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Posted on 19. April 2012

Treating Infusion Side Effects

by Carla Schick

Many patients who use either intravenous immunoglobulin (IVIG) or subcutaneous IG (SCIG) therapy to control their conditions are familiar with the occasional side effects that accompany their infusions. All medications come with adverse reactions that, although unwanted, are not surprising. And IVIG is no exception. But patients understand that while the side effects are by no means easy to tolerate, the benefits of their infusions far outweigh the consequences of mild to moderate side effects.

The good news is that most if not all side effects can either be treated or eliminated. Knowing what side effects, from mild to severe, to watch for during and after immune globulin infusions can help patients and their caregivers anticipate treatment changes to alleviate or halt a negative outcome.

Mild to Moderate Side Effects
Mild to moderate side effects usually occur because of the way in which the therapy is administered, and those can easily be managed. Adverse reactions from IVIG infusions can include headache, chills, flushing, myalgia, wheezing, tachycardia, lower back pain, nausea and hypotension. More severe headaches can include migraines.

An IG Living magazine article titled “Understanding and Treating IG Side Effects” by Ronale Tucker Rhodes and Kris McFalls mentions that patients can overcome headaches and migraines by treating with antihistamines, non-steroidal anti-inflammatory drugs (NSAIDs) and steroids both before and after an infusion, as well as by hydrating before, during and after an infusion.

Other treatment options are also available. In another IG Living article titled “Side Effects of IG,” authors Kris McFalls and Nancy Creadon suggest that most patients experiencing these side effects can be helped by slowing down the rate of infusion. For instance, one patient who suffered from migraines after her infusions was prescribed a small dose of prednisone by her physician to be taken the day before the infusion, the day of the infusion and the day after the infusion. In addition, the rate of her infusion also was decreased. With these adjustments, the patient still experienced mild headaches, but she no longer suffered debilitating migraines.

Another patient who experienced severe migraines after IVIG infusions was given Tylenol, Benadryl and steroids, as well as a migraine prophylaxis prior to her infusions to lessen her side effects, but the headaches continued. Her doctor tried a 5% IVIG formulation and then a 10% formulation, but the migraines persisted. The patient was then switched to SCIG, which successfully stopped her recurring migraines, and no premedications were required.

SCIG patients can also experience side effects including headaches, redness, swelling, itching and blanching at the needles sites. But these usually diminish as the body becomes accustomed to the treatment. Using a topical anesthetic cream 30 to 60 minutes prior to beginning the infusion can be beneficial. Also, applying ice or heat to the needle sites can provide comfort to local irritation. However, if a needle is not inserted properly, it is possible that some of the fluid can leak into the surrounding tissue rather than into the subcutaneous space. If this is the case, then a provider trained in SCIG therapy should be able to help the patient find the source of irritation and eliminate possible causes.

Severe Side Effects
Thankfully, severe side effects are uncommon and most can be reduced by testing the patient for factors predisposing them to complications. Severe side effects can include acute renal failure, thrombosis, Stevens-Johnson syndrome, serum sickness, aseptic meningitis and anaphylaxis. The most serious IG-related headache comes from aseptic meningitis, which can cause severe headache, photo sensitivity, chills, nausea, vomiting, fever and/or painful eye movement. To prevent or lessen the effects of aseptic meningitis, the prescribing physician may recommend antihistamines, NSAIDS and steroids both before and after an infusion.

Anaphylaxis, another rare severe side effect, is a rapidly progressing, life-threatening allergic reaction that can be caused by either IVIG or SCIG infusions. Anaphylaxis may require the administration of corticosteroids and antihistamines, and in very severe cases, administration of epinephrine.

There are two types of anaphylaxis reactions: anaphylactic and anaphylactoid. According to the article “Understanding and Treating IG Side Effects,” an anaphylactic reaction is an acute fatal, or potentially fatal, hypersensitivity reaction that requires the patient to be sensitized and their reaction mediated through immunoglobulin E (IgE) antibodies. An anaphylactoid reaction doesn’t need the presence of IgE antibodies for a hypersensitivity reaction to occur. Thus, an anaphylactic reaction occurs only after the patient has been previously exposed at least once to the antigen and is sensitized. Although anaphylactic and anaphylactoid reactions are extremely rare, they can happen to any patient at any time. Fortunately, many patients who have experienced anaphylaxis have had improved results by switching from IVIG infusions to SCIG therapy.

Side effects come with all medications, including immune globulin therapy. The trick is to know how to manage the side effects before they start to manage you.

To learn more about the information found in this blog, read the IG Living articles Understanding and Treating IG Side Effects and Side Effects of IG.

What have been your experiences with side effects and how did you treat them?

Comments (47) -

SueF
4:46 PM on Thursday, April 19, 2012

I have been on IVIG infusions for 8 years.  The side effects have been severe at times including swollen red eyes, nausea, headache, itching, etc.  My kidneys failed after an infusion a few years ago.  It was determined that the rate of my infusion had to be reduced to 20 ml per hour.  If my infusion is turned up for even 30 minutes, my creatinine levels are above normal levels the next day.  
It has been difficult to explain this to nursing staff administering my infusion, as they have never heard of this happening before, and they want to run it as fast as I can tolerate.
My physician has written specific orders regarding my rate to make sure it is never turned up past 20.  My infusion takes 26 hours, however my infection rate is decreased, I am healthier the rest of the time, and I still have functioning kidneys.

