sub cutaneous IgG

[skipro]

Curious about sub cutaneous as opposed to the IV IgG I receive

How long of a process is the weekly sub cut version

Does Medicare in the USA cover it?

Thx

Skipro

[AussieNeil Partner Administrator]

Takes about an hour to 90 minutes for spring loaded delivery (depends on whether a syringe 'sticks' and the IgG temperature - viscosity increases with lower temperature). Motorised infusion timing is more consistent. Add another 30 minutes for preparation and clean-up.

Neil

[Newdawn Administrator in reply to AussieNeil]

I’m wondering on the size of the infusion you administer Neil because I find 2 x 4g only takes a maximum of 20 mins which includes preparation and clean up. Is this perhaps because I have the pre-loaded infusions and you need to fill them from vials?

I find it a pretty quick process which I do once a week (7x4g and 1x2g) total over a month.

Newdawn

[AussieNeil Partner Administrator in reply to Newdawn]

It might be your preloaded infusions that make your infusions faster. They aren't (yet?) available here. Sounds like they will really cut back the time needed for both preparation and delivery! I infuse 8 or 9g (2x4g +/- 1 x1g weekly). The 60 to 90 minutes is just the infusion time, delivered from the syringe into a Y tube that splits to deliver the infusion via two needles. Some kits use four needles, which would be faster still. My fastest infusion times are about 45 minutes, but it's generally around an hour. I do find that some syringes can stick quite badly. Normally I can hear a steady 'click, click,click' sound as the syringe plunger slides down the syringe, but some syringes can struggle to move smoothly.

Neil

[Newdawn Administrator in reply to AussieNeil]

Sounds a much longer and clunkier process Neil. I have a pre-loaded syringe which we attach to a needle and then self administer from the plunger. Only one needle too but it’s quite long. I’ll time it but other half says it’s about 10 mins for both in total.

Newdawn

[ChillichilliBangBang in reply to Newdawn]

I go to the "Hotel du Jour " every 6 weeks for IVIG. I quite like the regular contact with the medics.

DIY does have the advantage of saving time, but your descriptions of your different processes are a bit off putting!

Is there a reason you have SC rather than IG?

[Newdawn Administrator in reply to ChillichilliBangBang]

As I indicated in my other post, it’s to save my veins which are difficult to access after nearly 13 yrs of ‘assault’ from CLL blood lets and treatments and also because parking is virtually impossible in my hospital.

I still have consults every 3 months and collect my supplies then but my day unit is very over subscribed and some days you’re lucky to find a chair for treatment so I’m happy to do it at home.

Newdawn

[ChillichilliBangBang in reply to Newdawn]

I am blessed with outstanding veins!

But all the other problems you mention are familiar to me.

[skipro in reply to AussieNeil]

Thank you

[thb4747]

Hi Skipro, time taken will depend on your dose. I infuse 4mg weekly in a 20mg solution. It takes a little over 30 minutes which includes preparation, transfer of fluid to syringe, infusion itself and clean up. Add 25 minutes for each 20mg bottle.

[jillybird13]

Hi I infuse 9mg weekly delivered through 4 needles . Delivery time is 45 mins but add another 40 mins prepping. Pre prepared syringes would be great as I find it difficult sometimes drawing the full amount into the syringe . My hands aren’t as strong as they used to be ., However , the difference it’s made to me is amazing .

[Newdawn Administrator]

From the responses, you’ll see that the pre-loaded syringes make the process a whole lot quicker Skipro but I’m afraid I’ve no idea what the USA provide for home use or how it’s funded.

Regards,

Newdawn

[kimiD]

It takes about 90 minutes deom set up to clean up for me. They send 2 pre-filled glass syringes 10g & 4g to the house. I transfer that into a larger syringe that fits into a pump. There are 3 lines with needles at the end, so 3 sites. The tubing size does matter when it comes to infusion time. I found it faster to transfer to the large syringe, also the pump doesn't require the adapter for the larger syringe. Convenience, a more constant level, and fewer side effects were the reasons I chose SC vs IG. I'm not on Medicare yet but my insurance covers the drug and supplies.

[skipro]

Thank you all!!!

[SERVrider]

I have 16g / 80ml weekly. I draw up the vials into a 100ml syringe which then fits into the Crono PID 100 pump. I use the Neria 4-way infusion sets. It all takes 1hr 15min to infuse and about 10 minutes to unpack the kit, insert the needles and draw up the syringe.

[Classicaljazz]

The physician who ordered my transition from IVIG to SCIG had an oncology pharmacist adjusting my dose-- I had the first two SCIG in an infusion center with an RN directing me the first time, then watching me the second time. I initially used a spring-loaded pump with a four-needle set every two weeks, but over time found that splitting the dose and infusing once a week or more frequently has fewer side effects. With the reduced dose, I eventually abandoned the pump and simply manually push the prefilled syringe into a single butterfly with 6 inch tubing set after doing a single bend of the 27 gauge 1/2 inch needle. There is a bit of resistance and it usually takes 15-20 minutes to infuse. With a 25 gauge needle butterfly set there is no resistance but I would time it so that I took 10 minutes as advised by the Hizentra package insert. The 25 gauge butterfly is 3/4 inch. I did weekly IgG labs for 4 weeks and messaged the oncology pharmacist who adjusted the prescription to keep the levels at what I negotiated with the physician as 600 mg/dL since I still got long-lasting skin and soft tissue infections when we used 400 or 500 as a baseline. Prior to this I would only get IVIG every 2 to 3 months only when IgG dropped under 400 and I was on antibiotics a lot--but, since going to Sub-q I have not had any antibiotics for the more than two years. The dose is tiny -- only 3 grams per week which for Hizentra is only 15 mL per week -- now I only get IgG tests every 6 months with my CLL labs. The first few infusions created quite a bit of rashes and bruising over injection sites, but using the same general areas makes this not happen over time. I usually get itching on day 2 not necessarily near the injection site, but taking a Claritin makes it go away. I usually take two-eight hour acetaminophen and a 10 mg Claritin right before the infusion to avoid any side effects.

If you want to see a video on how to use the bent butterfly set, see the 5-minute Rapid Push Youtube video at youtube.com/watch?v=0D-J1UV...(Not working as expected?)

or watch the Sub-q 90 degree needle set (that some home infusion pharmacies will order for you instead of an all-purpose butterfly set) YouTube Alberta Health Services 12-minute nurse's demo at youtube.com/watch?v=eEiDM7V...(Not working as expected?)

[hervec]

Bonjour I get 50ml Cuvitru 10gr subcutaneous 2 needles 1 pompe 2 hours injection with a Crono PID pump Once a week .

Herve