Gender
Height
Weight
Dosing weight =
0 kg
Dosing
g/kg
IVIg Dose =
0 g
Rounded Dose =
0 g
Rounded down to nearest 5 g
This is the dose to be ordered on the PPO
Dose Calculator (Adjusted Body Weight)
Adult Guidelines
Hematology
Idiopathic Thrombocytopenic Purpura (ITP)

There must be a diagnosis of ITP and one of the following three:

  1. major bleeding and platelet count less than 50 x 109/L; or
  2. failed to respond to steroids after 3 or more days
  3. rapid elevation of platelets required for surgery

Dose

Acute:
1 g/kg per day for 2 consecutive days

Chronic:
1-2 g/kg no more frequently than every 2 weeks

Open Dose Calculator
Pregnancy Associated ITP

Corticosteroids and IVIG are the first line treatments for maternal ITP. IVIG should be considered if corticosteroid therapy is ineffective, significant side effects occur with steroids or a more rapid platelet increase is required.

Must meet 1 of the following 3 criteria during the first 2 trimesters:

  1. when the patient is having a major bleed,
  2. when platelet counts fall below 10 x 109/L, anytime in the pregrancy OR
    10-30x109/L during the second or third trimester.
  3. rapid elevation of platelets required before delivery.

Dose

1 g/kg per day for 2 consecutive days

Open Dose Calculator
Secondary Immunodeficiency (Acquired Hypogammaglobulinemia)

Patient must be under the care of a Hematologist

Dose

0.4 g/kg every 3 to 4 wks

Reevaluation should be done every 4 – 6 months by a hematologist. A trough IgG level of greater than 7 g/L should be maintained. Consideration should be given to increasing the target trough level if an appropriate clinical response is not achieved. Using trough IgG levels may not be practical in patients with secondary immunodeficiencies with IgG subclass deficiency and who experience recurrent severe infections. In such cases it would be sufficient to assess the effectiveness of IVIG based on clinical response.

Open Dose Calculator
Post Transfusion Purpura (PTP)

No criteria are required other than a diagnosis of PTP

Dose

1 g/kg repeat if necessary

Open Dose Calculator
Acquired Hemophilia with Factor VIII Inhibitor

Patient must be under the care of a Hematologist

Dose

2 g/kg divided over 2 to 5 days

Open Dose Calculator
Factor XIII Inhibitor

Patient must be under the care of a Hematologist

Dose

2 g/kg divided over 2 to 5 days

Open Dose Calculator
Warm Autoimmune Hemolytic Anemia

Patient must be resistant to stereoids and exhibit symptomatic anemia

Dose

up to 2 g/kg

Open Dose Calculator
Immunology
Primary Immunodeficiency Conditions

Consult immunologist or physician experienced managing immunodeficiencies before administering IVIG/SCIG.

Monitor IgG every 5 months to achieve a minimum trough of 7g/L in most patients. After the IgG levels are stable, regularly monitor the levels and adjust the dose as needed.

Dose

0.4 - 0.6 g/kg every 4 weeks.

Open Dose Calculator
Secondary Immunodeficiency Conditions

Consult immunologist or physician experienced managing immunodeficiencies before administering IVIG/SCIG.

IG is only considered appropriate if patient has/had recent life threatening or recurrent clinically significant infection(s) related to low levels of polyclonal immunoglobulin.

Dose

0.4 to 0.6 g/kg every 4 weeks.

Open Dose Calculator
Chronic Idiopathic Urticaria

Patient must meet both of the following criteria:

  1. has failed to respond or has contraindications to high dose antihistamines

    AND
  2. failed to respond or has contraindications to Xolair® (if covered)

Dose

Induction: 1 g/kg per day fpr 3 consecutive days

Maintenance: 1 g/kg every 4 weeks

Open Dose Calculator
Neurology
Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) and variants

Patient must be under the care of a Neurologist

Dose

2 g/kg divided over 2 to 5 days

Maintenance dose: 1 g/kg every 2 to 6 weeks

Open Dose Calculator
Guillain-Barré Syndrome - including Miller Fisher Syndrome and other variants

