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Table 1 Summary of provincial guidelines on IG product use in Canada

From: Immunoglobulin utilization in Canada: a comparative analysis of provincial guidelines and a scoping review of the literature

IG Guidelines

Version in Use (Year)

Organization Committee

Number of Indications

IVIG Dose Calculatord

Disclaimer of Dose Calculator

Home Infusion Program

Materials Included

Ontario

V4, 2018

The Ontario Regional Blood Coordinating Network (ORBCoN)

37

Yes

The dose calculator is intended to be used when determining the dose of IVIG for clinically obese patients; it is not recommended for pediatric patients or any patients (including adults) under 5ft in height. The dosing information recommended in the IVIG Utilization Management guidelines should be followed for other patients

Yes

Recommendation categories; Dosing; IG request forms; Infusion guide and adverse reaction chart; Information for outpatients;

Documentation for travel

Prairies (Alberta, Saskatchewan, Manitoba)

V2, 2022

The Inter-Provincial Medical Expert Committee and the Institute of Health Economics (IHE)

143

Yesa

Same as the Ontario calculator, with the following additional information:

Height must be 153–241 cm (60–95 inches). Weight must be 20–400 kg (44–882 pounds)

Yes (AB)

Recommendation categories; Dosing;

SCIG administration;

Frequency of follow-up and assessment of effectiveness;

Instructions for weaning patients off IG, Off-label use;

Vaccinations;

Adverse effects

Atlantic (New Brunswick, Nova Scotia, Prince Edward Island, and Newfoundland and Labrador)

V2, 2022

The Atlantic Blood Utilization Strategy (ABUS) Working Group

74

Yesc

Use the dose calculator if the patient is over 152.4 cm in height and over 50 kg for males/45.5 kg for females

Yes

Recommendation categories;

Dosing;

SCIG administration

British Columbia

V5, 2019

The BC Provincial Blood Coordinating Office (PBCO)

25

Yes

Separate IVIG dose calculations for adults (18 years old and over), children (under 18 years old), and pregnant women. A dose calculator for SCIG is also available

Yes

Recommendation categories;

Dosing

Québec

2017–2022

The Institut national d’excellence en sante et en services sociaux (INESSS)

165

Yesb

N/Ab

No

Recommendation categories;

Dosing;

Frequency of administration;

Adverse reactions;

Relative contraindications;

Main precautions

  1. IVIG: intravenous immunoglobulin; SCIG: subcutaneous immunoglobulin; IG: immunoglobulin
  2. aPrairie guideline: Saskatchewan uses the Alberta dose calculator. Manitoba has its own calculator; however, the same formula is used. (https://healthproviders.sharedhealthmb.ca/services/diagnostic-services/transfusion-manitoba/resources-and-tools/immune-globulin-utilization/)
  3. bThe Quebec guideline for Infectious Disease, Transplant Medicine, and Rheumatology refers to a dose calculator. However, an online dose calculator is not available. We cannot confirm the equations used for the dose calculation in Quebec
  4. cAtlantic guideline: Newfoundland and Labrador have their own calculator; however, the same formula is used (https://www.gov.nl.ca/hcs/bloodservices/resources/dosage-calculator/). There are no specific calculators for New Brunswick and Prince Edward Island
  5. dAll available IVIG dose calculators use the same equations as follows:
  6. 1. The Ideal Boday Weight (IBW) is calculated by: Ideal Body Weight (male) = 50.0 kg + 2.3 kg (each inch > 5 feet or each 2.5 cm > 150 cm); Ideal Body Weight (female) = 45.5 kg + 2.3 kg (each inch > 5 feet or each 2.5 cm > 150 cm)
  7. 2. Dosing Weight is an adjusted body weight. It should only be used to calculate the dose of drugs for which there are recommendations specifying that the actual body weight should be adjusted for use in the dose calculations: If Actual Body Weight ≥ IBW, Dosing weight = IBW + 0.4 (Actual Body Weight–IBW); If Actual Body Weight < IBW, Dosing weight = Actual Body Weight
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Allergy, Asthma & Clinical Immunology

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