Infusion FAQs
How many infusion sites are there?
Recommended infusion sites include the thighs, upper arms, stomach, and hips. A Hizentra dose
may be infused into multiple injection sites, but no more than 4 sites may be used
during 1 infusion.
How long does it take to infuse?
Because Hizentra is a 20% Ig solution, infusion times are short (in the clinical
trial, the median duration ranged from 1.6 to 2 hours).
What infusion equipment is needed?
In a clinical trial of Hizentra, the Crono pump and bifurcated MarCal administration
set were used.6
For a complete list of items needed for self-administration, please
click here. Note that CSL Behring does not endorse specific equipment.
How quickly can you infuse Hizentra?
For the first infusion of Hizentra, the recommended maximum flow rate is 15 mL per
hour per site. For subsequent infusions, the flow rate may be increased to a maximum
of 25 mL per hour per site as tolerated. However, the maximum flow rate is not to
exceed a total of 50 mL per hour for all sites combined at any time. A Hizentra
dose may be infused into multiple injection sites, but no more than 4 during the
same infusion.
How does a fast infusion rate offered by Hizentra benefit my patients?
Because Hizentra has a fast infusion rate, your patients can spend less time infusing
and more time getting on with their lives.
What should my patients expect from infusion with Hizentra?
In the clinical trial (n=49), most adverse reactions (ARs) reported were nonserious.
The most common ARs, observed in ≥5% of study subjects, were local injection-site
reactions, headache, vomiting, pain, and fatigue.
Injection-site reactions were primarily mild (93.4%) or moderate (6.3%). These are to be expected.
Symptoms can include edema,
erythema, local heat, local pain, and itching. In moderate cases, the affected area
can be tender and larger than a half dollar.5
Can my patients self-administer Hizentra?
Yes, most patients can infuse on their own. However, this should take place only
after a patient goes through training and performs a successful return demonstration
in front of a healthcare professional.5
Develop an infusion plan that is individualized for each of your patients, including
a review of the "Information for Patients" included in the full Prescribing Information
for Hizentra5,9
Direct your patients to
watch the Hizentra self-administration video.
How is the dose titrated?
The dose of Hizentra should be individualized based on the patient's clinical response
to therapy and serum immunoglobulin G (IgG) trough levels.
Begin treatment with Hizentra 1 week after the patient's last IVIg infusion. Prior
to switching treatment from IVIg to Hizentra, obtain the patient's serum IgG trough
level to guide subsequent dose adjustments.
Establish the initial weekly dose of Hizentra by converting the monthly IVIg dose
into a weekly equivalent and increasing it using the dose adjustment factor below.
The goal is to achieve a systemic serum IgG exposure (area under the concentration-time
curve [AUC]) not inferior to that of the previous IVIg treatment.
Initial recommended weekly dose
To calculate the initial weekly dose of Hizentra, multiply the previous IVIg dose
in grams by the dose adjustment factor of 1.53; then divide this by the number of
weeks between doses during the patient's IVIg treatment (i.e., 3 or 4).
To convert the Hizentra dose (in grams) to milliliters (mL), multiply the calculated
dose (in grams) by 5.
An easy way to calculate this is to use the Hizentra dosage calculator.