Patient must meet both of the following criteria:

  1. IVIG is being given within 2 weeks of the symptoms onset

    AND
  2. Hughes Disability Score of Grade 3 severity or greater OR patients with less than Grade 3 severity whose symptoms are progressing

Hughes Disability Scale:

GradeDescription
0healthy
1minor signs or symptoms, able to run
2able to walk 5 m independently
3able to walk 5 m with a walker, stick, or one-person support
4bed- or chair-bound
5Requiring assisted ventilation

Dose

2 g/kg divided over 2 to 5 days

Multifocal Motor Neuropathy (MMN)

NO criteria are required other than a diagnosis of MMN

Dose

Acute: 2 g/kg divided over 2 to 5 days

Maintenance: 1 g/kg every 2 to 6 weeks

Open Dose Calculator
Multiple Sclerosis (MS) Relapsing/Remitting only

Patient must meet 1 of the following 2 criteria:

  1. Pregnant/immediate post partum period when other immunomodulation is contraindicated

    OR
  2. relapsing/remitting MS who fail or have contraindications to standard immunomodulatory therapies

Dose

1 g/kg monthly with or without a 5 day induction of 0.4 g/kg daily

Open Dose Calculator
Myasthenia Gravis (MG)

Patient must meet 1 of the following 3 criteria

  1. acute exacerbation (myasthenic crisis)

    OR
  2. optimization prior to surgery and/or thymectomy

    OR
  3. as maintenance therapy for moderate to severe MG in combination with immunosuppressive agents

Dose

2 g/kg divided over 2 to 5 days every 4 to 6 weeks

Open Dose Calculator
Stiff Person Syndrome

Patient has failed or has contraindications to GABAergic medications

Dose

2 g/kg divided over 2 to 5 days every 4 to 6 weeks

Open Dose Calculator
Autoimmune Encephalitis: N-Mehtyl-D-Asparate (NMDA)

Patient must meet both of the following criteria:

  1. cared for in consultation with a Neurologist

    AND
  2. used in conjuction with immunosupressives and/or plasmapheresis

Dose

2 gk/kg divided over 2 to 5 days

Open Dose Calculator
Autoimmune Encephalitis: Rasmussen's Encephalitis

IVIG is used as a short term temporizing measure

Dose

2 g/kg divided over 2 to 5 days

Open Dose Calculator
Autoimmune Optic Neuropathy

Patient has failed or has contraindications to steroids

Dose

2 g/kg divided over 2 to 5 days

Open Dose Calculator
Lambert-Eaton Myasthenic Syndrome (LEMS)

Patient must be under the care of a Neurologist

Dose

Induction dose: 2 g/kg in 2 to 5 divided doses

Maintenance dose: 0.4 to 1 g/kg every 2 to 6 weeks

Open Dose Calculator
Neuromyelitis Optica (NMO)

Patient has failed or has contraindications to plasma exchange and/or steroids

Dose

1-2 g/kg in 2 to 5 divided doses

Open Dose Calculator
Paraneoplastic Cerebellar Degeneration

Patient must meet both of the following criteria:

  1. treated withing 1 month of symptom onset

    AND
  2. used in conjuction with chemotherapy treatment

Dose

2 g/kg every 4 to 6 weeks

Open Dose Calculator
Dermatology
Scleromyxedema

Patient failed to respond or has contraindications to corticosteroids.

Dose

0.4 g/kg/day for 5 consecutive days every 4 weeks

Open Dose Calculator
Systemic Vasculitic Syndromes including Polyarteritis Nodosa and Livedoid Vasculopathy

Patient must be under the care of a Dermatologist.

Dose

2 g/kg every 4 weeks

Open Dose Calculator
Chronic Idiopathic Urticaria

Patient must meet both of the following criteria

  1. Has failed to respond or has contraindications to high dose antihistamines

    AND
  2. Failed to respond or has contraindications to Xolair®(if covered)

Dose

Induction dose: 1 g/kg/day for 3 days
Maintenance dose: 1 g/kg every 4 weeks

Open Dose Calculator
Dermatomyositis

Patient must meet both of the following criteria:

  1. Has significant muscle weakness

    AND
  2. Failed to respond or has contraindications to corticosteroids

Dose

2 g/kg divided over 2 to 5 days

Open Dose Calculator
Necrobiotic Xanthogranuloma

Patient failed to respond or has contraindications to corticosteroids.

