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IVIG Brands: In-Depth Guide

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IVIG Brands: In-Depth Guide

This page is an in-depth guide about all the IVIG brands and their major differences.

IVIG is the acronym for Intravenous Immune globulin and is mainly given in autoimmune or immunological disorders (diseases in which your immune system attacks your own cells or organs mistakenly). 

Some IVIG products are given intravenously, while some can be administered both subcutaneously or intravenously.

 

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There are ten different brands for IVIG, and this article will differentiate and explain all the IVIG brands in detail.

 

Intravenous Immune Globulin, Defined

Antibodies, or immunoglobulins, are proteins naturally made by our body’s immune systems to fight infections. 

However, sometimes the body is unable to make those antibodies due to any autoimmune disease present in the patient’s body. In other instances, the antibodies are being made, but because of a disorder, they do not function correctly. 

In these cases, antibodies (also known as immunoglobulins) have to be given externally in the form of a medicinal product or drug. 

Intravenous immune globulin (IVIG) is a product made up of antibodies (taken from human blood/pooled plasma of blood donors) and is given intravenously or subcutaneously to the patient. For some brands, IVIG therapy can be given to children starting from two years of age.

 

What Is IVIG Approved For?

The FDA (Food and Drug Administration) has given approval for IVIG to ADMA Biologics (a biopharmaceutical company that manufactures and markets plasma-derived products to treat infectious and immunocompromised diseases). 

The FDA approves IVIG brands for the following conditions: 

  1. Idiopathic (immune) thrombocytopenic purpura (ITP) 
  2. Kawasaki’s vasculitis 
  3. Primary immunodeficiencies

 

What Is IVIG Used To Treat?

IVIG is used to treat several autoimmune, infectious, or idiopathic diseases. The primary conditions that IVIG is used to treat are listed below:

  • Immune thrombocytopenia (IT): This disease occurs when your body doesn’t have enough platelets to clot blood. Immune thrombocytopenia is caused because your immune system has destroyed or attacked the platelets. Nearly all IVIG brands can treat this disorder.
  • Chronic inflammatory demyelinating polyneuropathy (CIDP): This is a neurological disorder that targets the patient’s peripheral nerves.
  • Kawasaki disease: This disease causes inflammation or swelling of the blood vessels in the entire body.
  • Myasthenia Gravis: Myasthenia Gravis is an autoimmune disease in which the communication between nerves and muscles is destroyed because of antibodies. This results in the weakening of skeletal muscles.
  • Lupus: Lupus is an autoimmune disease in which the immune system starts attacking the body’s own organs and tissues.
  • Myositis: Myositis is the inflammation of your voluntary muscles due to any autoimmune disease, injury, or infection.
  • Multifocal motor neuropathy: In this disease, your body’s immune system attacks the focal areas of numerous motor nerves.

 

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What Are the IVIG Brand Names?

The ten different IVIG brands are:

  1. Bivigam
  2. Carimune
  3. Flebogamma
  4. Gammagard S/D (low IgA)
  5. Gammagard Liquid
  6. Gammaked
  7. Gammaplex
  8. Gamunex
  9. Octagam
  10. Privigen

 

What Is the Best Brand of IVIG?

IVIG contains IgG antibodies as their primary component, along with IgE, IgA, IgM, and IgD antibodies in lower amounts.

For patients who have IgA antibodies, IVIG brands containing lower levels of IgA are preferred to avoid any adverse events. 

However, for patients deficient in IgA antibodies, brands having low IgA levels should not be given.

Gammagard S/D contains the lowest concentration of IgA (1 mcg/ml in a 5% solution). For this reason, it is regarded to be the best IVIG brand for patients with sufficient IgA antibodies. Brands like Flebogamma and Gammaplex also have low IgA levels.

 

IVIG Price

IVIG cost can vary from patient to patient, but IVIG is generally quite expensive.

Why Is IVIG so expensive?

IVIG therapy is expensive because of the high cost involved in manufacturing and administering IVIG.

A patient’s overall IVIG therapy cost starts from $5,000 to $10,000. This cost can vary depending on the number of infusions administered and the patient’s weight (hospital stay charges, if needed, are not included).

The per gram cost of IVIG ranges from $100 to $350.

 

Which Pharmaceutical Companies Make IVIG?

