Intravenous Immunoglobulin (IVIG)

Summary

The NAC supports the use of an adjusted body weight calculator to calculate IVIG dosing in adult patients. A recommendation for the use of one single calculator cannot be made until sufficient data is gathered and reviewed. For reference, here are some examples of calculators currently in use:

Credits
Prepared by
Alan Tinmouth, MD
Provincial Ministry Representative
Corinne Rowswell (PE)
Date of Approval
February 24, 2021
Date of Original Release
Immunoglobulin Utilization Statement

The National Advisory Committee (NAC) endorses the appropriate use of intravenous immunoglobulin (IVIg) and subcutaneous immunoglobulin (SCIg) in Canada. Previous national guidelines developed by the NAC are superseded by more recently updated provincial and regional guidelines.

Immunoglobulin (Ig) utilization, including both IVIg and SCIg, should follow recommendations with respect to indications and dosing stated in the applicable provincial/regional guideline.

In cases where a specific indication is not listed in the applicable regional/provincial guideline, Ig requests should be reviewed and approved by established local or regional/provincial processes, as appropriate. Guidelines from other jurisdictions may serve as a resource when condition specific indications are not listed in the applicable regional/provincial guideline.

For reference, links to the various Canadian and regional/provincial guidelines are provided:

A comparison document of the Canadian regional/provincial guidelines as well as other national guidelines is provided in Appendix D of the National Plan for Management of Shortages of Immunoglobulin - Interim Guidance.

The NAC also supports the use of an adjusted body weight calculator to calculate IVIg dosing in adult patients. Slight variation currently exists between available calculators nationally.

A recommendation for the use of a specific calculator cannot be made until sufficient data is gathered and reviewed.

For reference, links to IVIg adjusted body weight calculators currently in use are included below: