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immune globulin (intravenous and subcutaneous)

Pronunciation: im MYOON GLOB yoo lin

Brand: Gammagard, Gammaked, Gamunex-C

What is the most important information I should know about immune globulin?

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You should not use this medication if you have ever had an allergic reaction to an immune globulin, or if you have immune globulin A (IgA) deficiency with antibody to IgA.

Before using this medication, tell your doctor if you have kidney disease, heart disease, diabetes, hyperproteinemia (high levels of protein in the blood), paraproteinemia (abnormal proteins in the blood), a serious infection called sepsis, blood circulation problems or a blood vessel disorder, a history of stroke or blood clot, if you are on a low-salt diet, if you take diuretics, if you are 65 or older, or if you have been bed-ridden due to severe illness.

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Immune globulin can harm your kidneys, and this effect is increased when you also use certain other medicines harmful to the kidneys. Before using immune globulin, tell your doctor about all other medications you use. Many other drugs (including some over-the-counter medicines) can be harmful to the kidneys.

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You may need a dose adjustment if you are exposed to measles, or if you travel to an area where this disease is common.

What is immune globulin?

Immune globulin is a sterilized solution made from human plasma. It contains the antibodies to help your body protect itself against infection from various diseases.

Immune globulin intravenous and subcutaneous (for injection into a vein or under the skin) is used to treat primary immune deficiency, idiopathic thrombocytopenic purpura (ITP), or chronic inflammatory demyelinating polyneuropathy. This medication is also used to improve muscle strength in adults with multifocal motor neuropathy.

Immune globulin may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking immune globulin?

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You should not use this medication if you have ever had an allergic reaction to an immune globulin, or if you have immune globulin A (IgA) deficiency with antibody to IgA.

To make sure you can safely use immune globulin, tell your doctor if you have any of these other conditions:

  • kidney disease (or if you are on dialysis);
  • heart disease;
  • diabetes;
  • a serious infection called sepsis;
  • hyperproteinemia (high level of a certain amino acid in the blood);
  • a condition called paraproteinemia (abnormal proteins in the blood);
  • blood circulation problems or a blood vessel disorder;
  • a history of stroke or blood clot;
  • if you are on a low salt diet or you take diuretics (water pills);
  • if you have a prolonged illness that causes diarrhea or vomiting;
  • if you are 65 years or older; or
  • if you have been bed-ridden due to severe illness.
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You may need a dose adjustment if you are exposed to measles, or if you travel to an area where this disease is common.

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FDA pregnancy category C. It is not known whether immune globulin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

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It is not known whether immune globulin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Immune globulin is made from human plasma (part of the blood) which may contain viruses and other infectious agents. Donated plasma is tested and treated to reduce the risk of it containing infectious agents, but there is still a small possibility it could transmit disease. Talk with your doctor about the risks and benefits of using this medication.

How should I use immune globulin?

Immune globulin is injected into a vein through an IV, or injected under the skin using an infusion pump. You may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, tubing, and other items used to inject the medicine.

How you give this medication, how often you receive it, and the length of your infusion time will depend on the condition being treated. Follow your doctor's dosing instructions. If you are using the injections at home, be sure you understand how to properly mix and store the medicine.

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Do not inject immune globulin into a vein if you have been instructed to give the medicine as a subcutaneous injection (under the skin).

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Immune globulin must be given slowly. You may need to use several catheters to inject this medicine into different body areas at the same time. Your care provider will show you the best places on your body to inject the medication. Follow your doctor's instructions. Keep a diary of the days and times you gave the injection and where you injected it on your body.

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Do not shake the medication bottle or you may ruin the medicine. Prepare your dose only when you are ready to give yourself an injection. Do not mix immune globulin with other medications in the same infusion. Do not use the medication if it has changed colors, looks cloudy, or has particles in it. Call your doctor for a new prescription.

Use disposable injection items (needle, catheter, tubing) only once. Throw away the used items in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

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To be sure this medication is helping your condition, your blood may need to be tested often. Visit your doctor regularly.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using immune globulin.

Each single use vial (bottle) of this medicine is for one use only. Throw away after one use, even if there is still some medicine left in it after injecting your dose.

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Store this medicine in its original carton in the refrigerator. Do not freeze immune globulin, and throw away the medication if it has become frozen.

You may take the medicine out of the refrigerator and allow it to reach room temperature 1 hour before preparing your dose. Do not heat the medicine before using.

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You may also store immune globulin for up to 6 months at room temperature. Keep away from moisture and heat.

Throw away any unused immune globulin after the expiration date on the label has passed.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of immune globulin.

What happens if I overdose?

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Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using immune globulin?

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Do not receive a "live" vaccine while using immune globulin. The vaccine may not work as well during this time, and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), Bacillus Calmette-Guérin (BCG), oral polio, rotavirus, smallpox, typhoid, yellow fever, varicella (chickenpox), H1N1 influenza, and nasal flu vaccine.

What are the possible side effects of immune globulin?

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Get emergency medical help if you have any of these signs of an allergic reaction: hives; wheezing, difficulty breathing; dizziness, feeling like you might pass out; swelling of your face, lips, tongue, or throat.

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Call your doctor at once if you have a serious side effect such as:

  • swelling, rapid weight gain, feeling short of breath, urinating less than usual or not at all;
  • pain, swelling, redness, warmth, or a lump in your arms or legs;
  • pale or yellowed skin, dark colored urine, fever, confusion or weakness;
  • fever, chills, headache, neck stiffness, increased sensitivity to light, purple spots on the skin, and/or seizure (convulsions);
  • chest pain or tightness, trouble breathing; or
  • signs of new infection such as high fever, chills, body aches, flu symptoms, or sores in your mouth and throat.

Less serious side effects may include:

  • mild headache, blurred vision, tired feeling;
  • low fever, sore throat, cough;
  • redness, itching, and swelling of skin where the injection was given;
  • nausea, vomiting;
  • muscle spasm or weakness;
  • back pain, joint pain, pain in your arms or legs; or
  • mild skin rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect immune globulin?

Immune globulin can harm your kidneys. This effect is increased when you also use other drugs (including some over the counter medicines) harmful to the kidneys. You may need dose adjustments or special tests if you have recently used:

  • medicines to treat a bowel disorder;
  • medication to prevent organ transplant rejection;
  • antiviral medications;
  • chemotherapy;
  • pain or arthritis medicines, including aspirin (Anacin, Excedrin), acetaminophen (Tylenol), ibuprofen (Advil, Motrin), naproxen (Aleve), and others; or
  • any injected antibiotics.

This list is not complete and other drugs may interact with immune globulin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your doctor or pharmacist can provide more information about immune globulin.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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