Although a certain level of skin reaction to an infusion is expected, if you’re experiencing bothersome swelling or redness that lingers, there are strategies that may help.
Adjusting Volume or Rate per Site
How much immunoglobulin goes into each infusion site and how quickly it’s delivered can make a big difference in how swollen or sore the area feels afterward.
When a large volume of medication is delivered into one site, or when it flows in too quickly, the surrounding tissue may stretch faster than it can comfortably absorb the fluid. This can lead to more noticeable swelling, pressure, or pain at the infusion site.
One common adjustment is to slow the infusion rate, which gives the medication more time to spread through the tissue. Another option is reducing the volume per site and using more infusion sites to reduce pressure at each infusion area. Both approaches can help ease local reactions for some people.
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These changes aren’t something you should do on your own, though. Because infusion pumps vary by manufacturer, and each SCIg product has specific limits for flow rate and volume per site, you should talk with your nurse about any adjustments to ensure safety and efficacy, says Megan Ehret, PharmD, a professor in the department of practice, sciences, and health outcomes research at the University of Maryland School of Pharmacy in Baltimore.
Warming the Product Safely
Allowing SCIg to reach room temperature before infusion is important for a few reasons. It reduces the pressure required for infusion, which reduces pain at the site. Warmer immunoglobulin is also closer to normal body temperature, and so it naturally feels more comfortable than a cold fluid when entering your body.
Most products should be removed from the refrigerator and allowed to sit at room temperature for at least 30 minutes before use, but your nurse may recommend longer — an hour or even more. Check the label for specific instructions, because each product has specific limits for how long it can safely remain unrefrigerated.
You should not attempt to warm the product using methods such as microwaves, hot water, or heating devices, as they can damage the medication, says Ehret.
Rotating Sites Effectively
Rotating, or changing, infusion sites for each infusion helps protect the skin and reduce irritation over time. There is no single “right” rotation pattern, says Ehret.
Common infusion sites include:
- The abdomen
- Thighs
- Upper arms
- The sides of the hips or upper legs
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“Sites should be places you are comfortable using and should be placed at least one inch away from the previous infusion site,” she says.
Areas that are already red, bruised, painful, hard, or irritated should be avoided. Reusing the same spot repeatedly can increase swelling and discomfort and slow healing between infusions.
