Are At-Home IVIG Treatments Right for You?

Intravenous immunoglobulin (IVIG) is also known as gamma globulin. IVIG is used to treat a variety of autoimmune conditions, including myasthenia gravis (MG). IVIG boosts the number of healthy antibodies and strengthens the immune system.¹

IVIG is delivered into a vein through a needle or a catheter. This can be done in a hospital, at home, or at an infusion center. It may take a few hours or a few days.²

IVIG improves MG symptoms quickly (in 1 or 2 weeks). It works as well as plasma exchange to improve symptoms. But it is safer than plasma exchange during an exacerbation.¹

When is IVIG given?

IVIG may be prescribed when a person with MG:³

• Has a myasthenic crisis
• Has severe MG
• Is not getting results from other MG drugs
• Cannot stand the effects of other MG drugs
• Is getting ready for surgery (to strengthen their immune system)

Many people use IVIG for short periods to give other medicines time to begin working. Others may use IVIG regularly if other MG drugs do not control their symptoms or they cannot take drugs like steroids. Using IVIG regularly is called maintenance therapy.³

Receiving IVIG at home

When IVIG is given to help reverse or stop a myasthenic crisis, it is delivered in the hospital. This is because the person needs close monitoring and possibly help breathing. But people who receive IVIg as maintenance therapy may be able to take their infusions at home.^1-3

People who are good candidates for home therapy have received IVIG in the hospital or doctor’s office without problems. Having kidney problems, heart disease, or a history of blood clots and stroke may mean you are not a good candidate for home infusions.⁴

Many people prefer receiving IVIG at home because it reduces the amount of time away from work, school, and hobbies. Receiving IVIG in the hospital is more expensive and time-consuming.²

Someone from your healthcare team will assess you and your living situation to determine whether home infusions are a safe option. You will need to be capable of following very specific instructions. You may need to be capable of monitoring your own:^2,4

• Blood pressure
• Heart rate
• Temperature
• Breathing rate

Your healthcare team may recommend an infusion center or your doctor’s office as an alternative to the hospital or your home.²

You also may be able to receive infusions at home if a home health worker is there.¹

Possible side effects

If you choose home IVIG infusions, a doctor, nurse, or specialty pharmacist will train you to handle the most common side effects of IVIG, which are:^1,4

• Headache
• Rash
• Muscle pain
• Chills
• Fever
• Shortness of breath
• Nausea

Your healthcare team should also train you about signs of serious reactions and give you a number to call if you have concerns.⁴

You can reduce your chances of side effects by sticking to the same brand of IVIG, warming the fluid to room temperature, and slowing how fast you receive your injection. You should be well hydrated by drinking plenty of water the days before, the day of, and the days after your receiving IVIG.^4,5

It may take time to learn which strategies work best to decrease side effects for you when receiving IVIG at home. For example, some people need to divide a large dose into smaller doses that are given over several days. You may also want to take a pain reliever before starting your injection. Pain relievers include acetaminophen (Tylenol) or NSAIDs (Advil, Motrin).⁵

It is rare, but a serious allergic reaction called anaphylaxis may occur during IVIG. For safety, your doctor may prescribe epinephrine (EpiPen®) for you to have on hand in case this reaction occurs at home.⁴