Laurieann Skinner
5:43 PM on Thursday, April 19, 2012

IVIg caused Hemolytic Anemia after infusion.  I was given 3 blood transfusions of another blood type to stop antibodies from attacking my red blood cells.  To my understanding this is a very rare side effect of IVIg but I feel it needs more attention by physicians.

Angela Tischler
12:18 PM on Friday, April 20, 2012

I'm convenced that the infusion rate makes all the difference as far as the headaches and plead with the nurse to slow it down but she claims that as long as the blood pressure doesn't go up too much it is alright. I think that she just wants to go home.

Betty
2:27 AM on Saturday, April 21, 2012

After 6 years on Gamunex IVIG I started experiencing blinding auras- white lights in front of my eyes. I always had ro pre med. Benydryl zofran and tyelnol.

Then a steroid was added but the side effects were bothersome.

My Immunologist switched me to SCIG- first Vivaglobin (which I wish were still available as I did not have to pre medicate) and then Hizentra( benydryl tylenol before and after- sometimes two days on the tylenol.

For insurance reasons I was switched to Gammargard and had 7 side effects( even with pre meds )  and was put back on Hizentra.

This caused me to have to readjust and finally after a month= the migraines slowed down after the infusion.

After my experiences,I think it is the cleansers they use in the preoarationof the product that causes these side effects. Vivaglobin has the fewest of these cleansers.

SueF
9:39 AM on Sunday, April 22, 2012

Re Angela's comment.
I think you are probably right. Just because your blood pressure is ok does not give your nurse any indication that you are not suffering from side effects!
Especially post infusion headaches. If it were me I would speak with my doctor about what is happening to you. Your doctor should be able to speak to rate related side effects.

RES
8:50 AM on Sunday, April 29, 2012

I have been lucky so far, with no signficant adverse side effects.  I am given Tyelenol and Benadryl before the infusion.  I also drink lots of water before and during the infusion and bring food to eat.

Sue
9:33 AM on Friday, May 04, 2012

I have been getting weekly IVIG infusions for about 20 years. I still have headaches, muscle pain and nausea--wtihout premeds.

I used to go to the hospitals outpatient IV department for my infusions. Once they gave me the IV benadryl which put me to sleep for a while; the nurse turned the infusion rate from 50 to 250.  I would then wake up and throw up and have a massive heeadache. the nurse would then call my doctor and laugh. I reported her to the state nursing board.  IF anyone feels that the nruse is turing it up too high you shoudl tell her to slow it down and report her to the supervisor and to your doctor.  

Kelly Carroll
9:27 PM on Monday, May 07, 2012

I just discovered this site and read the comments. Scared me a bit. I have been receiving IGIV for four years now for my CVID and have not had any side effects. I just turned 65 and I feel very fortunate now that I see how severe some of these side effects can be. I suppose that the side effects can "kick in" at any time and just because I have not had any so far is not guarantee that I won't have any in the future. I went to a PID conference two weeks ago (my first) and learned lots, in addition to meeting many very nice folks. It is still hard for me to believe that I ended up with this "stuff." But I guess it is what it is. I will continue to count my blessings.

Marilyn
5:52 PM on Friday, May 11, 2012

I've been having IV/IG for 1 year as of this month and have had severe migraines, chills & fever pretty much every other time.  This is despite switching brands 3x (currently on 5%) and taking 20 mg Prednisone, 2 Tylenol Extra Strength & Allegra D morning of IV/IG.  The rate of infusion has been 150 and takes about 7 hours or so for 40 grams.  I am really open to any other suggestions, though am apprehensive about SCIG since I really don't want to do this twice a day.

Marilyn
5:53 PM on Friday, May 11, 2012

Sorry, I meant SCIG once a week at home, not twice a day.  Got distracted.

Dawn Milberger
9:42 AM on Monday, May 14, 2012

Sue, I'm in the same boat you are.  This May makes 19 years that I have been receiving IVIG.  Early on in my diagnosis, I was doing home infusions.  One time I feel asleep at one rate and when I would wake up feeling horrible at another rate.  The nurse turned up the rate because she had a date that she was going to be late for that evening, it was a friday!  Although I felt betrayd and unsafe, I didn't say anything because I was new at it. Now, it's a different story.  I'm currently going to my doctors infusion suite for treatment and have to go at a a rate of 30 to 35 because of my kidneys.  IF I EVER HAVE TO HAVE THEM AT HOME, BE DARN SURE THAT I'LL HAVE A FRIEND WITH ME IN CASE I FALL ASLEEP.  I wish I had your forethought and initiative way back when like you did to turn her in.  

Linda Thornrose
9:34 AM on Friday, June 01, 2012

I have been receiving IVIG for nearly 9 yrs.  At first, I used Gammunex with fairly mild side effects.  Then my supplier insisted it was no longer available and put me on Gammagard that caused bad headaches, fatigue, pain and some nausea.  I finally wrote to IG Living regarding how I could get back to Gammunex.  They quickly responded that all I needed to do was have my doctor write an RX for "Gammunex Only" and that did it!!  I do much better now.  My premeds are 400 mg Ibuprofen, 25 Benadryl, 50 mg IV solu-cortef pre and post treatment.  I also take my RX headache meds and pain meds as I also suffer from FM and chronic fatigue.  I am doing much better now and no longer have to wipe out my schedule for a week after tx!  Thank God for the resource of IG Living! I do have problems sleeping the first and often second night after tx that I am sure is due to the steroid.  I just block out a few days to adjust and rest when I can.  But, so much better than I did with Gammagard!!

