IVIG based on ideal rather than actual body weight.

Interesting.

And, let me emphasize, this discussion has nothing do with anybody’s BMI, weight level, overweight or obese status. OK?

I found some info on this.

1. From The Centre for Immunoglobulin Therapy in the U.K.

“[I]…Fat or thin?The dose of immunoglobulin depends on the patient’s weight, but since immunoglobulin isn’t fat soluble, perhaps ideal body weight is more important than actual body weight. …[/I]”

2. The 2nd info is from a .pdf file which I don’t care to try and re-type. It is at
[url]http://www.clevelandclinicmeded.com/medicalpubs/pharmacy/pdf/Pharmacotherapy_XI-1.pdf[/url]

Basically, it is a 2008 Cleveland Clinic Pharmacy article dealing with Formulary Restrictions (yep, that’s right, we’re headed right to what Lori said, in the poster’s case, it is probably an Insurance Company or Infusing Company ruling. The key point goes something like this- dosing is based on ideal body weight when following the Formulary Restrictions.

3. From a one patient study reported 1/20/2010 in US Pharm. 2010;35(1)(Oncology suppl):4-12.

“…It has been suggested that using the ideal body weight for dosage calculations may decrease adverse events.14,15 However, this has not been specifically studied. The use of an adjusted body weight in obese patients may also help minimize thromboembolic complications. Dosing is usually based on actual body weight, which in the obese population may result in a high intravascular concentration, predisposing patients to hypercoagulability due to increased serum viscosity….”

Note that they do footnote two reference articles (#14 & #15) from which they derived their data. Further, please note that I know it is a one patient report. That is not the point. The point is what they are talking about.

I would focus on the notion that Immune Globulin (IG) is not fat soluble and therefore unused by those cells. Therefore, if it were me paying for it out of my pocket, I’d do it their way.