Chetan A. Patel MD and Edward F. Bell, MD
Peer Review Status: Internally Peer Reviewed

IVIG should be administered by itself, with careful monitoring during the infusion. Vital signs should be monitored during the infusion (preferably q 15 min. X 2, then q hr). In the large multicenter trials involving infants, very few adverse reactions were noted during infusion. These consisted of mild increases or decreases in blood pressure, heart rate, or temperature (that were reversed by slowing the rate of infusion) or acute fluid overload. Since the dose of IVIG is equivalent to an approximately 10 ml/kg fluid bolus, the infusion is administered over several (typically 3 - 4) hours. 

Tolerance of IVIG Administration to Neonates Table
Brand name Form Characteristics Reconstituted In Cautions
Gammagard® (Baxter) 0.5, 2.5, 5 and 10 g vials pH 6.8, 2% glucose, 0.3% albumin Sterile Water Rate dependent side effects on HR, BP, Temperature
Gamimune N® (Miles-Cutter) 5% solutions (Premixed) pH 4.25. 10% maltose (For Isotonicity) Above; Hyperglycemia, and rare decreased pH
Sandoglobulin (Sandoz) 1, 3, and 6 g vials pH 6.6, 5 or 10% sucrose (1.67 g) 0.9% NaCl, D5W, or sterile water Above, Hyperglycemia


Jensen HB, Pollock BH. Meta-analysis of the effectiveness of intravenous immunoglobulin for prevention and treatment of neonatal sepsis. Pediatrics, 1997; 99:E2.

Baker CJ, Melish ME, Hall RT, et al. Intravenous immune globulin for the prevention of nosocomial infection in low-birth-weight neonates. N Engl J Med 1992; 327:213-9.

Fanaroff AF, Korones SB, Wright LL, et al. A controlled trial of intravenous immune globulin to reduce nosocomial infections in VLBW infants. N Engl J Med 1994; 330:1107-1113.

Kliegman RM and Clapp DW. Rational principles for immunoglobulin prophylaxis and therapy of neonatal infections. Clin Perinatol 1991; 18:303-24.

Weisman LE, Stoll BJ, Keuser TJ, et al. Intravenous immune globulin therapy for early-onset sepsis in premature neonates J Pediatr 1992; 121:434-43.