Adult clinical support tool
Flebogamma 5% DIF infusion protocol
Blank monitoring template. 50 mg/mL (0.05 g/mL) · Start 1.0 mL/kg/hr · maximum 6.0 mL/kg/hr. For patient-specific pump rates in mL/hour use the IVIG Infusion Rate Calculator.
Flebogamma 5% DIF: protocol notes
- Increase to the next rate in 30-minute steps only if the infusion is well tolerated. The maximum rate is 6.0 mL/kg/hr (0.10 mL/kg/min).
Protocol preview
FLEBOGAMMA 5% DIF – IVIG INFUSION PROTOCOL
Adult infusion observation and adverse-reaction checklist
| Patient | MRN | Date | Weight | IVIG dose | Batch / Lot |
|---|
Product: Flebogamma 5% DIF (50 mg/mL (0.05 g/mL)) · Only increase to the next rate if the infusion is well tolerated. Slow or stop the infusion if an adverse reaction occurs and follow the treating clinician's or institution's approved protocol.
| Time / stage | Infusion rate | Vital signs | Side effects and reactions (tick if present) | Symptoms / action taken | Nurse initials | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BP mmHg | Pulse /min | Temp °C | RR /min | SpO₂ % | 1 | 2 | 3 | 4 | 5 | 6 | ||||
| Baseline (before start) | No infusion rate | |||||||||||||
| First 30 minutes | 1 mL/kg/hr (0.017 mL/kg/min) | |||||||||||||
| 30–60 minutes | 2 mL/kg/hr (0.033 mL/kg/min) | |||||||||||||
| 60–90 minutes | 3 mL/kg/hr (0.05 mL/kg/min) | |||||||||||||
| 90–120 minutes | 4 mL/kg/hr (0.067 mL/kg/min) | |||||||||||||
| Next 30 minutes | 5 mL/kg/hr (0.083 mL/kg/min) | |||||||||||||
| Thereafter | 6 mL/kg/hr (0.1 mL/kg/min) — MAX | |||||||||||||
| End of infusion | No infusion rate | |||||||||||||
| Post-infusion (30 min after completion) | No infusion rate | |||||||||||||
1. Allergic reaction / anaphylaxis: rash, itching, facial swelling, wheeze • 2. Respiratory reaction / TRALI: dyspnoea, wheeze, hypoxia • 3. Thrombosis: chest pain, limb swelling, neurological symptoms • 4. Infusion or circulatory reaction: fever, chills, flushing, rigors, hypotension • 5. Severe headache / meningism: headache, neck stiffness, photophobia • 6. Renal / urine output: reduced urine output or signs of renal dysfunction
Flebogamma 5%: Increase to the next rate in 30-minute steps only if the infusion is well tolerated. The maximum rate is 6.0 mL/kg/hr (0.10 mL/kg/min).
Common / infusion-related reactions
Headache • Fever • Chills / rigors • Flushing • Dizziness • Nausea / vomiting • Diarrhoea • Back pain • Myalgia / arthralgia • Rash / urticaria / itching • Infusion-site pain / inflammation • Tachycardia / palpitations • Hypotension or hypertension
Red flags — stop infusion and assess urgently
- Anaphylaxis: hypotension, bronchospasm, angioedema or collapse
- Respiratory distress, hypoxaemia or pulmonary oedema; consider TRALI
- Chest pain, sudden dyspnoea, unilateral limb swelling/pain or focal neurology; consider thrombosis
- Severe headache with neck stiffness or photophobia; consider aseptic meningitis
- Reduced urine output or signs of renal dysfunction
If an infusion reaction occurs
Slow the infusion or stop it depending on severity. Assess ABCs and vital signs. Escalate to the treating clinician. For suspected anaphylaxis or another severe reaction, stop IVIG and initiate the institution's emergency or anaphylaxis protocol. If a mild reaction resolves, any restart should be at a lower tolerated rate according to the prescriber's or local protocol.
Higher-risk patients
Ensure adequate hydration. Use the minimum practicable dose and infusion rate in patients at risk of thrombosis or renal dysfunction. Monitor renal function and urine output when clinically indicated.
