Intravenous Immunoglobulin (IVIG) therapy provides the body with a concentrated dose of pooled antibodies, known as immunoglobulins, sourced from thousands of healthy donors. This therapy treats a wide range of conditions, including primary immune deficiencies and certain autoimmune and neurological disorders. Although IVIG is highly effective, patients often experience temporary side effects. Understanding the timeline for how long these reactions last helps patients manage expectations and prepare for the infusion process.
Acute Side Effects: Timing and Duration
Acute side effects occur during the infusion or immediately afterward, often starting within the first 30 to 60 minutes, especially if the treatment is administered too quickly. Common symptoms include a flu-like presentation such as headache, flushing, chills, fever, and mild muscle aches (myalgia).
These acute symptoms are typically very short, often resolving quickly once the infusion rate is slowed or after administering simple medications. Most immediate reactions subside completely within four to 24 hours after the infusion is finished. These rapid reactions are often linked to the speed of the infusion or the body’s initial response to the concentrated protein load.
Delayed Systemic Reactions and Resolution
Delayed side effects occur hours or days after the IVIG infusion is complete. The most frequently reported delayed reaction is a headache, which can be quite severe and may resemble a migraine. Other common delayed effects include profound fatigue, joint pain (arthralgia), and sometimes a delayed skin rash.
These symptoms typically last longer than acute reactions, often persisting for one to seven days. A severe headache may continue for 24 to 72 hours before fully resolving. Dermatological effects, such as a rash, may take up to two weeks to completely disappear.
Managing Side Effects to Minimize Length
Proactive management mitigates the severity of IVIG side effects and minimizes their duration. Maintaining excellent hydration before and after the infusion is effective, as dehydration can worsen symptoms like headache and fatigue. Slower infusion rates are also directly correlated with fewer and less intense adverse reactions.
Pre-treatment with certain medications, known as premedication, helps prevent or reduce the length of common reactions. This often involves taking acetaminophen or a non-steroidal anti-inflammatory drug (NSAID) for headache and fever. An antihistamine may also be used for flushing or mild allergic symptoms about an hour before the infusion begins. For patients with significant constitutional symptoms, a corticosteroid may be employed to suppress the inflammatory response and limit symptom duration.
Serious Adverse Events: Recognizing When Duration Is Critical
While most IVIG side effects are temporary and mild, rare but serious adverse events require immediate medical attention. These severe complications include signs of a blood clot (thrombosis), acute kidney injury, and aseptic meningitis. Aseptic meningitis, inflammation of the lining of the brain and spinal cord, typically manifests one to three days after infusion with symptoms like a severe headache, neck stiffness, and light sensitivity.
If a severe headache persists longer than 24 hours, or is accompanied by neck stiffness, photophobia, or extreme nausea, contact a healthcare provider immediately. Signs of potential kidney issues, such as decreased urine output, or symptoms suggestive of a clot—like sudden shortness of breath, chest pain, or weakness—require emergency intervention. Prompt treatment is necessary for these serious events.