Linda Thornrose
9:36 AM on Friday, June 01, 2012

PS After using Gammagard for years, I was no longer having "good days" and was down nearly the entire month.  Therefore, you can see why I am so happy about the change.

Leslie Tripp
3:39 PM on Saturday, June 02, 2012

As an infusion nurse who regularly infuses patients with IVIG, I ALWAYS look to the patient and her/his side effects to determine rate. Blood pressure is not the only indicator. I discuss and assess (an important nursing function) the patient's previous side effects and discuss the rate with the patient. It is important to only infuse the patient at a rate tolerated by that specific patient; not the last 5 patients who could tolerate at max rate. The patient should INSIST that the rate be lowered if side effects have been a problem. If I were the patient and someone turned up the rate while I was asleep in order to leave earlier, I would call the company and refuse that nurse in the future as well as report to the doctor. Be pro-active and know your rights and if your are not assertive to stand up for yourself, bring a family member or friend to ensure you are being treated fairly  and that your infusion is being run at a rate you agreed to.

Linda Thornrose
11:27 AM on Monday, June 04, 2012

Thank God for nurses like you, Leslie.  I have been so blessed to have home infusions nearly the entire 8+ years of treatments with the same nurse who has become a friend!  As of December, my husband retires, thus Medicare becomes primary.  As a result, I will have to drive an hour each way to have my treatments in my physician's office.  I am concerned that I may end up in outpatient hospital due to the length of my infusions...at least 8 hours.  I used to work at the doctor's office, so know some of the nurses.  I do hope I won't have problems with them, but my doctor is good at listening to my concerns.  I feel so blessed.  I only wish I could continue home care, though.  If only Congress would approve the bill before them that would include coverage for home infusions for those of us that are blessed enough not to be considered 'home bound' to meet Medicare's criteria!

SueM
1:48 PM on Monday, June 04, 2012

Marilyn,
I would recommend slowing down the rate of the infusion. I get 45 grams every week of Gammaguard. We infuse it at 50 for 30 minutes and then leave the rate at 100 for tthe remaining 6 hours. Slowing down the rate really helped me have less side effects. I hope this will help you.

Linda Thornrose
7:08 AM on Tuesday, June 05, 2012

I agree with this.  My doctor told me when I first started IVIG that flow rate was the biggest cause of side effects.  I have 30 gms over nearly 8 hours (includes pre meds of a liter of fluids, solu-cortef, benadryl and ibuprofen).  I still get a headache, but not as severe as with the faster flow rate.  In addition, my BP isn't impacted as much.  It is a learning process...God bless.

Saundra Ann Palmer
1:11 PM on Friday, June 08, 2012


Why is it that no one mentions hair loss with IVIG.  About a year or more ago, Gammagard was discontinued temporarily and Octagam substituted in its place. I noticed thinning hair.  The physician changed the prescription to Flebogamma and, after a few months, the same thing.  After much reading, I discovered that it falls out for as long as the prescription is in the body, then stops, and when another infusion is due, the hair loss starts all over again.  It is one long cycle of hair loss.  This side effect is purely anecdotal and, hence, not documented.  

I called several companies and they claimed it was less than 1%, while others never heard of it but skimmed over the issue by saying it would be included in "other side effects" in their literature.  

And, I speak up about side effects and have had nurses who claimed I did not need any hydration and that there is no need to start out slower, etc.  Once I had a nurse turn it down to a crawl because break-time was due, and I was close to going home.  Do the medical staff think we do not notice the ineptitude associated with ego-driven personalities.

My last infusion in March was the most frightening.  My hands, calves, and feet were swollen for two days, and my blood pressure was abnormally low.  Eventually, it dissipated but I still had to wait two weeks to see my doctor to discuss the side effects.  And, now I am off IVIG for a period of six months with blood work scheduled twice during that time to monitor levels.  

I sometimes wonder why I am on it.  All my life I have been asymptomatic and because I had an infection, I was put on infusions to bring up the levels.  All that time, money, and side effects--how could something claimed to be so beneficial be so physically disabling.  Let's not talk about fatigue, headaches, rashes, hives, cramps, flushes, joint pain and on and on and on.  But the hair loss was the most depressing.  My heart goes out to cancer victims.  

At this time, I am free--free from all side effects--free from a wasted day at the "office" and free from the thought that I might suffer from congestive heart failure because of this wonder drug.  

I won't let it claim my body.  

SueM
9:22 PM on Friday, June 08, 2012

Hair loss is a side effect I have never heard of. It sounds like you may want to consider getting a second opinion. If you really do have an immune deficency you will need some type of treatment. I have had CVID since birth. By the time it was offically diagnosed I was 30 and , years of infections have done significant damage to my lungs. Please don't write off a treatment that you might need.

