Intravenous Immunoglobulin (IVIG)

Intravenous immunoglobulin (IVIG) and subcutaneous immunoglobulin (SCIG) are treatments made from a pool of immunoglobulins (antibodies) from the blood (plasma) of thousands of healthy donors. Immunoglobulins are normally made by the immune system of healthy people to help fight infections.

IVIG/SCIG can help calm an overactive immune system. They help reduce inflammation and prevent the body from attacking its own tissues. These treatments do not increase the risk of infection. IVIG and SCIG are considered safe for use during pregnancy and breastfeeding. IVIG is used for many autoimmune conditions such as Kawasaki’s disease in children, dermatomyositis, polymyositis, and systemic lupus erythematosus (SLE). Additionally, it can be used to treat immunodeficiency.

How To Take It

IVIG is given as an intravenous (IV) infusion (through the vein in the arm) or subcutaneous (a shot under the skin). The infusion may be given once, or monthly, over one to five days. Frequency and duration of infusions depend on the condition being treated. IVIG can take several weeks to fully take effect. The dosing of IVIG also varies on the condition but is usually based on body weight.

Side Effects

The majority of people do well with treatment, experiencing only minor side effects. Common side effects may include headaches, fevers, chills, flushing, rash, muscle aches, and nausea. These side effects are usually mild and improve with rest, fluids, and medication such as anti-inflammatories or antihistamines.

Less common, but more severe side effects include severe headache with neck stiffness, nausea and vomiting (called aseptic meningitis). Allergic reactions such as trouble breathing, chest tightness or rash may also occur.

Drinking plenty of fluids and using pre-medications (like acetaminophen, NSAIDs, antihistamines, or steroids) can help reduce side effects.

Blood sugar levels may be increased briefly following an infusion, especially in people with diabetes. Side effects may be decreased by slowing down the infusions and staying well hydrated.

Additionally, because IVIG is given with a large volume of liquid, it may worsen heart failure and may cause blood pressure to increase temporarily. IVIG also increases the risk for blood clots slightly when given in high doses.

Tell Your Rheumatology Provider

If you develop a severe reaction (difficulty breathing, chest tightness, wheezing, rash, fevers) or if you have severe and persistent headaches with neck stiffness, nausea and vomiting, tell your rheumatology provider. While some reactions may occur while IVIG is being administered, others occur within a few hours to days after the infusion.

While vaccines are not contraindicated while on therapy with IVIG, your body may not be able to fully respond to the vaccines. Talk to your rheumatology provider about the best time to receive a vaccine.

Updated January 2026 by Nina Couette, DO, and reviewed by the American College of Rheumatology Communications and Marketing Committee.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.