Hematologist
CION Cancer Clinics
IVIG in ITP: when it is used | CION Cancer Clinics
IVIG is used in ITP when the platelet count needs to rise fast: serious bleeding, an operation or delivery coming up, or when steroids are unsafe. It often lifts the count within a day or two, but the rise usually fades within weeks, so it is a bridge, not a long-term plan. It is given as a drip over several hours. Headache and chills are common; clots and kidney problems are rare. At CION Cancer Clinics, our haematologist cares for anaemia, bleeding, clotting and inherited blood disorders, with ArogyaSri, CGHS and cashless insurance accepted.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- When is IVIG used for ITP?
- In which situations does IVIG make sense?
- What happens when IVIG is given?
- What do families often misunderstand about IVIG?
- Which side effects are common, and which are serious?
- What do the words on the summary mean?
- Who may IVIG not suit, and what can this page not tell you?
- Common questions about IVIG for ITP
The short answer
When is IVIG used for ITP?
IVIG is used in ITP when the platelet count needs to rise quickly. That usually means serious bleeding, an operation or delivery coming up, or a situation where steroids are unsafe or too slow. It often works within a day or two, but the effect wears off, so it is a bridge rather than a long-term treatment.
What IVIG actually is
IVIG stands for intravenous immunoglobulin. Immunoglobulins are antibodies, the proteins your immune system uses to fight germs. IVIG is made from the pooled plasma, the liquid part of blood, of many screened donors. It is given as a slow drip into a vein.
How it helps in ITP
In ITP, immune thrombocytopenia, your immune system clears your own platelets too fast. Thrombocytopenia means a low platelet count. IVIG distracts the cells in the spleen that remove coated platelets, so more platelets stay in the blood for a while. It does not change the underlying immune fault.
Why it is not given to everyone
Many people with ITP have a low count but little or no bleeding. They are often watched, or given steroids or other tablets, because IVIG is costly, needs a hospital bed and its effect is short. The decision rests on bleeding and upcoming events, not on the number alone.
When doctors reach for it
In which situations does IVIG make sense?
These are the usual reasons. Your haematologist weighs them against your own health, your other options and what the drip involves.
Bleeding that needs a fast rise
Bleeding from the gut, heavy nosebleeds that will not settle, or any sign of bleeding in the head. IVIG is often given with steroids, and sometimes with a platelet transfusion, in an emergency.
Before surgery or a procedure
When an operation, a tooth extraction or a biopsy cannot wait, IVIG can lift the count for long enough to get through it more safely.
Tell the team early
- The date of the procedure
- Which doctor is doing it
Pregnancy and delivery
IVIG is one of the options used in pregnancy, particularly close to delivery. The plan is made jointly by the haematologist and the obstetrician, and it also considers the baby.
Children with bleeding
Most children with ITP are watched. IVIG is considered when a child has bleeding beyond bruises and tiny red spots, or needs a quick rise for another reason.
Steroids are an alternative in children too. The choice depends on the child.Not sure whether this applies to you?
Ask an oncologistOn the day
What happens when IVIG is given?
Checks first
Your weight, blood pressure, kidney function and blood count are checked. Tell the team about kidney disease, heart problems, past clots, diabetes, or any reaction to a blood product before. These change how the drip is run.
Starting slowly
A nurse puts a thin tube into a vein. The drip starts slowly and speeds up only if you feel well. You may be given medicines beforehand to reduce headache or chills, and fluids to protect your kidneys.
Watching during the drip
Pulse, blood pressure and temperature are checked regularly. It takes several hours, and it may be repeated on a second day. Say at once if you feel breathless, itchy, flushed or have chest tightness.
The count afterwards
Blood tests over the next few days show whether the count has climbed. The team then plans what comes next, because the rise usually fades within weeks.
Commonly believed
What do families often misunderstand about IVIG?
"Once the count goes up with IVIG, the ITP is gone."
The rise is temporary in most adults. IVIG buys time. It does not switch off the immune attack on platelets, so the count often falls back and a longer-term plan is still needed.
"IVIG is a platelet transfusion."
It is not. A transfusion gives you someone else's platelets, which ITP clears very fast. IVIG gives you antibodies that slow the clearing of your own platelets. The two are sometimes given together in an emergency.
"Because it comes from donors, it will give me an infection."
Donors are screened and the product goes through steps designed to remove or kill viruses. No blood product is entirely free of risk, and your team will explain this, but passing on an infection from modern IVIG is very rare.
"If our child's count is low, they need IVIG straight away."
Many children with a low count and only mild bruising are safely watched, because ITP in children often clears on its own. IVIG is kept for bleeding or special situations, and it carries its own side effects.
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Side effects
Which side effects are common, and which are serious?
