Ask the Pharmacist: What is IVIG

Dear Doc,
I just attended a support group for MG and hear other patients talking about IVIG. What is it? Is it superior to the Mestinon I’m taking now. What does it cost? Does insurance pay? I live in Glendale.

Intravenous Immunoglobulin (IVIG) is a plasma protein replacement therapy which is obtained from blood donors. The pooled plasma goes through a rigorous process of fractionation (obtaining the IgG antibodies from the pooled plasma) and a viral inactivation process for manufacturing IVIG free of any dangerous pathogens. Once safely manufactured, it is administered to patients with immune deficiencies and various autoimmune disorders including Myasthenia Gravis. Even though IVIG is considered an off-label indication for MG and the cost can be very high, insurance companies are only authorizing the use of IVIG for patients who develop a myasthenic exacerbation such as acute respiratory failure, difficulty in swallowing or any major functional disability responsible for the discontinuation of physical activity. Until more studies are conducted to determine the effectiveness of IVIG in the long term treatment of MG, it will be very important for patients to work closely with their physicians and stay compliant with their current therapies to prevent any exacerbations of their condition.