Hizentra

See full labeling. Individualize. Give by SC infusion using an infusion pump into abdomen, thigh, upper arm, or lateral hip areas. May use up to 8 infusion sites (at least 2 inches apart) simultaneously. Rotate sites. Primary immunodeficiency: <2yrs: not established. Ensure patients have received IGIV at regular intervals for at least 3 months before initiation; obtain serum IgG trough level to guide subsequent dose adjustments. Start 1 week after last IGIV or IGSC infusion (for weekly or frequent dosing), or 1–2 weeks after last IGIV infusion or 1 week after last weekly IGSC infusion (for biweekly dosing). ≥2yrs: initial weekly dose: (1.37 x previous IGIV dose [in grams])/number of weeks between IGIV doses. Infuse as tolerated up to max 15mL per infusion site at max 15mL/hr/site for first dose; may increase to 25mL/site at max 25mL/hr/site for subsequent doses. Biweekly dose: multiply the calculated weekly dose by 2. Frequent dosing (2–7 times/week): divide calculated weekly dose by the desired number of times per week. Switching from IGSC: maintain previous IGSC weekly dose. Risk of measles exposure: give a minimum total weekly dose of 0.2g/kg for 2 consecutive weeks; if biweekly dosing: give one infusion at minimum of 400mg/kg. Dose adjustments: based on serum IgG trough levels after 2–3 months of initiation and desired clinical response (see full labeling). CIDP: <18yrs: not established. Start 1 week after last IGIV infusion. ≥18yrs: 0.2g/kg (1mL/kg) per week in 1–2 sessions over 1–2 consecutive days (0.4g/kg/week was also shown effective in clinical study). Infuse as tolerated up to max 20mL per infusion site at max 20mL/hr/site for first dose; may increase to 50mL/site at max 50mL/hr/site for subsequent doses. If worsening CIDP symptoms on 0.2g/kg/week: consider increasing to 0.4g/kg/week. If CIDP symptoms worsen on 0.4g/kg/week, consider re-initiating IGIV while discontinuing Hizentra (see full labeling). Thrombosis risk: give at minimum dose and/or infusion rate practicable.