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Posted on 13. May 2021

Side Effects of Immune Globulin (IG) Therapy

By Abbie Cornett

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No one can argue that immune globulin (IG) therapy is a game-changer for people who require this life-saving treatment. Unfortunately, it comes at a price, often in the form of side effects. Fortunately, when side effects occur, reactions are typically mild to moderate. And, while serious side effects can occur, they are rare. The good news is in almost all cases, effects can be controlled or even eliminated.

Side effects are quite different between intravenous IG (IVIG) and subcutaneous IG (SCIG) products. Even though both enter the bloodstream, IVIG is given into a vein (intravenously) via infusion that usually takes one to four hours. Because IVIG goes directly into a vein, there is a rapid spike in serum IgG. On the other hand, SCIG infusions, which have become increasingly popular in recent years, are given by slowly injecting purified IG into the fatty tissue just underneath the skin using a mechanical infusion pump.

The most common side effects of IVIG are flu-like symptoms, including headaches, fatigue, body aches and fever. Premedicating with acetaminophen is routine for most people, and if a headache occurs, the dose can be repeated. If headaches are severe, predosing with a steroid or migraine medicine may be appropriate. More serious side effects such as nausea, vomiting, neck pain or stiffness can signal a more serious adverse reaction known as aseptic meningitis. If patients experience these symptoms, a physician should be notified, and emergency medical attention may be needed.

Fluctuations in blood pressure can also occur during an IVIG infusion. The nurse administering IVIG should take a baseline blood pressure before starting the infusion, and the rate of infusion should be started slowly and gradually increased until the maximum rate is reached. Blood pressure should also be taken at intervals throughout the infusion. These precautions are essential if patients have a history of hypertension. If at any point patients do not feel well, blood pressure and other vital signs such as pulse, breathing rate and temperature should be reassessed. If blood pressure is high, the infusion should be paused and restarted when symptoms or blood pressure normalize. It is important to remember many reactions can be controlled by slowing the rate of infusion or pausing it until symptoms subside. Patients can also develop a rash, which does not necessarily mean they are allergic. In many instances, the rash can be treated with a premedication of steroids.

With SCIG, the drug is absorbed more slowly, and therefore, the potential for systemic reactions is greatly reduced. This makes SCIG a good option for patients who have experienced serious side effects with IVIG. Common injection site reactions to SCIG include redness, swelling and itching, which are usually mild and go away after a day or two. In many cases, these reactions are generally worse with the first few infusions and diminish over time.

Adverse reactions to SCIG are rare and usually mild, but they can include headaches, feeling hot, nausea, diarrhea, sore throat, rash, increased cough and back pain. Extremely rare are serious side effects such as allergic reactions, kidney problems or blood clots.1

One of the most important things patients can do to reduce side effects of treatment is to hydrate; drinking an adequate amount of water several days before the infusion, on infusion day and a few days after the infusion is critical. The only time patients should not increase their fluid intake is if they have a clinical reason not to.


1.   Cook, AE. Benefits of Home IVIG Therapy. IG Living, April-May 2016. Accessed at
Accessed at https://www.igliving.com/magazine/articles/IGL_2016-04_AR_Benefits-of-Home-IVIG-Therapy.pdf.


Comments (5) -

10:09 AM on Friday, May 14, 2021

After  three months of SCIG I broke out in massive hives from neck to knees. The hives lasted two weeks. Red and itchy. So the SCIG was stopped.

Lydia Padgett
3:30 PM on Friday, May 14, 2021

I guess I'm one of the rare of the rare. I've had anaphylactic reactions to two brands of SCIG, and continue to have severe side effects with each infusion. Since these are twice per week, it is hard to have a day without side effects. I'm considering stopping treatment due to this. I'm already on steroids, but have to add migraine meds, benadryl, and nausea meds for 2-3 days after infusions as well as the evening of infusion. I wish there were  alternative treatments for the disease and/or side effects!

Jenny Gardner
8:04 PM on Friday, June 18, 2021

I use to do IVIG treatments and it made me horribly sick the day of and usually took to 2 to 3 days to fully recover.  In the beginning my employer was very patient and understanding but after a while that disappeared.  It became very uncomfortable in the Office.  I ended up resigning.  That was extremely difficult for me because I loved my job.  This was before SCIG.  I sure wish this had been an option when I first started the treatments.  I really believe I would have been able to continue working.  Even though that was not an option at the time, I am still very thankful that SCIG became an option.  Not only are treatment day side effects not as severe but I am also healthier than I have ever been.  I have heard others may not have had the positive results that I have, but the only thing I would like to say is don't give up looking for answers.  If I had given up, my treatments would have continued being miserable and I'm not sure I would still be able to continue with those treatments even if the outcome would have been positive.  To this day I can still remember how sick the treatments made me and how many days after the side effects continued.    

Georgeann Massey
11:05 AM on Monday, August 23, 2021

I have an infusion every 4 weeks for CVID.   IVIG. I have no problems. I also have a port in my chest. Have been doing this for 7 years. They changed my meds. about 2 or 3 years ago. I take 2 asprine, benadryl and my blood pressure pill. Before and drink lots of water, a couple of days before and after. And try to get on my elliptic evey other day for a week. I feel so much better then I have in a long time. God is good!

Kerri Marshall
8:22 AM on Friday, September 10, 2021

I was originally diagnosed in 2013 CVID and sent into a cancer center and second year a different cancer center because of Humana insurance! Humana eventually found a loop hole and cancelled me one month before Medicare kicked in! Shame on Humana!! Two years infused with gammagard and octagam! Complained about rashes and itching to the point I dragged my feet on carpet because they itched so much! Plus, clubbing thumbs and my fingers and thumbs would bleed around the nails! IDF seminar w Dr Rosenbach saved me! First, allergy test on the chemicals in ivig! I was only NOT allergic to one!! Plus, Dr Rosenbach found I have also CMID!! I am on five day infusions on xemplify! Dr Rosenbach saved me! Life is different for me but grateful and confident I am with the best specialist!! However, I am curious if any other immune deficient patients have the problem of loosing their ability to speak when sick or in an episode?  

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