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IVIG Dosing to be based on Ideal Body Weight for Alberta Patients

February 13 , 2018

From AHS Laboratory Services

Key Message:

  • Authorized prescribers of intravenous immunoglobulin (IVIG) in Alberta will be required to prescribe using adjusted body weight dosing for patients. Immuniglobulin is not lipid soluble. Appropriate IVIG dosing takes into account the paitent's ideal body weight, adjusted to compensate for the increasing volume distribution into the patient's larger volume of body fluids.1
  • This change to IVIG dosing will be rolled out on a zone by zone basis. Edmonton zone will be the first to implement in February 2018. Each zone will provide further communications as they get closer to their live dates,

Background:

  • An online calculator has been published on AHS external website. Please click here to calculate dosing weight as well as the resulting IVIG dose. Note that it is acceptable to prescribe lower than the calculated dose. The goal is to provide the lowest possisble dose that maintains clinical efficacy. This is particularly important given that adverse reactions like hemolysis, aseptic meningitis and thrombosis are substantially more likely to happen when a high dose of IVIG is infused.2 Reducing IVIG to the minimal effective dose increases patient safety.

Why this is important:
Changes you will notice as a result of adjusted body weight dosing implementation include:

  • The patient's height and weight are both required when ordering IVIG;
  • the authorized prescriber is responsible for calculating the adjusted dose, and providing this information on the Provinicial IVIG request form at; https://www.albertahealthservices.ca/lab/Page5496.aspx
  • if the dose has not been adjusted, the Transfusion Service will calculate the adjusted dose and communicate the adjusted dose to the patient care unit.

Inquiries and feedback may be directed to:

This bulletin has been reviewed and approved by: Transfusion Medicine Network Co=chairs

  • Leland Baskin, MD, MS, FCAP, FACB, VP Medical Operations, Deputy Medical Director, Calgary Laboratory Services
  • Trevor Richardson BSc(MLS), PMP, CSSGB, CM(Prosci), Transfusion Medicine Lead, Alberta Health Services.

1 Siegel J. Immunoglobulins and obesity. Pharmacy Practice News. 2010;37(1):8-9.

2 Canadian Adverse Reaction Newsletter. 2009;19(4).

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