Pooled antibodies (human immunoglobulin)
Normal immunoglobulin
Pooled human antibodies used to replace antibodies in immune deficiency and to treat some immune, inflammatory and infectious conditions.
What is Normal immunoglobulin?
Normal immunoglobulin is a preparation of antibodies pooled from many blood donors. It is used to replace antibodies in people whose immune system cannot make enough of its own, and to treat a range of immune, inflammatory and some infectious conditions. It is given either into a vein or under the skin. Because it is given by infusion, reactions can happen, particularly when first started, and there are small risks of blood clots, kidney problems and a temporary irritation of the lining around the brain. As a product made from human plasma, it carries the safeguards that go with blood-derived medicines.
Education and reference only. This is a plain-language guide to Normal immunoglobulin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Normal immunoglobulin is made from the antibody-rich part of blood (plasma) donated by many people, pooled and purified into a concentrated antibody preparation. Antibodies are the proteins the immune system uses to fight infection. The medicine has two broad jobs: replacing antibodies in people who cannot make enough of their own, leaving them prone to infections, and acting as a treatment in certain immune and inflammatory diseases and some infections, where large amounts of antibodies can calm or alter the immune response. It is given into a vein or, in some cases, under the skin, under specialist supervision.
How it works
When used as replacement, the donated antibodies stand in for the ones the person's own immune system cannot make, helping defend against infection. When used as a treatment in immune or inflammatory conditions, large amounts of antibodies are thought to dampen down or rebalance an overactive immune response in several ways, easing the disease. In some infections, the antibodies can help neutralise the germ or its effects. Because the antibodies are gradually used up and broken down, treatment usually needs to be repeated on a regular schedule, especially when it is being used to keep antibody levels topped up.
Company & origin
Originated / developed by: Specialist manufacturers.
A specialist plasma-derived medicine used in the UK to replace antibodies and to treat certain immune, inflammatory and infectious conditions, given into a vein or under the skin.
Practical use
How to take Normal immunoglobulin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given into a vein or under the skin by trained staff, or at home after training for some people.
- Infusions are started slowly and the rate increased carefully, as reactions are most likely early on.
- Drink enough fluids around the time of treatment, as this helps lower the small risk of clots and kidney problems.
- Treatment is usually repeated on a regular schedule, especially when replacing antibodies long term.
- Tell the team about any reaction during or after an infusion, and about other medicines you take.
Weighing it up
Advantages & disadvantages of Normal immunoglobulin
Advantages
- Replaces missing antibodies in people who cannot make enough, helping prevent infections.
- Treats a range of immune, inflammatory and some infectious conditions.
- Can be given into a vein or, for some people, under the skin, including at home.
Disadvantages
- Can cause infusion or allergic reactions, especially when first started.
- Carries small risks of blood clots, kidney problems and a temporary irritation of the lining around the brain.
- Is made from pooled human plasma and usually needs to be repeated regularly.
Practical use
Good to know
A few important points come with this medicine. Because it is given by infusion, reactions can occur, such as headache, fever, chills, flushing or, rarely, more serious allergic reactions, and these are most likely when treatment is first started or the rate is increased, so it is given slowly and watched. There are small but recognised risks of blood clots and of kidney problems, which is why people are kept well hydrated and the infusion rate is controlled. A temporary irritation of the lining around the brain, causing severe headache and neck stiffness, can occasionally occur and settles after treatment. As a product made from pooled human plasma, it is prepared with strict donor screening and steps to reduce the risk of passing on infection, and a record is kept of which product is given.
Who should not take it / use with caution
- People who have had a serious allergic reaction to immunoglobulin should not receive it.
- People with certain antibody deficiencies (a lack of IgA with antibodies against it) need special care because of reaction risk.
- It is used with caution in people at higher risk of blood clots or with kidney problems, under specialist guidance.
Monitoring
- Watching closely for reactions during and after each infusion.
- Checking kidney function and, where relevant, antibody levels.
- Keeping a record of which product and batch is given, as with all plasma-derived medicines.
Side effects
- Headache, fever, chills, flushing or aching, particularly during or soon after an infusion.
- A temporary irritation of the lining around the brain, causing severe headache and neck stiffness, which settles.
- Rarely, blood clots, kidney problems or serious allergic reactions.
Key interactions
- It can interfere with the response to some vaccines, particularly live vaccines, so timing is planned.
- It can affect the results of some blood tests for a while, so labs should know it has been given.
- Tell the team about all your medicines, including any that affect clotting or the kidneys.
Available as: A solution given into a vein or under the skin.
Answers
Normal immunoglobulin: frequently asked questions
What is normal immunoglobulin used for?
It replaces antibodies in people who cannot make enough of their own and treats some immune, inflammatory and infectious conditions, using antibodies pooled from many donors.
How is it given?
It is given either into a vein or under the skin; some people learn to give the under-the-skin form at home after training.
Why might I get a headache afterwards?
Headache is a common reaction, and occasionally there can be a temporary irritation of the lining around the brain causing severe headache and neck stiffness, which settles after treatment.
Is it safe, as it comes from blood?
It is made from pooled human plasma with strict donor screening and steps to reduce infection risk, and a record is kept of the product given.
Why do I need it regularly?
The antibodies are gradually used up by the body, so when it is replacing antibodies it usually needs to be repeated on a regular schedule.
The wider class
About Pooled human antibodies (immunoglobulin)
Normal immunoglobulin belongs to the pooled human antibodies (immunoglobulin) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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