Hizentra is an immune globulin medicine used to treat primary immunodeficiency and chronic inflammatory demyelinating polyneuropathy (CIDP). Like all medicines, Hizentra can cause side effects, and it may affect certain vaccines and lab tests.
This article covers common and serious side effects of Hizentra, how to manage them, and potential drug interactions to be aware of. It doesn't cover every possible side effect or interaction. Tell your health care provider about any symptoms that concern you or don't go away.
Common Side Effects of Hizentra
Commonly reported side effects include:
- Pain, swelling, redness, itching, or bruising where the infusion needle goes in
- Headache
- Diarrhea
- Fatigue or tiredness
- Back pain or pain in your arms or legs
- Nausea or vomiting
- Cough or other cold-like symptoms
- Rash or itching
- Joint pain
Serious Side Effects of Hizentra
The list below includes potentially serious side effects of Hizentra, along with the signs or symptoms to watch for:
- Blood clot: swelling, warmth, or pain in an arm or leg, chest pain, or sudden shortness of breath
- Aseptic meningitis: severe headache with neck stiffness, fever, and sensitivity to light
- Kidney problems: little or no urination or sudden swelling
- Hemolysis (red blood cell breakdown): unusual fatigue, fast heartbeat, or yellowing of the skin or eyes
- Severe allergic reaction: hives, trouble breathing, or swelling of the face or throat
- Lung problems: sudden trouble breathing or chest tightness
If you have symptoms that feel serious or life-threatening, seek medical care right away.
How to Manage Hizentra Side Effects
The following tips may help prevent or manage some side effects of Hizentra. Contact your health care provider about any side effect that bothers you or doesn't go away, even if it isn't listed here.
Infusion-site reactions
Infusion-site reactions are the most commonly reported side effect of Hizentra, especially when you're first starting treatment. Symptoms at or near the infusion site may include:
- Pain
- Swelling
- Redness or discoloration
- Itching
- Warmth
- Bruising
Most of these reactions are mild and go away on their own within a day or two. Tips that may help:
- Rotate your infusion sites with each use. Don't infuse into the same spot every time; choose a new site that's at least 2 inches away from your last one.
- Follow the step-by-step instructions that come with Hizentra, or watch the instructional videos on the drugmaker's website, to ensure your technique is right.
- Ask your health care provider if a cool compress or an over-the-counter pain reliever is OK to use for comfort.
Let your health care provider know if infusion-site reactions don't improve within a few days, get worse, or keep happening at the same site. They may want to review your technique with you or adjust your infusion rate or volume per site.
Headache
Headache is a commonly reported side effect of Hizentra. Symptoms may include mild to moderate head pain or pressure, most often within a day or two of an infusion.
To help manage headaches:
- Rest in a quiet, dark room if needed.
- Drink enough fluids throughout the day.
- Try relaxation techniques, such as deep breathing.
- Maintain a regular sleep schedule.
- Eat regular meals or snacks.
An over-the-counter pain reliever may help ease headache pain, but check with your health care provider or pharmacist first to make sure it's safe for you. Call your health care provider right away if your headache is severe or comes with a stiff neck, fever, or sensitivity to light. These can be signs of aseptic meningitis (see below).
Fatigue
Feeling unusually tired is a common side effect of Hizentra. These symptoms may improve over time. To help support your energy:
- Get plenty of sleep and keep a regular sleep schedule.
- Include nutrient-rich foods in your meals.
- Try to stay physically active, as inactivity can worsen fatigue.
- Plan more demanding activities for times of day when your energy is usually highest.
Let your health care provider know if fatigue is severe or doesn't improve. They may want to check for other causes, such as anemia.
Nausea and vomiting
Nausea and vomiting have been reported with Hizentra. Nausea is the feeling that you might throw up, and it doesn't always lead to vomiting.
Tips that may help:
- Eat smaller, more frequent meals instead of large ones.
- Choose bland foods, such as crackers, toast, or rice.
- Avoid greasy or high-fat foods.
- Sip clear liquids throughout the day to stay hydrated.
Tell your health care provider if nausea or vomiting is severe, doesn't improve, or keeps you from staying hydrated.
