Intravenous Immunoglobulin (IVIG)
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Intravenous immunoglobulin (IVIG) is an infusion of concentrated antibodies from healthy donors, used to support people whose immune systems are weakened by a health condition or by other treatments. It is given through a vein, usually over several hours, and side effects are usually mild [1].
Quick Answer: What is IVIG?
Intravenous immunoglobulin (IVIG) is a concentrated dose of antibodies from healthy donors' plasma, given through a vein to help the body fight infections. It is used for immunodeficiency caused by health conditions or treatments such as chemotherapy. Fewer than 5% of people have moderate or severe side effects, and it is considered safe for almost everyone, including pregnant women. [1]
What the research says
Higher antibody levels between infusions were linked to fewer pneumonias in primary immunodeficiency. A meta-analysis of 17 studies (676 patients, 2,127 patient-years) of people with primary immunodeficiency and low antibody levels who received IVIG found that pneumonia incidence fell by 27% with each 100 mg/dL increase in the trough IgG level (incidence rate ratio 0.726, 95% CI 0.658 to 0.801). A trough of 500 mg/dL was associated with about five times the pneumonia rate seen at 1,000 mg/dL (0.113 vs 0.023 cases per patient-year) (Orange et al., Clin Immunol, 2010 [2]).
Lower IVIG doses look promising for some immune-mediated conditions, but the evidence is limited. IVIG is used as replacement therapy for primary and secondary immunodeficiency and, at higher doses (about 2 g/kg monthly), to control autoimmune and inflammatory disease. A review of lower-dose use (under 2 g/kg monthly), motivated by cost and plasma supply, found promising results in Kawasaki disease and immune thrombocytopenia and concluded that more research is needed for other conditions (Danieli et al., Autoimmun Rev, 2023 [3]).
IVIG did not clearly help hospitalized adults with COVID-19. A meta-analysis of 13 studies (2,313 patients) found no statistically significant effect of IVIG on mortality (risk ratio 0.91, 95% CI 0.59 to 1.39) or on length of hospital stay (mean difference 0.51 days, 95% CI -2.80 to 3.81), and the authors concluded that the results do not support its use in this group (Marcec et al., Rev Med Virol, 2022 [4]).
Understanding Intravenous Immunoglobulin (IVIG)
IVIG is a specialized therapy made from antibodies collected from healthy donors. For people whose bodies don't make enough antibodies, or whose immune systems mistakenly attack their own tissues, it provides essential support [1].
Like a blood transfusion, IVIG delivers specific components of donated blood. Here, though, you receive antibodies rather than whole blood, and they work with your immune system's natural antibodies to help fight infections. Because an IVIG product contains antibodies from thousands of donors, this broad mix helps strengthen your body against a wide range of infections. It is particularly useful when natural defenses have been weakened by chronic illness or intensive medical treatment [1].
Antibodies attach to viruses and bacteria so the immune system can neutralize them. IVIG supplies a broad mix of donated antibodies.
Common Indications for IVIG Therapy
Healthcare providers use IVIG to manage immunodeficiency caused by a range of health conditions and as a side effect of other treatments [1]. Whether IVIG is appropriate for a particular condition on this list depends on your provider's assessment and on how strong the evidence is for that condition.
Category | Specific indications |
|---|---|
Autoimmune and inflammatory | Lupus, myositis and polymyositis, vasculitis, Sjögren's syndrome, Kawasaki disease, adult-onset Still's disease. |
Infectious diseases | HIV in some children, to help prevent bacterial infections. IVIG is not recommended for treating COVID-19. |
Other conditions | Immune thrombocytopenia (ITP), Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP). |
Treatment side effects | Immunosuppression from chemotherapy, corticosteroids, or immunosuppressants used for autoimmune diseases. |
The IVIG Infusion Procedure
Receiving IVIG is straightforward, but it takes time because the infusion runs slowly [1].
Preparation and Monitoring
You usually don't need any special preparation for an IVIG appointment. You can generally eat, drink, and take your usual medications, but ask your provider whether you should change your routine. Your provider may do blood tests or other checks beforehand to measure your overall health and to monitor any changes before you start [1].
During the Infusion
A healthcare professional inserts a needle into a vein, usually in your arm, and the immunoglobulin slowly infuses into your body. Appointments can take up to several hours, so it helps to bring something to read, watch, or listen to [1].
An IVIG infusion: the antibody solution drips slowly through an IV line into a vein in the arm.