Linda Thornrose
9:25 AM on Saturday, June 09, 2012

I am so sorry, Saundra, to hear you have had such a difficult time with side effects.  Of course, you always have to weigh the good and bad from any treatments.  If you are doing well without them, good for you!  From my own experience, the benefits far outweigh the side effects.  I was diagnosed with CVID when I came down with tuberculosis.  Thank God I worked for physicians because it was the annual TB testing that caught it!  I had all sorts of complications from the TB drugs, but after 9 months, finally completed tx.  They started testing me for PID after and found the CVID, thus starting me on IVIG.  I have done quite well, in spite of some side effects, doing better on Gammunex than any other.  I have had pneumonias, sinus infections, Hepatitis A, and some other issues, but have recovered, thank God.  Before treatment, I was sick a lot, but after nine years, I am mostly doing well.

We all are impacted as individuals, so what is good for one is not necessarily good for another.  This blog is a wonderful forum for exchanging ideas and experiences.  I feel blessed to have IG Living as a guide and this blog for ideas to help me live and cope with CVID.  I thank God for the treatments available to those of us that are helped by it.  Otherwise, I wouldn't be able to go out in public and enjoy and pretty normal life.

God bless you.  You are in my prayers, Saundra.

Saundra Ann Palmer
11:39 AM on Monday, June 11, 2012


Just a quick note of appreciation to Sue M and Linda T for your encouraging responses.  My aim was to call attention to this devastating side effect that is never addressed by the companies who market the globulin.  I included a rather interesting link to wellness.com that addresses a wide array of the side effects we experience.  To confirm my concern that hair loss is on the back burner, notice where it is mentioned in the article--under OTHER and the very LAST TWO WORDS, no less.  We need to let our IVIG family know this.  Google your medication plus the words hair loss to see what comes up.

And, to clarify, I am three months free of the medication and have never felt better since the treatment stopped.  And, so has the hair loss, by the way.  I lived 70 healthy years without globulin, and the last five years have been the worst I ever lived--now, at least, the mitochondria are doing what they do best--providing energy.  If the visible side effects are burdensome, what is happening to the rest of the cells in our body that we do not see on a daily basis?  

www.wellness.com/.../intravenous-immunoglobulin-therapy

Linda Thornrose
5:12 AM on Tuesday, June 12, 2012

I am so happy you are doing well.  Maybe you don't need IVIG?  Certainly, you don't need such awful side effects.  God bless you and may you continue to do well.

susan willits
3:39 PM on Thursday, June 14, 2012

I've had 6 infusions so far and have noticed some changes but not a lot.Does anyone know when I will start feeling like myself again?I still feel so tired and week at times.

Sue M
4:41 PM on Thursday, June 14, 2012


I have been receiving IVIG for many years. I always feel tired for about 2-3 days after my infusion. I would recommend making sure you eat a balanced diet and exercising on a regular basis. I can only walk or ride my exercise bike (due to lung issues) but, I do one or the other every day. I do feel better and have more energy if I exercise.

Do you have reactions to the IVIG? If so, you may want to try some pre-meds to lessen the reaction.  

Linda Thornrose
7:25 PM on Thursday, June 14, 2012

I have been having them for nearly eight years and I honestly don't remember how long.  I started with Gammunex and didn't have too many problems.  However, my supplier changed me to Gammagard and I continued to have worsening side effects until I rarely had a good day!  I finally (through the help of IG Living!)found out how to get back on Gammunex and am doing much better, thank God.  Check with your physician with your side effects and hopefully, he/she will work with you until you find the best treatment for you.  Oh, also, as you probably know, the flow rate of the infusion has a big impact.  Mine was slowed down to nearly eight hours which lessened the headaches.  God bless and good luck!

Linda Thornrose
8:33 AM on Friday, June 15, 2012

I, too, feel fatigued and have headaches for a a few days with each treatment.  I do have l liter of fluid, 50 mg solu-cortef pre and post treatment, 25 mg benadryl and 400 mg ibuprofen.  I also use my headache or pain meds to help.  One of the main things I do, when possible, is plan no commitments for a few days after treatment.  This is mainly due to lack of sleep from the solu-cortef the first night or two.  All in all, I feel I am doing pretty well.  I also feel better if I can walk,and one of the best things for exercise is doing them in a heated pool.  This was prescribed for my fibromyalgia pain, but it is wonderful  for all over.  I do not have a pool, but my physical therapy facility has one I can use for $58 a month as often as I want to.  I would like to get a small pool at home because it is 20 miles away, taking time, gas and commitment!  Hopefully, some of these ideas will help.  

Denise Brown
2:58 PM on Tuesday, August 07, 2012

I have had infusions since November last year, the first few months were not so bad but then the provider for the medicine was changed and since then I have still been sick most of the time, am very tired and have noticed hair loss in the last 2 months. I am wondering what can be done for the joint pain and hair loss, and how many others have had the same problems.

Denise Brown
7:50 AM on Tuesday, August 14, 2012

Does hair loss from ivig infusions ever stop? Does anyone know if there is a hair product that can be used to stop hair loss caused by ivig infusions?