Dose

2 g/kg every 4 weeks

Open Dose Calculator
Pre-Tibial Myxederma

Patient failed to respond or has contraindications to intralesional and oral steroids.

Dose

2 g/kg every 4 weeks

Open Dose Calculator
Pyoderma Gangrenosum

Patient must meet both of the following criteria.

  1. Is under the care of a Dermatologist

    AND
  2. Failed to respond or has contraindications to systemic steroids

Dose

2 g/kg every 4 weeks

Open Dose Calculator
Severe Forms of Autoimmune Blistering Diseases

(Pemphigus vulgaris, Pemphigus foliaceus, Pemphigoid, Cicatricial Pemphigoid, Linear IgA disease, Epidermolysis bullosa acquisita, Pemphigoid gestationis)

Patient must meet both of the following criteria.

  1. Disease is rapidly progressing

    AND
  2. Failed to respond or has contraindications to systemic steroids

Dose

2 g/kg every 4 weeks

Open Dose Calculator
Severe Lupus Erythematosus

Patient failed to respond or has contraindications to corticosteroids

Dose

2 g/kg every 4 weeks

Open Dose Calculator
Rheumatology
Immune-Mediated Inflammatory Myositis

Patient must meet 1 of the following 2 criteria

  1. Failed to respond or has contraindications to corticosteroids with/without immunosuppressive therapies

    OR
  2. The presence of life-threatening disease

Dose

Initial dose: 2 g/kg divided over 2 to 5 days every 4 to 6 weeks

Taper when disease stable

Catastrophic Antiphospholipid Antibody Syndrome

Patient must be under the care of a Rheumatologist

Dose

2 g/kg divided over 2 to 5 days

Adult-onset Still's Disease

Patient must be under the care of a Rheumatologist

Dose

2 g/kg divided over 2 to 5 days

Sjogren's Syndrome

Patient must be under the care of a Rheumatologist

Dose

2 g/kg divided over 2 to 5 days

Hematophagocytic Lympohistiocytosis

Patient must be under the care of a Rheumatologist

Dose

2 g/kg divided over 2 to 5 days

Infectious Disease
Group A Streptococcus (GAS) Necrotizing Fasciitis or Toxic Shock Syndrome

Patient must be treated with a combination therapy of antibiotics and IVIG

Dose

1 g/kg on day 1 and 0.5 g/kg per day on days 2 and 3 OR 0.15 g/kg per day for 5 days

Staphylococcus Aureus Toxic Shock Syndrome (TSS)

Patient must be treated with a combination therapy of antibiotics and IVIG

Dose

1 g/kg on day 1 and 0.5 g/kg per day on days 2 and 3 OR 0.15 g/kg per day for 5 days

Chronic Parvovirus Infection with Anemia

Immunocomprised patient with HPV-B19 Pure Red Cell Aplasia

Dose

Initial dose: 2 g/kg
Maintenance dose: 0.4 -1 g/kg every 4 weeks

Solid Organ Transplant
Acute Mediated Rejection

Give IVIG with plasmapheresis to improve graft survival.

Dose

IVIG is commonly administered as part of a treatment protocol that includes plasmapheresis. Regimens for administration include IVIG after each plasmapheresis treatment or as a set dose of 2 g/kg total, alone or if given with plasmapheresis after the final plasmapheresis treatment. There is no comparative data to indicate which of these approaches are superior.