Pharmaceutical companies that manufacture different brands of IVIG are: 

  • Biotest AG
  • Octapharma AG
  • Grifols, S.A.
  • LFB Biotechnologies
  • Takeda Pharmaceutical Company, Limited (Shire PLC)
  • Bio Products Laboratory, Ltd.
  • Baxter International, Inc.
  • ADMA Biologics, Inc.
  • Kedrion Biopharma, Inc 
  • BDI Pharma, Inc.
  • CSL Behring

 

IVIG and Normal Saline Compatibility

Normal saline is mainly used and preferred for flushing IV lines before and after IVIG administration. However, because it is incompatible with some IVIG brands such as Gammagard, it is not recommended as diluent.

If hydration is needed during IVIG therapy, Vaughan Nufactor recommends using D5W hypotonic saline solution, as this solution is compatible with IVIG and can run simultaneously with IVIG. 

For diabetic patients, IVIG brands containing a sugar solution or dilution with D5W hypotonic saline solution should be contraindicated.

IVIG Brand

Reconstitution Required

IgA Content

Available Concentrations and Routes of Administration

Sugar Content

Reviews and Ratings on Drugs.com

Bivigam Liquid form, ready to use. Less than or equal to 200 ug/ml 10% liquid solution (IV) No sugar added. 7.0/10
Carimune NF Yes. Available in powder form. Should be reconstituted before use. 720 ug/ml 3% to 12% (IV) Sucrose present 7.0/10
Flebogamma DIF Liquid form, ready to use. Less than 3 mcg/ml 5% and 10% liquid solution (IV) No sugar added. 7.0/10
Gammagard S/D Yes. Available in powder form. Should be reconstituted before use. Less than or equal to 2.2 ug/ml 5% and 10% (IV) Glucose added. 7.0/10
Gammagard Liquid Liquid form, ready to use 37 ug/ml 10% liquid solution
(Can be given intravenously or subcutaneously.)
No sodium, preservatives, sucrose or added sugars. Should be used immediately after opening. 6.3/10
Gammaked Liquid form, ready to use. 46 ug/ml 10% liquid solution
(Can be given intravenously or subcutaneously.)
No sugar added. 7.0/10
Gammaplex Liquid form, ready to use. Less than 4 mcg/ml for 5%;   less than 20 mcg/ml for 10% 5% and 10% liquid solution (IV) D-sorbitol present in 5% solution. 7.0/10
Gamunex-C Liquid form, ready to use. 46 ug/ml 10% liquid solution
(Can be given intravenously or subcutaneously.)
No sugar added. 8.7/10
Octagam Liquid form, ready to use. Less than 100 ug/ml in 5% solution; average of 106 ug/ml in 10% solution 5% and 10% liquid solution (IV) Maltose present. 8.5/10
Some patients experienced mild headaches.
Privigen Liquid form, ready to use. Less than or equal to 25 mcg/ml 10% Protein Liquid (IV) Stabilized with proline. No sugar added. 5.5/10
One patient reported experiencing anaphylactic shock after taking Privigen for primary immunodeficiency. For the other patient, the drug proved to be beneficial with no serious side effects.

 

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IVIG Brands

Detailed reviews of all IVIG brands are given below. The dosage may be adjusted according to the disease and the patient’s condition or response.

 

1. Bivigam: 10% Liquid Solution

Overview:

Bivigam is a 10% liquid solution that is given intravenously. The drug contains a 10% (100 mg/ml) IgG antibody level.

Treatment:

Bivigam, 10% liquid, is mainly indicated for treating primary humoral immunodeficiency (PI) or raising platelet levels.

What is PI?

Primary humoral immunodeficiency is defined as a set of various disorders. In these conditions, the patient encounters B cell-intrinsic abnormalities, which results in a decrease in B cell production along with a lack of normal antibody production.

Common side effects include:

  • Fatigue 
  • Headache or migraine
  • Nausea
  • Diarrhea
  • Muscle and back pain
  • High blood pressure

Adverse effects include:

  • Thrombosis
  • Infusion site reaction
  • Sinusitis
  • High blood pressure

Dosing

The recommended dose for Bivigam given in primary humoral immunodeficiency is 300 – 800 mg/kg delivered every 3 to 4 weeks.

The exact dose of IVIG drugs may vary from patient to patient according to their condition and response, and may be adjusted with time for achieving the desired trough level (minimum drug concentration in blood).

Price

The price for Bivigam 50 ml starts at $704.

 

2. Carimune 

Treatment

Carimune therapy is used to treat primary immunodeficiency (PI). In this disease, patients have a weakened immunity because their immune system is not working properly. As a result, the chances of infections and sickness increase.

Common side effects include:

  • Cough and difficulty breathing
  • Fever
  • Fatigue
  • Pale skin
  • Runny nose
  • Weakness and chest tightness

Dosing

0.4 – 0.8 g/kg every 3 to 4 weeks by IV infusion.

 

3. Flebogamma

Treatment

Flebogamma is given if a patient doesn’t have enough antibodies to fight infections or is suffering from a condition associated with an inability to produce enough antibodies (e.g., primary immunodeficiency).

It also treats certain immune disorders such as: 

  • Hypogammaglobulinemia (reduction in the levels of antibodies).
  • Idiopathic thrombocytopenic purpura (ITP) (insufficient platelets in the blood).
  • Kawasaki disease (inflammation in several organs of the body). 
  • Guillain-Barre syndrome (inflammation of the nerves in various parts of the body).

Side effects include:

  • Headache
  • Fast heart rate
  • Fever and chest pain
  • Chills
  • Vomiting and nausea
  • Back pain or muscle pain
  • Dizziness and diarrhea
  • High or low blood pressure 

Dosing (for PI)

300 – 600 mg/kg every 3 to 4 weeks. 1 mg/kg per minute should be given as the initial infusion rate, followed by a maintenance dose (if tolerated) of 8 mg/kg per minute.

 

4. Gammagard S/D (low IgA)

Treatment

Gammagard S/D contains the least amount of IgA, which is less than 2.2 ug/ml in a 5% solution. It can treat the following conditions: 

  • Primary immunodeficiency
  • Chronic ITP 
  • Other immune disorders

Common side effects include:

  • Dizziness
  • Joint pain
  • Fever
  • Earache
  • Throat irritation
  • Skin rash
  • Headache and cough
  • Nausea and vomiting
  • Diarrhea

Severe side effects include:

  • Breathing difficulties and wheezing

Dosing

300 – 600 mg/kg for PI, infused every 3 to 4 weeks.

 

5. Gammagard Liquid

Treatment

Gammagard liquid, a ready-to-use liquid product, is the first FDA-approved IVIG product that is used to treat multifocal neuropathy. It is also given for primary immune deficiency syndromes and contains immunoglobulin IgG to protect the body and fight infections.

Common side effects include: 

  • Headache
  • Nausea or vomiting
  • Back or joint pain
  • Muscle cramps
  • Dizziness
  • Fever 
  • High blood pressure

 Consult your doctor if any of these symptoms worsen or persist for an unusual duration.

 Severe side effects include: 

  • Fainting
  • Bleeding or bruising
  • Irregular heartbeat
  • Abnormally high blood pressure 

Dosing

The common dose for patients with a primary immune deficiency is 300 – 600 mg/kg administered every 3 to 4 weeks.

Price

The price for a Gammagard 10% liquid solution for 10 ml is $165.33, but the price can vary slightly for different pharmacies.

 

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6. Gammaked 

Treatment

Gammaked is administered either subcutaneously or intravenously to treat PI in adults and children who are two years or older.

Gammaked should be administered only intravenously for the treatment of ITP and CIPD. (It is only given to adults for treating CIPD).

Side effects include:

  • Cough and sore throat
  • Runny nose
  • Sinusitis
  • Headache
  • Fever
  • Chills
  • Nausea
  • Diarrhea
  • Fatigue
  • Joint pain
  • Back pain
  • Upper respiratory tract infection
  • Bronchitis or asthma
  • Allergic reaction (rash, redness, pain, or itchiness at the site of injection or elsewhere)

Dosing

For PI, the dose for Gammaked is 300 – 600 mg/kg administered every 3 to 4 weeks intravenously. The dose may be adjusted according to the patient’s response.

Price

 A 10 ml supply of Gammaked 10% solution costs around $176.

 

7. Gammaplex

Treatment

Gammaplex treats the following conditions: 

  • Primary humoral immunodeficiency in patients who are two years and older. Diseases may include:
  • Chronic immune thrombocytopenic purpura (ITP) to increase platelet levels.

 Common side effects include:

  • Nausea or vomiting
  • Dehydration
  • Chest pain
  • Headache
  • Dizziness and fever

Seek immediate medical attention if side effects persist or worsen.

Serious side effects include: 

  • Vomiting and dehydration
  • Thrombosis

Dosing

For patients with PI, the recommended dose of Gammaplex is 300 – 800 mg/kg administered every 3 to 4 weeks.

For patients with ITP, the recommended dose is 1 g/kg given for 2 consecutive days.

Price

Gammaplex 5% costs around $940 for a 100 ml intravenous solution.