Chris Jones
2:32 PM on Tuesday, January 15, 2013

I have been on IVIG for over three years now. I started dosing at 80 and had MASSIVE headaches 2 - 3 days after therapy. I have since reduced to about 50 - 55 and am doing much better. I still get headaches but they are tolerable. I have found a combination of meds to help significantly: Benadryl immediately before infusion and every 4 - 6 hours after for 2 - 3 days. I also alternate aspirin and Advil every 4 - 6 hours as well. The aspirin helps to thin the blood, a side effect of infusion. Hydration is also very important. Drink at least 64 ozs. of fluids the day before, the day of, and up to three days after infusion. I have also found Meloxicam (anti-inflammatory NSAID) to be very helpful when symptoms of headaches and muscle aches flair up. When the headaches come, and they sometimes still do, the only thing that helps is Vicodin.
I have also experienced hair loss but chalked it up to peri-menopause. Now I am not so sure. I will have to talk to my doctor about this side effect.
As for rate of improvement in general health, it was a good 4 - 6 months after I first started therapy before I got my energy back and felt like a real person again. I am grateful to have this treatment as it has significantly reduced my rate of infections.
I would like to know if any other CVID or CLL patients have had bowel problems as one of their continuing health issues. I have been treated for both H-Pylori and SBBO (small bowel bacterial overgrowth) over two years time and seem to have lingering issues. Anyone else?

Shelley Hunt
11:07 PM on Thursday, February 07, 2013

I had my first monthly IV infusion on December 5th, 2012. At about 2 the following morning, I woke up with a severe headache, a fever and a stiff neck. Yep--I'm one of a handful of people who got aseptic meningitis from the infusion. Fun times at the hospital for several days. My doctor then decided--I have CVID--that I should try the sub-cutaneous infusions, and I started those around the 6th of January and have been having then every week since.

I have, sometimes, pretty nasty side effects. Full flu-like symptoms, extreme weakness, low grade fever and headache. I am usually down for 3 days or so after an infusion. THis coming week I am going on vacation for 5 days. I am a full-time caretaker, so 5 days away is a big deal. I have SO much to do to make sure my husband is OK while I'm gone. Tomorrow is infusion day, and I DO NOT want to do it. But I know I have to. I can't risk not having it. But I am afraid I won't get everything done. I know this sounds stupid, but I keep thinking--what if the meningitis comes back? What if what if what if.

So tonight I have taken ibuprofen and benedryl. I thought I had some steroids left, but can't find them, so I'm hoping the benadryl (sp?) will help. DO any of you know of anything else that might help? Thanks for being here!

Karen Sheiles
4:11 AM on Sunday, May 19, 2013

My son Matt was 19 years old and was having ivig for kidney rejection he has been on this treatment for 8 weeks every time he had ivig infusion he was sick the flow rate was never to go over 30 on his last dose which was a wednesday they gave in phenergan to put him to sleep so they could increase the flow which was increased to 120 two days later for son has passes away in his sleep.....please don't let the nurses increase the flow rate we believe he had adverse reaction anaphylaxis shock. We were never informed about in side effects of this treatment We are now waiting for the autopsy report to confirm.

Bob Mathews
10:51 PM on Friday, May 31, 2013

My prayers to all of you who are experiencing problems.  About a year and a half ago I had a cough induced sub-arachnoid hemorrhage after having a cough for several months.  I got a life flight out of the deal (not cheap) and very nearly died.  I have had recurring sinusitis, pneumonia, bronchitis, ear infections for years and was finally diagnosed with low IG.  A compromised immune system is a bad thing for a school teacher.
Anyway, for me the IVIG infusions are wonderful.  They help me stay so much more healthy than before I started them.  I still get a reoccurring cough from time to time  but nothing like before.  
I too get headaches after my infusions.  The wonderful nurses at our local hospital infusion center know me and how fast they can go with me.  It makes little difference.  I still can plan on not feeling great for a couple of days and having a headache. (Even with pre meds)
Everyone is different and all experience different side effects but again, mine are mild compared to the good effects!
God bless you all, and I hope something can be done to help you.  
I truly understand.
It is nice to know that there are so many out there that I can empathize with!

Sydney
6:31 PM on Monday, July 15, 2013

Hello everyone, a newbie to IVIG, I am scheduled to start receiving treatments in the next few weeks. I am scared. Does anyone here use IVIG to treat dermatomyositis?

Shelley Hunt
7:49 PM on Wednesday, July 24, 2013

Hi! I have CVID, and am currently (sort of) on SCIG. Last December I had my first infusion, the IVIG, for the entire month. 15 hours later I was in the ER with aseptic meningitis. It was not fun.

So my doc changed me to SCIG, and I learned to do my infusions at home. I learned that if I premedicated with Tylenol, and with a Histamine 1 blocker (Zyrtec or benedryl) and a Histamine 2 blocker (Famotadine, or Pepcid, works best), and if I continued these meds for a couple of days after the infusions, I was fine.

Until 4 weeks ago. A few days after an infusion I had a horrific headache, and my neck hurt like hell and got stiff. I ran a fever of 102. But even after having meningitis--it did not click. I got better in a few days. The next week, after the infusion, it happened again. And the week after that--last week. I managed to get an appointment with my PCP last Wednesday. I had a headache, fever, and my neck was stiff--here was the weird part--I could bend it to my chest but could not turn it left or right. (Apparently stiff in general is not good). He decided to do an LP (spinal tap) but the only way to get one quickly was to admit me into the hospital, have one done, and then discharge me the next day. We all expected the CFS (spinal) fluid to be clean. Instead they found white cells, and that means meningitis. So no, I didn't get to go home for several days.

