Intravenous Immunoglobulin (IVIG)
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 Previous national guidelines developed by the NAC are superseded by more recently updated provincial and regional guidelines.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:
- Atlantic Clinical Indications and Criteria for Intravenous and Subcutaneous Immunoglobulin (IVIG/SCIG) Version 1.0
- Ontario IG Utilization Management Guidelines
- Prairie Collaborative Immune Globulin Utilization Management Framework Project. Criteria for the clinical use of immune globulin
- British Columbia IVIG Utilization Management Program Recommendations
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:
- Atlantic Provinces - Adjusted Body Weight Calculator with IVIG Dosing in Adults
- Ontario - Ideal Body Weight Calculator with IVIG Dosing
- Alberta - IVIG_Dosing_Calculator.htm
- British Columbia - IVIG_Dosing_Calculator.htm