 

8. Gamunex

Gammunex can be used to treat: 

  • Primary humoral immunodeficiency diseases in patients who are two years or older.
  • ITP in adults and children
  • CIDP in adults

Common side effects include:

  • Headache
  • Dizziness
  • Cough
  • Nausea and vomiting
  • Fever or chills
  • Back or joint pain
  • Pain and swelling at the site of injection

Consult a doctor if symptoms persist.

Serious side effects that require immediate consultation include: 

  • Fast heartbeat
  • Excessive tiredness
  • Inflammation of the brain
  • Severe headache
  • Sensitivity to light

Dosing (for PI)

300 – 600 mg/kg administered every 3 to 4 weeks.

Price

The average cost is $145 for 10 ml.

 

9. Octagam

Treatment

Octagam can be used to treat: 

  • PI
  • ITP
  • Dermatomyositis (DM) in adults

Common side effects include: 

  • Mild headache
  • Tiredness
  • Dizziness
  • Minor chest pain
  • Pain and swelling at the injection site
  • Abdominal or back pain
  • Muscle cramps

Serious side effects include: 

  • Kidney, liver, or lung problems
  • Blood clots or initial signs of blood clots in the brain, heart, lungs, or legs.

Dosing

The dose may be adjusted according to the patient’s response. The recommended dose for Octagam 5% liquid for PI diseases is usually 300 – 600 mg/kg administered every 3 to 4 weeks.

Price

Octagam 10% costs $385 for 20 ml.

 

10. Privigen 10% Protein Liquid

Privigen is a ready-to-use liquid made with IgG antibodies given to patients as their IgG therapy.  It has proven to be safe in clinical trials, and it is the only IVIG brand and immunoglobulin therapy that is stabilized with proline.

Proline, a naturally occurring amino acid, is incorporated to keep the product stable at room temperature. It can be convenient for patients because they do not have to store Privigen in the refrigerator. 

Privigen must not be given to patients with hyperprolinemia (excess proline in the blood) since the product already contains proline. Using Privigen in these patients may aggravate their condition.

Treatment/Therapy:

Privigen can treat the following conditions: 

  • Various types of primary immunodeficiency (PI).
  • Chronic Immune thrombocytopenic purpura (ITP) for patients over the age of 15.
  • Chronic inflammatory demyelinating polyneuropathy (CIDP) in adults.

Common side effects include: 

  • Headache
  • Nausea
  • Fatigue
  • High blood pressure
  • Fever

Serious side effects that should be reported immediately include: 

  • Serious allergic reaction.
  • Shock, chest tightness, breathing difficulty or wheezing.
  • Sudden weight gain.
  • Worsening of the common side effects like excessive drowsiness, high fever, headache, stiff neck, or fatigue.
  • Pain or/and swelling in arms or legs.
  • Difficulty in urine output.

Dosing

The common dosage for treating PI is 200 – 800 mg/kg administered every 3 to 4 weeks.

The dose for chronic ITP is 1 g/kg for 2 consecutive days.

Price

The price for Privigen is $804 for 50 ml.

 

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Are There Different Types Of IVIG?

There are mainly five different types of IVIG (immunoglobulin).

  1. IgG 
  2. IgA
  3. IgM
  4. IgE
  5. IgG 

The primary component present in IVIG is IgG antibody, while the other antibodies are present in trace amounts. The IgG antibody is the main antibody present in our blood.

IgG is more durable than IgM, and it is a fundamental component of the humoral immune system.

 

SCIG (Subcutaneous Immunoglobulin) Brands

The different brands of immunoglobulin can be given either subcutaneously or intravenously. 

SCIG is given subcutaneously to treat primary immune disorders. 

SCIG brands include:

  • Gammagard liquid
  • Gammaked
  • Gamunex

 

Conclusion

There are ten different IVIG brands. All are being used to treat autoimmune diseases such as primary immunodeficiency and chronic idiopathic thrombocytopenic purpura. 

However, some brands are contraindicated in diabetic patients due to the presence of sugar content. Other brands, such as Gammagard S/D, are appropriate for patients who have IgA antibodies. For patients with hyperprolinemia, Privigen should be contraindicated. In short, the specific brand used will depend on each patient’s individual condition and disorder.

Healthcare professionals should remain cautious and keep a keen eye on the patient’s history before prescribing any IVIG brand.  

The dosage of each IVIG drug may vary for each patient and should be modified during the course of therapy to achieve the desired therapeutic response.

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