The problem with aseptic meningitis is it looks just like other nastier forms of the disease. So you get pumped full of antibiotics and antivirals and things you cannot pronounce or spell. if, after culturing your CFS, you do not have any growth in those cultures after 72 hours--which means it IS aseptic--you (meaning me) get to go home.

Here's my dilemma. My immunology doc has not contacted me, either when I was in hospital or since I've been home. I haven't had an infusion for 10 days. No way in HELL am I doing another without major premedication. I don't know the answer to this--there might not be one. I do know this--the infusions helped me so much! I have not been sick until this last bit. So I KNOW they are worth it.

However, as you can imagine, I'm a bit nervous. Aseptic meningitis doesn't kill you. Other things I could catch could. I know this. I just wish my doc would call.

Thank you for giving me a place to talk about this.

Heather Watrous
6:07 AM on Sunday, August 11, 2013

I just received 3 days of IVIG for chronic severe thrombocytopenia. They gave it to me in 3 hours, and on the machine it said"100g", so I figure that was the rate of infusion. The first day I did okay, except I felt like I had asthma and was very knocked out by the benadryl. As the benadryl wore off, my breathing got better, so the second day they did not give me any benadryl, only tylenol.  My breathing was fine without the benadryl. BUT, my vein in my upper arm started to hurt for the last 30 minutes of the infusion, and it seemed to be bruising my vein. The nurses just looked at it and said something like "Gee, I don't really see much of anything." They did not change the rate of infusion. Later that day, I started to get a fine headache, which actually grew worse as time went on. By the third day, I went in and told them of my headache, but no mention was made that perhaps we needed some other antihistamine. To her credit, the nurse did ask me if I was to have it at the rate of 50 or 100, and I said 100 since I that was what was done before, and I had not yet been enlightened by this website as to the benefits of taking it in more slowly. My head hurts but advil did not do much for it, my eyes feel sore and sensitive to light. I feel a repulsion towards protein, which is not normal for me.
The other little thing I discovered was that if I took the stray IV cord and warmed it up against my chest and in my hands, my arm did not hurt and I could fall asleep. Why would nurses not know to suggest that?
It seems there is such a top-down hierarchy in the medical profession,  that many nurses just do not have the information they need to be helpful or proactive with each new patient. They just are expected to take orders and do all the work, without being empowered with the knowledge needed. That must be how millions of serious mistakes are made. How could they let me go without some kind of antihistamine?
I am calling the doctor now, because it is possible I have aseptic meningitis. But no-one informed me of what to look for at the hospital with serious side-effects. They seem to just hope for the best.
Thank you all for sharing your valuable experiences and wisdom.

Anthony Denny
10:54 AM on Saturday, September 14, 2013

I have just been formally with having Stiff Persons Syndrome, although I have been living with it for nigh on 25years. It has been treated with drugs clonazepam and sodium valproate and I have been reasonably stable on this regime. My Consultant now is asking for me to go onto an IVIg regime and to stop the drugs.

The middle of last year I had an 8 hour operation for cancer which required me to go into intensive care for observation purposes, but ended up on a life support machine for a few hours as I was having difficulty in breathing. This is probably a red herring, in this thread, but I've mentioned it - just in case.

Reading your comments/experiences fills me with dread at the thought of IVIg and as I suspect I am being used as a guinea pig especially as my Consultant says I don't have to go for it I feel like telling him NO. He hasn't mentioned any side effects other than it is a 50/50 chance it might do me some good!

Your comments are all very negative, which is what I would expect on a site referring to side effects, but is there anyone among you who can offer me any uplifting experience to even out the playing field and help me to come to an informed decision.

Thank you, in advance, for your comments  

C. Jones
10:06 PM on Sunday, September 15, 2013

Yes, most people post here because they are having side effects of IVIG. I still have side effects that last for a few days after infusion - headache, stiffness, joint pain, etc. It's like getting sick with the flu. Many side effects can be reduced with the same treatments you would take for flu symptoms (Tylenol, fluids, Benadryl, etc.). In the end I can say that IVIG has changed my life. I have Chronic Lymphocytic Leukemia which has significantly depleted my B-cells and how they function causing a severely depressed immune system. I used to be completely exhausted every day and I suffered from multiple infections all the time. I was on constant antibiotics. It got to the point where I couldn't get rid of a urinary tract infection without being on a 20 day course of Cipproflaxen, a very strong antibiotic. The overuse of antibiotics completely messed up my bowels and I lost 15% of my total body weight. Since I started IVIG three ears ago I have only had to take antibiotics a few times and I am healthier than I have been in a long time. While the side effects can be bothersome, and sometimes overwhelming, the benefits of IVIG far outweigh the negative points.

