Hyqvia – Hyaluronidase Recombinant Immune Globulin

What is Hyqvia

Hyqvia is a subcutaneous immunoglobulin (SCIG) used with recombinant human hyaluronidase for the treatment of primary immunoglobulin deficiency. It is the first SCIG that requires just 1 infusion up to once per month.

At least 98% of the immune globulin protein is IgG. The product is a dual vial unit consisting of 1 vial of human immune globulin and 1 vial of recombinant human hyaluronidase.

Hyaluronidase is subcutaneously infused prior to infusion of SCIG, which increases the absorption and dispersion of immune globulin.

Lifelong replacement therapy with human immune globulin provides passive immunity to decrease susceptibility to life-threatening infections in patients with predominant antibody deficiencies.

The use of SCIG may decrease the incidence of systemic adverse events compared to IVIG; however, local reactions are more common.

Subcutaneous administration may be desirable for patients who have poor venous access.

Patients or caregivers can self-administer the immune globulin and hyaluronidase infusions at home with proper training.

Indications

  • immunoglobulin deficiency

General dosing information:

  • Initiate treatment using an interval/dosage ramp-up schedule, which allows for dosage escalation over 7 weeks to a target dose to be given every 3—4 weeks. During dosage escalation, the time intervals between doses increases.
  • A full therapeutic dose may be administered in 1 site up to every 4 weeks.
  • Consider drug volume, total infusion time, and tolerability when adjusting dosage frequency and number of infusion sites. Adjust the frequency of administration so that the patient receives the same weekly equivalent dose.
  • Suggested sites for infusion are the middle to upper abdomen and thighs.
  • Consider the use of a second infusion site or infusing at shorter intervals when the volume exceeds 300 ml for patients < 40 kg or 600 ml for patients >= 40 kg

Side Effects

  1. abdominal pain
  2. acute respiratory distress syndrome (ARDS)
  3. anaphylactic shock
  4. anaphylactoid reactions
  5. antibody formation
  6. anxiety
  7. apnea
  8. aseptic meningitis
  9. back pain
  10. bronchospasm
  11. bullous rash
  12. cardiac arrest
  13. coma
  14. cyanosis
  15. dyspnea
  16. erythema
  17. erythema multiforme
  18. fatigue
  19. fever
  20. headache
  21. hemolysis
  22. hemolytic anemia
  23. hyperhidrosis
  24. hypertension
  25. hypotension
  26. hypoxia
  27. infection
  28. injection site reaction
  29. insomnia
  30. leukopenia
  31. myocardial infarction
  32. nausea
  33. osmotic nephrosis
  34. pancytopenia
  35. pruritus
  36. pulmonary edema
  37. renal failure (unspecified)
  38. renal tubular necrosis
  39. seizures
  40. Stevens-Johnson syndrome
  41. thromboembolism
  42. tremor
  43. vomiting

Monitoring Parameters

  • serum creatinine/BUN
  • serum IgG concentations

Contraindications

  • breast-feeding
  • cardiac disease
  • coronary artery disease
  • dehydration
  • diabetes mellitus
  • geriatric
  • heart failure
  • hypertriglyceridemia
  • hyponatremia
  • hypovolemia
  • IgA deficiency
  • infection
  • intramuscular administration
  • intravenous administration
  • obesity
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment
  • sepsis
  • thromboembolism
  • vaccination
  • viral infection

Interactions

  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acyclovir
  • Adefovir
  • Amide local anesthetics
  • Amikacin
  • Aminoglycosides
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amlodipine; Celecoxib
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Articaine; Epinephrine
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Bacitracin
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bupivacaine
  • Bupivacaine Liposomal
  • Bupivacaine; Lidocaine
  • Capreomycin
  • Celecoxib
  • Chloroprocaine
  • Choline Salicylate; Magnesium Salicylate
  • Cidofovir
  • Cisplatin
  • Cocaine
  • Colistimethate, Colistin, Polymyxin E
  • Conjugated Estrogens
  • Conjugated Estrogens; Bazedoxifene
  • Conjugated Estrogens; Medroxyprogesterone
  • Corticotropin, ACTH
  • Cortisone
  • Cyclosporine
  • Diclofenac
  • Diclofenac; Misoprostol
  • Dienogest; Estradiol valerate
  • Diethylstilbestrol, DES
  • Diflunisal
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Elagolix; Estradiol; Norethindrone acetate
  • Esomeprazole; Naproxen
  • Ester local anesthetics
  • Esterified Estrogens
  • Esterified Estrogens; Methyltestosterone
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Estradiol; Levonorgestrel
  • Estradiol; Norethindrone
  • Estradiol; Norgestimate
  • Estradiol; Progesterone
  • Estrogens
  • Estropipate
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Etodolac
  • Famotidine; Ibuprofen
  • Fenoprofen
  • Flurbiprofen
  • Foscarnet
  • Ganciclovir
  • Gentamicin
  • Hydrocodone; Ibuprofen
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Indomethacin
  • Kanamycin
  • Ketoprofen
  • Ketorolac
  • Lansoprazole; Naproxen
  • Levobupivacaine
  • Lidocaine
  • Lidocaine; Prilocaine
  • Magnesium Salicylate
  • Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
  • Measles/Mumps/Rubella Vaccines, MMR
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
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