This tool supports, but does not replace, the locally approved IVIG protocol, product information, treating clinician's instructions, clinical monitoring and emergency procedures.
This tool supports, but does not replace, the locally approved IVIG protocol, product information, treating clinician's instructions, clinical monitoring and emergency procedures.
FLEBOGAMMA 5% DIF – IVIG INFUSION PROTOCOL
Adult infusion observation and adverse-reaction checklist
| Patient | MRN | Date | Weight | IVIG dose | Batch / Lot |
|---|
Product: Flebogamma 5% DIF (50 mg/mL (0.05 g/mL)) · Only increase to the next rate if the infusion is well tolerated. Slow or stop the infusion if an adverse reaction occurs and follow the treating clinician's or institution's approved protocol.
| Time / stage | Infusion rate | Vital signs | Side effects and reactions (tick if present) | Symptoms / action taken | Nurse initials | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BP mmHg | Pulse /min | Temp °C | RR /min | SpO₂ % | 1 | 2 | 3 | 4 | 5 | 6 | ||||
| Baseline (before start) | No infusion rate | |||||||||||||
| First 30 minutes | 1 mL/kg/hr (0.017 mL/kg/min) | |||||||||||||
| 30–60 minutes | 2 mL/kg/hr (0.033 mL/kg/min) | |||||||||||||
| 60–90 minutes | 3 mL/kg/hr (0.05 mL/kg/min) | |||||||||||||
| 90–120 minutes | 4 mL/kg/hr (0.067 mL/kg/min) | |||||||||||||
| Next 30 minutes | 5 mL/kg/hr (0.083 mL/kg/min) | |||||||||||||
| Thereafter | 6 mL/kg/hr (0.1 mL/kg/min) — MAX | |||||||||||||
| End of infusion | No infusion rate | |||||||||||||
| Post-infusion (30 min after completion) | No infusion rate | |||||||||||||
1. Allergic reaction / anaphylaxis: rash, itching, facial swelling, wheeze • 2. Respiratory reaction / TRALI: dyspnoea, wheeze, hypoxia • 3. Thrombosis: chest pain, limb swelling, neurological symptoms • 4. Infusion or circulatory reaction: fever, chills, flushing, rigors, hypotension • 5. Severe headache / meningism: headache, neck stiffness, photophobia • 6. Renal / urine output: reduced urine output or signs of renal dysfunction
Flebogamma 5%: Increase to the next rate in 30-minute steps only if the infusion is well tolerated. The maximum rate is 6.0 mL/kg/hr (0.10 mL/kg/min).
Common / infusion-related reactions
Headache • Fever • Chills / rigors • Flushing • Dizziness • Nausea / vomiting • Diarrhoea • Back pain • Myalgia / arthralgia • Rash / urticaria / itching • Infusion-site pain / inflammation • Tachycardia / palpitations • Hypotension or hypertension
Red flags — stop infusion and assess urgently
- Anaphylaxis: hypotension, bronchospasm, angioedema or collapse
- Respiratory distress, hypoxaemia or pulmonary oedema; consider TRALI
- Chest pain, sudden dyspnoea, unilateral limb swelling/pain or focal neurology; consider thrombosis
- Severe headache with neck stiffness or photophobia; consider aseptic meningitis
- Reduced urine output or signs of renal dysfunction
If an infusion reaction occurs
Slow the infusion or stop it depending on severity. Assess ABCs and vital signs. Escalate to the treating clinician. For suspected anaphylaxis or another severe reaction, stop IVIG and initiate the institution's emergency or anaphylaxis protocol. If a mild reaction resolves, any restart should be at a lower tolerated rate according to the prescriber's or local protocol.
Higher-risk patients
Ensure adequate hydration. Use the minimum practicable dose and infusion rate in patients at risk of thrombosis or renal dysfunction. Monitor renal function and urine output when clinically indicated.
This tool supports, but does not replace, the locally approved IVIG protocol, product information, treating clinician's instructions, clinical monitoring and emergency procedures.