Laura
2:08 AM on Wednesday, September 18, 2013

I get 90 grams infused over 2 days (about 3-4 hours a day) for a dx of Lewis-Sumner Syndrom which is a form of CIDP (my anti-bodies attack the Myelin Sheath a.k.a. the covering over my nerves in my extremities) I was infused on the 12th and 13th, had bad sinus allergies at the time, and saw my regular Doc after my infusion on the 13th and he told me to get Zyrtec D. I have had 4 instances of bad reactions with Gammagard since I was dx in 2007. 1st ocurrance it was run too fast and I experienced fast heart rate and a few days later, a bad headache, but it was caught pretty quick and the nurse dropped the rate way down for the rest of the infusion. 2nd occurance I got a bad batch and my right leg and foot (which has the most permanent nerve damage) felt like someone put it in the colest icy water ever...it hurt so bad and I had 2 heating pads on it on high..not a good idea btw...the warmth cant be felt physically inside or outside but you can burn your skin without knowing it. I went to the hospital and they had to give me Morphine...it didnt even the touch this pain...they ended up having to give me dilated. 3rd occurance, It was run too fast, it was my fault though...I had other plans made and asked my nurse if we could go a little faster because I usually tolerate well. Learned my lesson there! I had the worst migraine from hell..I was in tears. **Which brings me to this infusion...had to do an early a.m. infusion bcuz I had a Dr. appt. for my sinus' at Noon and my nurse was late getting here so we started later than planned. I forgot to take my prednisone steroid and took only 1/2 of the IV Benadryl amount b/cuz I didnt want to be too sleepy at my appt. I did take my Excedrin Migraine too. We probably ran it just a little quicker but not much than usual...my side effects have always presented 3-4 days after an infusion when I have had them. A slight headache and fairly bad fatigue is the norm for me, pre and post taking of antihistamines, steroids and migraine meds work like a charm for me usually and I thank God for that after seeing what some of you go through, I feel so so sry for you guys! Especially the kids...the story of the 11 year old boy breaks my heart that he has to go through all those terribly painful side effects! ...yesterday I had increased headache (that I attributed it to sinus headache), and terrible neck and shoulder muscle pain on the right side into the shoulder blade, but my back hurt everywhere (I am use to lower back pain bcuz I have degenerative disk disease in my L5-S1) I was also getting more frequent, intense leg cramps in my upper front right thigh. Nothing was helping for the pain with the neck, back and thigh cramps so I took one flexeril muscle relaxant and it helped, enough for me to sleep anyway. BUT TODAY...the muscle shoulder pain was gone but the neck and the back pain on either side of my entire length of the spine was unbearable... especially dead center between my shoulder blades. By 10:00 p.m. I couldnt take it anymore and knew I wouldnt be able to sleep with the pain anyway, so I took 40 mg. of Prednisone steroid....by 2:20 a.m. no relief, so I took 2 Norco and a Zyrtec D and Im just now getting a bit of relief. Its still there but tolerable, at least for now. ***QUESTION: from everything I researched I think these side effects along with others I have are probably Asceptic Menengitis. But from what Ive read, I dont think its all that worrisome...it seems to me having sinus allergies (not an infection) at the time of my infusion was why it presented and like the lady said above, her Doc told her it is common for IVIG to cause inflammation of the meningies. If I went to the hospital, they would have to do a spinal tap and if they find white cells in my spinal fluid, they will pump me full of anti-biotics and cortisteriods "just in case" while I wait 72 hours for a culture to develop, or not, telling me if its bacterial or viral (Aseptic). If its viral I get sent home. Anti-biotics dont do anything for viral cases anyway! Just more liver and kidney stress for nothing. If IVIG is known to cause  Asceptic Meningitis, isnt it ok for me to just take my steroids, zyrtec and pain meds? I saw one article said that everybody has probably had Asceptic Meningitis at one time or another following a flu bug. I just really really dont want to be stuck in a hospital for 3 days if I dont need to. I guess I will go if the pain gets too bad but ugh! ***AND YES*** ive been experiencing hair loss for years! Ive asked my regular Md about it a few times and he attributed it to age (Im 44) pre menopausal symptoms. But the hair loss is ridiculous!! My hair strands are everywhere and it looks like a small rodent has died in my shower drain at the end of my shower! I had alot of hair (thank goodness) and its long so nobody seems to notice how it is thinning. I am definitely gonna mention it to the makers of Gammagard and to my Specialist!! Yes to bowel problems also. I now have joint pain in both my elbows that presented a few months ago and is painful whenever I move my arms. I do have to agree with the ppl that say they are better off with the tx even having to deal with the side effects! I would be in a wheelchair with no use of my feet, legs, arms or hands right now. My disorder was progressing fast but luckily I was dx within 6 mos. and some damage was reversed and this tx is all that is keeping it from progressing again. It was truly a miracle for me!

Laura
2:42 AM on Wednesday, September 18, 2013

It seems to me that all we hear from doctors with this tx is drink more water...water, water, water...and clearly sometimes its not enough, If fluids is such a big part of stopping serious side effects and its needed for healthy kidney and liver function, why isnt it included in the tx's? Why dont they infuse IV fluids for a half hour before and a half hour after and also tell us to drink more water? Just saying...how much does a bag of water with electrolytes and minerals cost? Ya know? Seems like it would help alot.

Kelly Carroll
8:38 PM on Monday, December 02, 2013

I have been on IVIG for five years now and have recently noticed that I am experiencing lower back pain and some joint pain. I am wondering if some of this is related to the IVIG (Gammagaurd), or if it is related to the fact that I am getting older (66 now) If it is related to the IVIG, does any one have any suggestions for relief?  I feel fortunate that these are the only side effects (If in fact they are side effects) that I have experienced. It has slowed me down a bit, but not much.

