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Managing common infusion issues7,10

Your patients may experience issues during and after infusion with Hizentra. Use this troubleshooting chart to find out how to minimize any issues that may arise.

Issue Clinical management troubleshooting7,10
Injection-site reaction
  • Blanching
  • Redness/Rash
  • Itching
  • Discomfort
  • Swelling
  • Assess for tape allergy; change to paper/hypoallergenic tape
  • Assess size–choose a needle size that is consistent with volume being infused
  • Assess length of catheter–may be too short and fluid may be leaking into intradermal layer
  • Assess site location–may be too close to muscle
  • Decrease rate of infusion or decease volume per site
  • Avoid tracking lgG through the intradermal tissue by not allowing drops of lgG on needle tip prior to needle insertion
  • Assess appropriateness of rotating sites
  • Consider use of topical anesthetic ointment
Leaking at
catheter site
  • Assess catheter; ensure it is affixed securely and fully inserted
  • Assess placement–may be in location that is subject to movement; advise regarding selection of site
  • Assess length of catheter–may be too short; suggest change
  • Assess infusion volume–amount per site may be too great; adjust volume
  • Assess rate of infusion; adjust rate
Extreme discomfort with needle
  • Assess needle length–may be too long and irritating abdominal wall
  • Try catheter that allows introducer needle to be removed, leaving indwelling flexible cannula catheter
  • Try ice or topical anesthetic cream prior to insertion
Long infusion time
  • Assess infusion preparation–Hizentra is ready to use at room temperature
  • Assess volume per site, rate of infusion, and number of sites, or adjust infusion regimen
  • Check equipment for pump setting, correct selection of tubing size and length to match infusion rates; check pump function, battery function, etc
  • Arrange observation of patient technique (specialty pharmacy provider or office visit)
  • Remove and discard catheter that demonstrated blood return; use new set (notify supplier of need for replacement)
Blood return observed
  • Remove and discard catheter that demonstrated blood return; use new set (notify supplier of need for replacement)
 

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Questions about infusion?

These frequently asked questions can help you learn more about infusing Hizentra.

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Important Safety Information

Immune Globulin Subcutaneous (Human), Hizentra®, is indicated as replacement therapy for patients with primary humoral immunodeficiency (PI), age 2 and older. This includes but is not limited to the humoral immune defect in congenital agammaglobulinemia, common variable immunodeficiency, X-linked agammaglobulinemia, Wiskott-Aldrich syndrome, and severe combined immunodeficiencies.

Hizentra is contraindicated in patients with a history of anaphylactic or severe systemic reaction to human immune globulin preparations or components of Hizentra, such as polysorbate 80. Because it contains the stabilizer L-proline, Hizentra is contraindicated in patients with hyperprolinemia. Hizentra is also contraindicated in patients with immunoglobulin A deficiency who have antibodies against IgA and a history of hypersensitivity.

Hizentra should be administered subcutaneously only. Do not administer intravenously.

IgA-deficient patients with anti-IgA antibodies may be at greater risk of developing potentially severe hypersensitivity and anaphylactic reactions with administration of Hizentra. If hypersensitivity occurs or anaphylactic reactions are suspected, discontinue administration immediately and treat as medically appropriate.

Hizentra is derived from human plasma. The risk of transmission of infectious agents, including viruses and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent, cannot be completely eliminated.

The most common drug-related adverse reactions (observed in 5% or more of study subjects receiving Hizentra) were local reactions (ie, swelling, redness, heat, pain, and itching at the injection site), headache, diarrhea, fatigue, back pain, nausea, extremity pain, cough, rash, pruritis, vomiting, upper abdominal pain, pain, and migraine.

Monitor patients for thrombotic events and aseptic meningitis (AMS), which have been reported with SCIg. Also look forreactions reported to occur with IVIg treatment that might also occur with Hizentra, including renal dysfunction/failure, hemolysis, and transfusion-related acute lung injury (TRALI).

Ig administration can transiently impair the efficacy of live attenuated virus vaccines, such as measles, mumps and rubella. It can also lead to misinterpretation of serologic testing.

Please see full prescribing information for Hizentra.