Pediatric Guidelines
Hematology
Fetal Alloimmune Thrombocytopenia (FAIT)

Patient must meet both of the following criteria:

  1. Mother had a previously affected pregnancy OR has a family history of F/NAIT OR has been found to have platelet alloantibodies

    AND
  2. Treatment is under the direction of a maternal fetal medicine center

Dose

1 g/kg per week throughout the pregnancy

Neonatal Alloimmune Thrombocytopenia (NAIT)

Treatment includes consultation with or is within a high-risk neonatal center

Dose

1 g/kg per day x 2 days

Hemolytic Disease of the Newborn(HDN)

Total serum bilirubin (TSB) rising despite intensive phototherapy

Dose

0.5 to 1 g/kg, with repeat dosing every 12-24 hours as necessary

Idiopathic Thrombocytopenic Purpura(ITP)

Patient must meet 1 of the following 2 criteria:

  1. Platelets less than 50 x 109/L AND either the presence of major bleeding or surgery required

    OR
  2. Platelets less than 20 x 109/L AND treatment clinically indicated

Dose

0.8 to 1 g/kg, with a 2nd dose within 48 hours if the platelet count has not increased to above 20 x 109/L

Neonates of Mothers with ITP

Patient must meet 1 of the following 2 criteria:

  1. Platelets less than 50 x 109/L

    OR
  2. Imaging evidence of intracranial hemorrhage or other serious bleeding

Dose

1 g/kg daily for 2 days with a second dose of 1 g/kg if platelet count is still less than 30 x 109/L

Hematological Malignancy

Patient must meet criteria number 1 and either criteria number 2 or 3:

  1. Acquired hypogammaglobulinemia

    PLUS
  2. History of severe invasive or recurrent sinopulmonary infections

    OR
  3. Registered on a multinational protocol which requires IVIG support

Dose

0.4 to 0.6 g/kg every 3 to 4 weeks

Secondary Immunodeficiency

Patient must be under the care of a pediatric Hematologist

Dose

0.4 g/kg every 3 to 4 weeks

Immunology
Primary Immune Deficiency (PID)

Patient must be under the care of an Immunologist.

Dose

0.3 to 0.6 g/kg every 4 weeks

Secondary Immune Deficiency

Patient must be under the care of an Immunologist

Dose

0.6 to 0.7 g/kg every 3 to 4 weeks

Neurology
Guillain-Barré Syndrome (GBS)

Patient must meet both of the following criteria:

  1. IVIG is being given within 2 weeks of symptom onset

    AND
  2. Hughes Disability score of 3 or more or less than 3 with symptoms progressing
GradeDescription
0healthy
1minor signs or symptoms, able to run
2able to walk 5 m independently
3able to walk 5 m with a walker, stick, or one-person support
4bed- or chair-bound
5Requiring assisted ventilation

Dose

2 g/kg divided over 2 to 5 days

Myasthenia Gravis (MG)

Patient must meet 1 of the following 3 criteria:

  1. Acute exacerbation (myasthenic crisis)

    OR
  2. Optimization prior to surgery and/or thymectomy

    OR
  3. As maintenance therapy for moderate to severe MG in combination with immunosuppressive agents

Dose

2 g/kg divided over 2 to 5 days

Acute Disseminated Encephalomyelitis (ADEM)

Patient failed to respond or has contraindications to corticosteroids

Dose

1 g/kg daily for 2 days every 4 to 6 weeks

Autoimmune Encephalitis: N-Methyl-D-Aspartate (NMDA)

Patient must meet both of the following criteria

  1. Cared for in consultation with a pediatric Neurologist

    AND
  2. Used in conjunction with immunosuppressives and/or plasmapheresis

Dose

1 g/kg daily for 2 days

Autoimmune Encephalitis: Rasmussen's Encephalitis

IVIG is used as a short term, temporizing measure

Dose

2 g/kg daily for 2 days

Post-streptococcal Autoimmune Disorders: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Sydenham's Chorea

Patient must be cared for in consultation with a pediatric Neurologist

Dose

1 g/kg daily for 2 days

Rheumatology
Juvenile Dermatomyositis

Patient must meet both of the following criteria:

  1. Glucocorticoids and other 2nd line agents are contraindicated OR IVIG is part of early therapy in a critically ill child

    AND
  2. Is under the care of a pediatric Rheumatologist

Dose

2 g/kg every 2 to 4 weeks

Kawasaki Disease

No criteria are required other than a diagnosis of Kawasaki Syndrome

Dose

2 g/kg given once

If failure to respond to initial dose, a 2nd dose may be given at least 24 hours after the 1st dose.