Thrombosis (blood clots)
Hizentra has a boxed warning (the FDA's strongest warning) about the risk of blood clots (thrombosis). This risk applies to immune globulin products in general, not just Hizentra, and it can happen even in people without known risk factors.
Your risk may be higher if you have:
- Older age
- A history of blood clots
- Limited mobility for a long period
- A condition that makes your blood clot more easily
- Use of estrogen-containing medicines, such as birth control pills
- Certain heart or blood vessel conditions
- Thick blood (high viscosity)
Your health care provider will use the lowest effective dose and infusion rate for you if you're at higher risk. They may recommend staying well-hydrated before each infusion.
Get medical help right away if you notice the following signs, as these can indicate a blood clot:
- Swelling, warmth, pain, or discoloration in an arm or leg
- Sudden shortness of breath
- Chest pain that worsens with deep breaths
- A fast heartbeat
- Numbness or weakness on one side of your body
Aseptic meningitis syndrome
Aseptic meningitis syndrome is a rare but serious side effect that has been reported with immune globulin products, including Hizentra. It may start within a few hours to two days after treatment and tends to be more common with higher doses or faster infusion rates.
Symptoms may include:
- Severe headache
- Neck stiffness
- Drowsiness
- Fever
- Sensitivity to light
- Painful eye movements
- Nausea and vomiting
Call your health care provider right away if you have these symptoms. They may want to examine you and rule out other causes of meningitis. Symptoms typically go away within several days of stopping treatment, without lasting effects.
Does Hizentra Interact With Other Medicines?
An interaction happens when one substance changes how a medicine works or affects your body. Hizentra's interaction risks mainly affect certain vaccines and lab tests rather than other medicines you take every day. This isn't a complete list of interactions, so always share your full medicine and vaccine history with your health care provider and pharmacist.
Live virus vaccines
Hizentra contains antibodies that can interfere with how well certain vaccines work. This mainly applies to live virus vaccines, which use a weakened form of a virus to help your body build immunity. Examples include vaccines for:
- Measles
- Mumps
- Rubella
- Chickenpox (varicella)
The antibodies in Hizentra may blunt your immune response to these vaccines, making them less effective. If you're due for a live virus vaccine, tell your immunizing health care provider that you're being treated with Hizentra. They can help decide on the right timing, which may mean delaying a vaccine or waiting for a certain amount of time after your last Hizentra infusion.
Lab test results
Hizentra contains many different antibodies collected from donated plasma. These antibodies can sometimes interfere with certain blood tests, particularly serological tests (tests that look for antibodies to diagnose infections or check immunity). This can lead to a false test result, which doesn't accurately reflect your immune status.
Let any health care provider or lab know that you're being treated with Hizentra before you have blood tests done, especially if you're being tested for a past infection or immunity to a specific disease.
Common Questions About Hizentra Interactions
Does Hizentra interact with alcohol?
Alcohol is not known to directly interact with Hizentra. However, drinking alcohol can lead to dehydration, which may increase the risk of certain serious side effects, such as blood clots and kidney problems. Staying well-hydrated is important while receiving Hizentra. Heavy alcohol use can also weaken your immune system. Ask your health care provider whether drinking alcohol is safe for you during treatment.
Will Hizentra affect other vaccines I need?
Hizentra mainly affects live virus vaccines, as described above. Non-live (inactivated) vaccines, such as a flu shot, generally aren't affected in the same way, but it's still a good idea to let your immunizing health care provider know you're on Hizentra.
Reducing Your Risk
There are several steps you can take to lower your risk of side effects and stay safe during treatment with Hizentra.
- Tell your pharmacist and other health care providers about everything you take, including prescription medicines, over-the-counter products, vitamins, herbs, and supplements.
- Check with your health care provider before you receive any vaccines.
- Attend all recommended lab tests and monitoring appointments.
- Tell your health care provider about any new or worsening symptoms, even if they seem minor
If side effects become troublesome, your health care provider may need to adjust your treatment plan. Don't change your dose or stop using Hizentra without first contacting your health care provider.