What you may feel
What to do
Headache, chills, flushing or aches during the drip or the next day
Common. Tell the nurse; the drip can often be slowed
Severe headache with a stiff neck and dislike of light
Uncommon. Tell the team the same day
Breathlessness, rash or swelling of the lips during the drip
Rare allergic reaction. The nurse stops the drip at once
Chest pain, a swollen painful leg, weakness on one side
Rare clot. Call 108 or go to emergency now
Passing much less urine, or dark urine with tiredness
Rare kidney or red cell effect. Get checked the same day
On your discharge summary
What do the words on the summary mean?
- IVIG
- Intravenous immunoglobulin. Antibodies from donated plasma, given through a drip into a vein.
- Rescue treatment
- A treatment used to raise the count quickly during bleeding or before a procedure, not to keep it up long term.
- IgA deficiency
- A low level of one type of antibody. It can raise the chance of an allergic reaction to IVIG, so the team may check for it.
- Haemolysis
- Red cells breaking down faster than usual. It can cause a drop in haemoglobin, the red protein that carries oxygen, and is looked for on follow-up tests.
- Platelet count
- The number of platelets in your blood. Reference ranges differ between laboratories, so compare it with the range on your own report.
Being straight with you
Who may IVIG not suit, and what can this page not tell you?
IVIG needs more care in people with kidney disease, heart failure, a past stroke or clot, poorly controlled diabetes, or a known severe reaction to a blood product. Older adults and people who are very dehydrated also need closer watching. In these groups the team may choose another route, or give IVIG more slowly with extra checks.
Cost and access
IVIG is one of the more expensive treatments used in ITP, and supply can vary. Whether it is covered by Aarogyasri, CGHS, ECHS, EHS, PM-JAY or your cashless insurance depends on the scheme and the reason it is given. Scheme rules change, so check your current cover before a planned drip.
What this page cannot tell you
It cannot tell you whether you need IVIG, how well your count will respond, or how long any rise will last. A single platelet result is always read with your bleeding, your symptoms and repeat tests. CION's haematology team reviews the whole picture, discusses it at a tumour board where needed, and explains which options fit you.
Do not stop or skip any ITP medicine because IVIG has been given. Ask your team what to continue.Questions we are asked
Common questions about IVIG for ITP
How fast does IVIG raise the platelet count?
It is one of the quickest treatments for ITP. Many people see a rise within a day or two, which is why it is used when bleeding is serious or a procedure is close. Not everyone responds. Your team checks the count over the following days to see what has happened before planning the next step.
How long does the effect of IVIG last?
Usually only a few weeks in adults, and it varies from person to person. The count often drifts back down as the antibodies are used up. That is why IVIG is a short-term bridge. Your haematologist will talk about a longer-term plan, which may include steroids or other medicines, or simply watching.
Do I need to stay in hospital for IVIG?
Usually you stay at least for the drip, which takes several hours and is sometimes repeated the next day. If you have come in with bleeding, you will be admitted anyway. For a planned drip before a procedure, some centres give it as a day-care treatment. Your team will tell you what to expect.
Is IVIG safe in pregnancy?
IVIG is one of the treatments used for ITP in pregnancy, often near delivery. It is planned together by your haematologist and obstetrician, who also think about the baby's platelets after birth. Tell both teams about every medicine you take. Do not change anything yourself, and keep all your antenatal visits.
Is IVIG better than steroids?
Neither is better in general. IVIG usually works faster but wears off sooner and costs more. Steroids are tablets, cheaper and easier to give, but take a little longer and have their own side effects. In emergencies the two are often used together. The right choice depends on your bleeding and your health.
Why did I get a bad headache after the drip?
Headache is one of the most common effects, often starting during the drip or the next day. It usually settles with rest, fluids and simple pain relief your team approves. Tell them the same day if it is severe, comes with a stiff neck or vomiting, or if you have had any head injury while your count is low.
Can IVIG be repeated if the count falls again?
Yes, it can be repeated when there is a good reason, such as new bleeding or another procedure. Relying on repeated IVIG is not a long-term plan, though. If the count keeps falling, the team discusses other options, such as medicines that help the body make more platelets, rituximab, or spleen removal for some adults.
Will IVIG affect my vaccines?
It can. The antibodies in IVIG may stop some live vaccines, such as measles, mumps and rubella, from working properly for a while. Tell any doctor who plans a vaccine for you or your child that IVIG was given, and when. Your haematologist can advise on timing for each vaccine.
Your Haematologist
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Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Sources
- NHS — Immune thrombocytopenia (ITP)
- National Heart, Lung, and Blood Institute — Immune Thrombocytopenia (ITP)
- American Society of Hematology — Immune Thrombocytopenia (ITP)
- American Society of Hematology — Clinical practice guidelines
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Steroids for ITP and Their Side EffectsThe usual first treatment, and what it causesPlatelet Thresholds: When Treatment StartsWhen doctors decide to treat at allITP in PregnancyHow ITP is managed before and around deliveryITP in Children: Usually Self-LimitingWhy many children are watched insteadITP and Low PlateletsThe full guide to ITP and low platelets
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Told you may need IVIG for a low platelet count?
Share the blood report with us. CION's haematology team will go through it with you and explain the options. One helpline serves every CION centre.