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← Return to Rituxan infusion concerns
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@jomac Regular IVIG carries a black box warning for thrombosis so if you're off Eliquis, I am hoping they either run your infusions super slowly and that you hydrate like no tomorrow or they have you on a product like Alyglo. We went through the dilemma of whether to continue IVIG as I'd already had 2 DVT's but I still wanted to try . . . however, they found a clot in my brain after my first round of IVIG. After lots of second opinions with hematology, rheumatology, neurovascular, and neurology - it was decided that SCIG was a considerably lower risk option than IVIG given the clotting issue, even though I remained on Eliquis twice daily. Lowering or discontinuing anti-coagulation therapy on IVIG might depend on the source of the clotting, but after 2 clots, the general consensus is lifelong anticoagulation. so discontinuing on IVIG is generally not recommended due to the increased risk of thrombosis.
Good to hear that Rituxan is working well for you 🙂
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@pm56 Thank you for this valuable information. I will discuss this with my rheumatologist, cardiologists, and neurologist. I've been on IVIG for two years, but the Rituxin is fairly new. Currently the IVIG infusions are gradually titrated and take about 3 1/2 hours after magnesium and prednisone are done. This may need to be slowed because of the elimination of Eliquis. I do have monthly CBC panels prior to IVIG and Rituxin infusions and watch the numbers carefully. I think perhaps I might also need to do this after the Rituxin infusion. The bleeding started two days after the first infusion. I wonder whether a lower dose of Eliquis could be resumed at some point after the Rituxin infusion, but prior to IVIG. So far I've seen no signs of clotting, but it only takes one. I hate playing roulette with my medications.
Thanks again for the information.