Thanks

Emily
9:15 AM on Friday, December 20, 2013

I have just discovered this site and believe it will be very helpful to me.  Three years ago I had sepsis induced by pneumonia and was on life support for 9 days.  Survival at all was doubtful, loss of kidneys a concern, but I emerged with lung damage. (I did have a diagnosis of mild COPD previous to this, but with no symptoms.)  My result was a lung function of about 25%, pulmonary rehab, many upper respiratory infections and 3 hospitalizations.  During the last and never ending sinus infection for which there was no antibiotic left for me due to allergic reactions or having become resistant, I was put on a pic line for 3 weeks.  During that time I asked to have my blood checked to see if I had any immunities.  It all came back with indications that I was minimal in the g subclass and IVIG for CVID was recommended.  I had my first infusion a week ago with some fairly mild side effects of headache, body aches, and extreme fatique.  My Dr. is going to premedicate next time (28) days with Benedryl and tylenol.  I am caught between 2 worlds as I also see a homeopath who has tried to build my immune system in a more natural way...not working.  I guess my question and I do not really understand, is what is actually happening inside the body during and after an infusion.  Are the side effects because the antibodies are fighting against weaknesses?  I keep reading everything I can get my hands on, but never arrive at a simple explanation of what is happening.  It would seem a toxic situation is produced.  Any information appreciated.  I am a 68 year old woman who up until 3 years ago could do anything!

shelli nelson
4:03 PM on Friday, February 28, 2014

Hello everyone.  I just had my first IVIG infusion of Carimune a week ago today.  I have been diagnosed with CVID and I also have fibromyalgia.  I had a headache that was tolerable (I premedicated with zantac and zyrtec plus lots of fluids).  I find myself with very bad chills and joint pain and fatigue still a week after the infusion. Noted, I was just diagnosed with another sinus infection yesterday and started small dose of prednisone and amoxycillin (the infection never really goes away). I can't tell if I am sick because of the infection or still having side effects from the infusion. The pain in my joints is new. I am better than I was yesterday, but trying to tease apart what is caused by what is nuts.  My doctor said side effects from an infusion should be over within 72 hours.  Yet I have read here that some of you are sick for much longer than that.  Also, can someone please tell me how the infusions have helped them?  I am a bit in the wilderness here.  Thanks for any information any of you may shed on this.  I confess to being overwhelmed by getting a CVID diagnosis after already being very sick with cfs/fibro for 26 years.  But at least I know why I get all these blasted sinus infections that leave me as knocked out.  

Joan
9:00 PM on Friday, March 07, 2014

I took IVIG for almost two yrs, but the side effects never fully went away, no matter what we did, so I got fed up, going to the hospital infusion center once a month, being so sick for many days, so======
I quit.
  so far it's been two months with no treatments, and my igg levels are very low (500, and dropping).  My dr says that for me, the infusions are "just a bandaid" and by stopping eventually pneumonia or something simular will "take me out".
  so far since oct 2013 I've had 3 pneumonias, & no antibiotic has,  worked  I'm tired of being sick , has anyone heard of others in my  situation?     God knows everything and is in control

Holly
11:51 PM on Friday, March 21, 2014

Hi, try 2 weeks of being super sick after an IV!  3 days of being sick?  I would take it.  My first 2 infusions with Gammaguard were great.  I do saline, Benadryl, and Tylenol.  My reactions happen that night but really kick in 72 hours in.  This time, I broke out in a full body rash all over, super high blood pressure, heart rate of 130 and this is a week after the IVIG.  It's crazy.  I was so excited for this diagnosis of CVID.  Now I am scratching my head.

I am going to try a more experienced immuno but I am nervous with this treatment.  Hizentra made me SICKER than a dog.

So far, I have had no benefits of feeling better.  I feel much worse and I almost feel poisoned by it.  My fibro pain goes nuts from the Gammaguard.  The 3rd infusion, I had to be put on prednisone for 4 days due to rash and pain.  Yesterday, my rash was biopsies.  This is just not right.

I want this posted so that if others don't do well on IVIG, they know they are not alone.  It's very hard and scary.  

karen
3:52 PM on Monday, March 24, 2014



Hi Holly

Could you tell me what dose you had and what the flow rate was when
you had a reaction 72hours later

thanks Karen

Holly
5:14 PM on Monday, March 24, 2014

Hi Karen, it was run slowly.  3 grams per hour, supposedly 25 grams in total.  Only received 18 grams due to side effects.

Judy W
10:21 PM on Sunday, April 06, 2014

Hello everyone. I've been reading posts and thought I would join in. I was diagnosed with PIDD Nov '13. Tomorrow will be my 18th treatment. I do subQ once a wk.after my first treatment I had a slight headache/nausea.I do premedicate.side effects for me are as unpredictable as the weather. I ALWAYS feel crappy Mon. & Tues, that's a given. Best way I can describe it is a general feeling of being unwell.achy,sluggish, my belly feels weird and swollen.by Tues. night, that starts letting up. From Wed-Sun it varies. One wk I may feel good, the next I can hardly get around.I especially am having pain in my hip and ankles. Don't know if this is related to the Hizentra or a totally different problem. My good news is, that although I have had 4 sinus infections since starting trtmnt, they DID NOT go to my lungs.I have copd never smoked, asthma, cfs, fibromyalgia, chronic pancreatitis, erosive esophagitis. Had no idea of my deficiency until Nov.13. Do any of you feel strange, thinking about so many people's blood products being in your body?  I try to not look too far ahead, thinking I have to do this the rest of my life. I too have had periods of denial, anxiety. Thanks everyone for being open about your experiences and for listening to me.

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