Normoglobin

Indications

Human immunoglobulin G (IgG) is a solution of antibodies collected from the blood plasma of many healthy donors. Given into a vein (IVIG), it is used to replace antibodies in people with primary or secondary immune deficiency who get repeated infections, and to treat certain immune conditions such as immune thrombocytopenia (ITP, a low platelet count), Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy (CIDP) and Kawasaki disease. Some products are given into the muscle or under the skin. It is a hospital medicine.

How It Works

IgG antibodies recognise and help destroy many bacteria and viruses, giving immediate protection to people who cannot make enough antibodies themselves. In immune and inflammatory conditions, high doses calm an overactive immune system, for example by reducing the destruction of platelets or nerve damage caused by the body's own antibodies.

Dosage and Administration

It is given only by a doctor or nurse, usually as a slow intravenous infusion, starting at a low rate that is increased if well tolerated. The dose depends on body weight, the condition being treated and blood antibody levels, and is set by the specialist, as prescribed. Replacement treatment is usually repeated every 3 to 4 weeks. Patients are watched closely during and after the infusion.

Interactions

• Live vaccines such as measles, mumps, rubella and varicella may not work well for up to 3 months or longer after immunoglobulin; tell the vaccinator.
• Blood tests for antibodies may give misleading results after treatment.
• Do not mix with other medicines in the same infusion line.

Contraindications

• Allergy to human immunoglobulin or any ingredient.
• IgA deficiency with antibodies against IgA, unless the doctor uses a suitable product.
• Some products should not be used in hereditary fructose intolerance (if they contain sorbitol or maltose).

Side Effects

Common effects during or after infusion include headache, chills, fever, tiredness, flushing, nausea, back or muscle pain and changes in blood pressure. Most are mild and linked to the infusion speed. Rare but serious effects include blood clots, kidney problems, a severe headache with neck stiffness (aseptic meningitis) and breakdown of red blood cells (haemolysis).

Get urgent medical help, or tell the nurse at once, if there is difficulty breathing, chest pain, swelling of the face or throat, fainting, a painful swollen leg, sudden weakness on one side, very little urine, dark urine or yellowing of the skin.

Pregnancy and Lactation

Immunoglobulins have been used in pregnancy and breastfeeding for many years without known harm to the baby. Use only if the doctor decides it is needed.

Precautions and Warnings

Patients should be well hydrated before infusion. Extra care is needed in older people and those with heart disease, kidney disease, diabetes, high blood pressure, obesity or a history of blood clots. Because it is made from human plasma, there is a very small theoretical risk of passing on infections, although donors are screened and the product is treated to inactivate viruses. Each batch number should be recorded.

Overdose

Too much may cause fluid overload and thickening of the blood, especially in older people or those with heart or kidney disease. Treatment is supportive by the medical team.

Therapeutic Class

Immune sera and immunoglobulins; normal human immunoglobulin.

Storage

Store in a refrigerator at 2 to 8°C, or as stated on the pack. Do not freeze. Protect from light. Hospital product: store and handle as directed on the pack.