Myasthenia Gravis : sa

Why am I being treated with IVIG?

IVIg might be prescribed for an individual with MG for one of several reasons. The first indication for use might be for a hospitalized patient who is extremely ill and might not be responding adequately to other treatments. Some patients with MG who are being treated with IVIg have improved quickly, thus allowing time for other treatments to begin working. Patients at home who are having significant symptoms in spite of aggressive treatment with other drugs and treatments may be considered for treatment with IVIg also.

What are some important things to consider when taking pyridostigmine?

It is important to take pyridostigmine on time and exactly as it has been prescribed. If one dose is missed within an hour of the prescribed dose, the patient should take the missed dose and continue with the other doses as scheduled. If the dose is missed by more than one hour, the patient should take the dose immediately and then wait the required 3 to 4 hours before taking the next dose. Subsequent doses should be taken with the prescribed intervals as well. For example, if a dose of pyridostigmine missed at noon is taken at 2 p.m., the next dose would be taken at 5 or 6 p.m. or as directed by the neuro surgeon. Never take a double dose to make up for a missed one.

How does IVIg work?

IVIg seems to effect the function or the production of antibodies in the immune system. The exact mechanism of how IVIg works in successfully treating myasthenia gravis and other autoimmune disorders is not entirely understood.
Since IVIg is a blood product, is it safe? IVIg is felt to be very safe with regard to exposure to infection or viruses. Donors are screened. The processing of IVIg inactivates such infections as HIV and Hepatitis B and C. Nonetheless, it is a human blood product that comes from multiple donors.
Are there adverse effects that occur with IVIg treatments? For the most part, IVIg is considered quite safe. However, there are several adverse effects that may occur on occasion. Some patients develop headache, chills and aches during the infusion. Slowing the infusion and using medicines to relieve these symptoms may be helpful.
Some patients will experience fatigue, fever or nausea that may persist up to 24 hours after the infusion. Some patients may have migraine headaches, aseptic meningitis, skin reactions or a more severe allergic type reaction. Because IVIg is a highly concentrated protein, it can sometimes interfere with blood flow and clotting.

How is IVIg administered?

IVIg treatments are administered intravenously. The medication is infused slowly over a number of hours. The dose is based on the individual’s weight. Many patients are treated with a series of infusions over a period of three to five days. Other patients may have infusion intervals even farther apart. Patients who are treated with long-term maintenance therapy have a single infusion every few weeks.
For some patients, the infusion is given in a neuro surgeon’s office, while others may have it in the home using a home health agency. Patients who are severely weakened are treated in the hospital. A week or two may be required before the patient feels the onset of improvement, although this varies from patient to patient. The duration of improvement from IVIg is usually limited to a few weeks to a few months.

What are other concerns about using IVIg?

IVIg is expensive and this can be a major issue in management. It is important to discuss the cost issues with one’s health insurance provider in order to prevent an unforeseen financial dilemma.