The Dept of Anaesthesia & Intensive Care, CUHK thanks

for an unrestricted education grant
BASIC instructor/provider course, Hong Kong, July 2nd-4th
Other upcoming courses
Home Feedback Contents

IV immunoglobulin

Up ACE inhibitors Adenosine Anaphylaxis Antiarrhythmics Antibacterials Anticoagulants Anti-fibrinolytics Antifungals Antiplatelet drugs Anti-virals Beta2 agonists Ca antagonists Corticosteroids Erythropoietin Fosphenytoin Hydralazine Immunosuppressants Inotropes & vasopressors Insulin IV immunoglobulin Labetalol Mannitol Metoclopramide N-acetylcysteine Nesiritide Neuroleptic malignant syn Nitric oxide Nitroprusside Proton pump inhibitors Sedatives Serotonin syndrome Sucralfate Suxamethonium Theophylline Vasopressin

Created May 2007 and updated September 2008 by Charles Gomersall


  • batched blood product prepared from 1,00-15,000 plasmapheresis and blood donations
  • >95% IgG with trace amounts of IgM and IgA
  • there are significant differences in donor pool, stabilizers, additives and production processes between different manufacturers. Patients should receive the same brand with each course/dose because:
    • limiting exposure to a minimum donor pool reduces risk of infection
    • changing products is associated with a higher risk of adverse reactions

Clinical uses

Immunomodulatory therapy

Neuromuscular disorders

Established therapy for:

Some evidence of benefit in acute disseminated encephalomyelitis

Dermatological disorders

Vasculitic disorders




Not indicated

  • antiphospholipid syndrome (non-obstetric)
  • haemolytic uraemic syndrome
  • sepsis (except possibly septic shock due to encapsulated bacteria, eg pneumococcus or patients with hypogammaglobulinaemia)
  • others

Adverse effects


  • headaches, backache, chills, nausea, myalgia
    • usually infusion rate-related
    • more common in patients with co-existing infection
  • anaphylaxis (very rare)

Transmission of infection

  • Hepatitis C
    • most manufacturers have introduced additional precautions since last outbreak

Due to increasing serum immunoglobulin

  • reversible renal impairment
  • cerebral and coronary thromboses
  • acute haemolysis
  • neutropaenia
  • acute aseptic meningitis
  • eczema, urticaria, erythema multiforme, cutaneous vasculitis

Further reading

©Charles Gomersall, April, 2014 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
Copyright policy    Contributors