Section 07 · Monograph
Immune globulin SC
Reviewed Nov 2026FDA label
HizentraImmunomodulator · SC
- Forms
- SC: 20% (200mg/mL)
- Dose
- CIDP maintenance: 0.2g/kg once weekly
- MOA
- FcRn saturation, anti-idiotypic and complement/cytokine modulation
Black Box Warning
- Thrombosis may occur with immune globulin products, including Hizentra
Indications
- Primary humoral immunodeficiencyFDA-labeled
- Maintenance therapy in chronic inflammatory demyelinating polyneuropathy (CIDP) to prevent relapse of neuromuscular disability (adults)FDA-labeled
Mechanism of Action
- Pooled polyclonal IgG (20% liquid) with immunomodulatory effects including FcRn saturation and anti-idiotypic neutralization
Full Dosing
Adult / usual
- CIDP maintenance: 0.2g/kg (1mL/kg) weekly, given in 1-2 sessions over 1-2 consecutive days; may increase to 0.4g/kg weekly if relapse occurs
- Start one week after the last IV immune globulin infusion when transitioning
Contraindications
- Anaphylactic or severe systemic reaction to human immune globulin
- Hyperprolinemia (type I or II)
- IgA-deficient patients with antibodies to IgA and a history of hypersensitivity
Drug Interactions
- May impair response to live virus vaccines — delay vaccination
Adverse Effects
- Local infusion-site reactions (common)
- Headache, fatigue
- Thrombosis
- Aseptic meningitis, hemolysis
Monitoring Parameters
- Infusion-site reactions
- Signs of thrombosis and hemolysis
- Neuromuscular disability scores for CIDP
Pregnancy & Lactation
- IgG crosses the placenta; generally used when clinically needed
- Present in milk; considered compatible with breastfeeding