drawstring shorts, pants, or skirt.
• Refer patient to a SCIG site body map illustration and explain the use of a lidocaine numbing cream and occlusive dressing if patient chooses to include this step. *Please note: this step must take place 1 hour prior to sc needle insertion in order to be effective.
• Select an area to infuse in a well-lit area with a clean table for supplies. Wear reading glasses if needed.

Above all else, communication between all disciplines is critical to the delivery of efficient and safe care. IgG infusions are generally well tolerated. We utilize a team approach to patient care. Nufactor encourages open lines of communication between patients, infusion nurses, and all Nufactor Customer Service Specialists, pharmacists, and nurses. Please do not hesitate to reach out with any pre-infusion questions or concerns.

Phone: (800) 323-6832
Referral Fax: (855) 270-7347