Benefits and Safety Profile
IVIG is a safe, effective way to manage immunodeficiencies and is safe for almost everyone, including pregnant women. It can work alongside other treatments and medications. Its biggest advantage is boosting the strength of your immune system, which lowers your risk of getting sick and can reduce how severe infections are if you do [1].
Potential Side Effects
IVIG is not considered a high-risk medication. Experts estimate that fewer than 5% of people have moderate or severe side effects, but mild reactions are more common and can happen during or shortly after treatment [1].
Mild reactions: nausea, vomiting, headache, fever, chest pain, and muscle or back pain.
Rare complications: hives and itchy skin, high or low blood pressure, meningitis, trouble breathing, blood clots, or kidney damage. All IVIG products carry an FDA boxed warning for blood clots and kidney problems, so get urgent care for chest pain, leg swelling, sudden shortness of breath or passing very little urine.
Recovery and Long-Term Outlook
How often you need IVIG depends on what is weakening your immune system and how your body responds to the first few sessions. You may need only one treatment, but most people need several infusions, usually weekly or monthly [1].
If side effects occur, most start within a few hours or days of a session and are usually mild. Tell your provider about them even when they are mild, because the dose or the speed of the infusion can be adjusted for future sessions [1].
Repeat infusions on a weekly or monthly schedule help keep the immune system's defenses strong over time.
Bottom Line
Intravenous immunoglobulin (IVIG) is an important treatment for people with weakened immune systems. By supplying donated antibodies, this low-risk therapy helps the body fight infection and can improve quality of life for many patients.
Your next step: if you have a condition that affects your immune health, talk with your healthcare provider about whether IVIG could be an appropriate part of your treatment plan.
Frequently Asked Questions
Is IVIG the same as a blood transfusion?
No. Both involve donated components, but IVIG delivers concentrated antibodies rather than whole blood or red blood cells.
How long does an IVIG infusion take?
The duration varies, but appointments can take up to several hours, depending on the dose and how well you tolerate the infusion. Ask your provider how long yours will last.
What are the main benefits of IVIG?
IVIG strengthens your immune system's defenses by supplying antibodies that help the body fight infections, which lowers your risk of getting sick and can reduce how severe an illness is.
Is IVIG safe during pregnancy?
Yes. IVIG is considered safe for almost everyone, including pregnant women, and it can work alongside other treatments and medications.
How soon will I feel the benefits of IVIG?
The antibodies are available to your body as soon as they are infused, although the long-term effect on how often you get infections may take several sessions to become clear.
What is the most common side effect of IVIG?
Mild reactions such as headache and fever are among the most frequently reported side effects and usually appear within hours or days of the infusion.
Can IVIG be administered at home?
Sometimes. IVIG is usually given in a hospital or clinic, but home infusions may be possible with a specialized nurse, depending on your condition and your provider's judgment.
Does IVIG weaken the body's own immune system?
No. IVIG works alongside your own antibodies to help fight infection; it does not stop your body from making its own immune cells.
What are the potential risks of IVIG?
Serious complications are very rare. They can include hives, blood pressure changes, trouble breathing, meningitis, or reduced kidney function, although most people have only mild symptoms such as nausea.
When should I contact my healthcare provider after IVIG?
Contact your provider if you feel uncomfortable or notice side effects during or after an infusion. They can adjust your dose or how fast the infusion runs for future sessions.
Related Reading
Convalescent Plasma: How It Works, Uses and Effectiveness explains convalescent plasma.
References
Cleveland Clinic. IVIG (Intravenous Immunoglobulin). Cleveland Clinic. October 2, 2024. https://my.clevelandclinic.org/health/treatments/ivig-intravenous-immunoglobulin
Orange JS, Grossman WJ, Navickis RJ, et al. Impact of trough IgG on pneumonia incidence in primary immunodeficiency: a meta-analysis of clinical studies. Clinical Immunology. 2010;137(1):21-30. PMID 20675197. https://doi.org/10.1016/j.clim.2010.06.012
Danieli MG, Antonelli E, Auria S, et al. Low-dose intravenous immunoglobulin (IVIg) in different immune-mediated conditions. Autoimmunity Reviews. 2023;22(11):103451. PMID 37748542. https://doi.org/10.1016/j.autrev.2023.103451
Marcec R, Dodig VM, Radanovic I, et al. Intravenous immunoglobulin (IVIg) therapy in hospitalised adult COVID-19 patients: a systematic review and meta-analysis. Reviews in Medical Virology. 2022;32(6):e2397. PMID 36097650. https://doi.org/10.1002/rmv.2397
Medical disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. The clinical information in this guide reflects source material last reviewed in October 2024.
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