How do you treat post-IVIG headache that is not responsive to Tylenol or NSAIDs?

In my opinion, there is no one simple treatment for such headaches.

We try slowing the infusion rate, premedicate with steroids, low dose Lasix, or premedicate with Nurtec.

Usually, one of these methods helps minimize or eliminate the headaches.

In my opinion, the best approach is premedication with steroids and/or NSAIDs. If that does not work, consider whether it is an immune-mediated headache (will start a few days later and can last days to a week). Another option is to switch to subcutaneous IG and patients may have no headache or mild...

If NSAIDs are ineffective, you can do a short course of steroids. I use prednisone 10-20mg for 1-3 days starting the day before the headache usually starts, if it is very predictable.

Steroids and NSAIDs work well.

Have a low threshold for MR or CT venogram of the head as severe non responsive headaches may be a sign of cerebral venous sinus thrombosis.