Systemic Onset Juvenile Idiopathic Arthritis

Patient must meet both of the following criteria:

  1. Is resistant to other forms of therapy

    AND
  2. Is under the care of a pediatric Rheumatologist

Dose

1 to 2 g/kg every 2 to 4 weeks

Dermatology
Kawasaki Syndrome

No criteria are required other than a diagnosis of Kawasaki Syndrome

Dose

2 g/kg given once

If failure to respond to initial dose, a 2nd dose may be given at least 24 hours after the 1st dose

Scleromyxedema

Patient failed to respond or has contraindications to corticosteroids

Dose

0.4 g/kg/day for 5 consecutive days every 4 weeks

Systemic Vasculitic Syndromes including Polyarteritis Nodosa and Livedoid Vasculopathy

Patient must be under the care of a Dermatologist

Dose

2 g/kg every 4 weeks

Chronic Idiopathic Urticaria

Patient must meet both of the following criteria:

  1. Failed to respond or has contraindications to high dose antihistamines

    AND
  2. Failed to respond or has contraindications to Xolair®(if approved)

Dose

Induction dose: 1 g/kg/day for 3 days
Maintenance dose: 1 g/kg every 4 weeks

Dermatomyositis

Patient must meet both of the following criteria:

  1. Has significant muscle weakness

    AND
  2. Failed to respond or has contraindications to corticosteroids

Dose

2 g/kg over 2 days

Necrobiotic Xanthogranuloma

Patient failed to respond or has contraindications to corticosteroids

Dose

2 g/kg every 4 weeks

Pediatric Atopic Dermatitis

Patient failed to respond or has contraindications to topical steroids and calcineurin inhibitors

Dose

2 g/kg every 4 weeks

Pre-Tibial Myxedema

Patient failed to respond or has contraindications to intralesional and oral steroids

Dose

2 g/kg every 4 weeks

Pyoderma Gangrenosum

Patient must meet both of the following criteria:

  1. Is under the care of a Dermatologist

    AND
  2. Failed to respond or has contraindications to systemic steroids

Dose

2 g/kg every 4 weeks

Severe Forms of Autoimmune Blistering Diseases

(Pemphigus vulgaris, Pemphigus foliaceus, Pemphigoid, Cicatricial Pemphigoid, Linear IgA disease, Epidermolysis bullosa acquisita, Pemphigoid gestationis)

Patient must meet both of the following criteria:

  1. Disease is rapidly progressing

    AND
  2. Failed to respond or has contraindications to systemic steroids

Dose

2 g/kg every 4 weeks

Severe Lupus Erythematosus

Patient failed to respond or has contraindications to corticosteroids

Dose

2 g/kg every 4 weeks

Infectious Disease
Group A Streptococcus (GAS) Necrotizing Fasciitis or Toxic Shock Syndrome

Patient must be treated with a combination therapy of antibiotics and IVIG

Dose

1 g/kg on day 1 and 0.5 g/kg per day on days 2 and 3 OR 0.15 g/kg per day for 5 days

Staphylococcus Aureus Toxic Shock Syndrome(TSS)

Patient must be treated with a combination therapy of antibiotics and IVIG

Dose

1 g/kg on day 1 and 0.5 g/kg per day on days 2 and 3 OR 0.15 g/kg per day for 5 days

Chronic Parvovirus Infection with Anemia

Immunocomprised patient with HPV-B19 Pure Red Cell Aplasia

Dose

Initial dose: 2 g/kg
Maintenance dose: 0.4 -1 g/kg every 4 weeks

Solid Organ Transplant
Acute Antibody Mediated Rejection

Patient must meet the following criterion:

Pathology proven acute antibody mediated rejection IVIG is commonly administered as part of a treatment protocol that includes plasmapheresis.

Regimens for administration include IVIG after each plasmapheresis treatment as a set dose of 2 g/kg total, alone or if given with plasmapheresis after the final plasmapheresis treatment