Referring for Non-Oncology Infusion

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To Schedule an Appointment:  Call 315-472-7504 and press #2

Questions? Call Amanda Kazanivsky RN, BSN, OCN at 315- 506-2469.

 

Our Expert Infusion Team Now Provides Comprehensive Care for Your Non-Oncology Patients

 IV and Injectable medications readily available*

 

Benlysta

Belimumab (Benlysta)

Initial Dose: 10mg/kg IV every 2 weeks for 3 doses

Maintenance Dose: 10mg/kg every 4 weeks

Standard Pre-medications to be given: Tylenol and Benadryl

Desmopressin

Desmopressin (DDAVP/Stimate)

Dose IV:  0.3 mcg/kg; may repeat if needed

Dose Intranasal (use 1.5mg/ml concentration): 50 kg: 300 mcg (1 spray each nostril)

Repeat use is determined by the patient's clinical condition and laboratory work

If using preoperatively, administer 2 hours before surgery

Monitoring Parameters: Factor VIII anticoagulant activity

Standard Pre-medications to be given: None needed.

Entyvio

Vedolizumab (Entyvio)

Dose IV: 300mg at week 0, 2, and 6; then every 8 weeks

Monitoring Parameters: Liver function tests

Standard Pre-medications to be given: Tylenol and Benadryl

Evenity

Romosozumab (Evenity)

Dose SQ: 210 mg SQ monthly. Limit duration of treatment to 12 doses.

Monitoring Parameters:

Signs/symptoms of hypersensitivity and adverse cardiovascular events

Serum calcium. Bone mineral density at baseline and at 6 or 12 months.

Monitor for symptoms of ONJ- pain, numbness, swelling or drainage from the jaw/mouth/teeth. Avoid invasive dental procedures during treatment.

Standard Pre-medications to be given: None needed

***Dental clearance or dental waiver will be obtained before administration of this medication

Inclisiran

Leqvio (Inclisiran)

Dose Initial SQ:  284mg then again at 3 months, then every 6 months

Dose Maintenance SQ: 284 mg every 6 months

Prior to initiation: lipid & cholesterol panel  

Standard Pre-medications to be given: None

 

  • ICD 10 Codes: E78.0, E78.2, E78.4, E78.5, I25.10
  • Leqvio Service Center Start Form:
    • Please request co-pay card program & include insurance information when submitting this form to the Leqvio Service Center
  • Clinical Indication:
    • Indication as an adjunct to diet and maximally tolerated statin therapy for treatment of adults with
      • heterozygous familial hypercholesterolemia (HeFH)
      • clinical atherosclerotic cardiovascular disease (ASCVD)
      • someone who requires additional lowering of low density lipoprotein cholesterol (LDL-C)

 

IVIG

Immune Globulin (IVIG, Gamunex-C)

Dose IV: typical range is 300 – 2000 mg/kg/day IV

Monitoring Parameters: Renal function, urine output, IgG concentrations, hemoglobin and hematocrit, platelets (in patients with ITP), signs and symptoms of infusion reaction/anaphylaxis or hemolysis.

Standard Pre-medications to be given: Acetaminophen and diphenhydramine

IV Iron

Ferumoxytrol (Feraheme)

Dose IV: 510 mg as an IV infusion followed by a second 510 mg IV infusion 3 - 8 days after initial dose.

Monitoring Parameters: Hemoglobin and hematocrit, serum ferritin, iron saturation and vital signs (especially BP for hypotension); Assess response at least 30 days following the second dose.

Standard Pre-medications to be given: None required.

 

Ferric Gluconate (Ferrlecit)

Dose IV: Chemotherapy-associated anemia: 125mg once a week for 6-8 doses.

Test dose is not required, but may be given if patient had a previous reaction to other iron formulations or is at high risk for hypersensitivity reactions.

Monitoring Parameters: hemoglobin, hematocrit, serum ferritin, iron saturation and vital signs (BP for hypotension)

Standard Pre-medications to be given:

Benadryl use is controversial because it may also cause hypotension, somnolence, flushing and SVT.

Consider of methylprednisolone 125 mg prior to infusion, to prevent arthralgia-myalgia syndrome if needed

 

Iron Dextran (Infed)

Dose IV: Usual is 1000-1500mg IV per day

Administer a test dose of 25mg (0.5ml) in 50 ml NS over 20 minutes then follow by one hour observation. (at HOA, test dose is recommended every 6 months; some sources recommend giving prior to each dose, especially if patient had a prior reaction or has multiple drug allergies) Administer rest of dose in 250ml NS at a maximum rate of 50mg/min (usually over 2 hours) (Per NCCN guidelines, if calculated dose is >1000mg, it is recommended to administer the amount >1000mg four weeks later.)

Monitoring Parameters: hemoglobin, hematocrit, serum ferritin, iron saturation and vital signs (BP for hypotension)

Standard Pre-medications to be given:

Benadryl use is controversial because may also cause hypotension, somnolence, flushing and SVT.

Consideration of methylprednisolone 125mg prior to infusion, to prevent arthralgia-myalgia syndrome if needed

 

Ferric Carboxymaltose (Injectafer)

Dose IV: Administer two doses of 750 mg/dose IV separated by at least 7 days. Do not exceed 1500 mg of iron per course. Treatment may be repeated if iron deficiency anemia reoccurs. Test dose is not required.

Monitoring Parameters: Hemoglobin and hematocrit, serum ferritin, iron saturation and vital signs (especially BP for hypertension or hypotension).

Standard Pre-medications to be given: None required.

 

 

Ocrevus

Ocrelizumab (Ocrevus)

Dose Initial IV: 300mg on day 1 followed by 300mg 2 weeks later

Dose Maintenance IV: 600mg every 6 months (beginning 6 months after the 1st dose)

Prior to initiation: Screen for Hepatitis B virus (HBsAg and anti-HBc measurements)

Standard Pre-medications to be given: Tylenol, Benadryl, Hydrocortisone prior to each infusion

 

  • ICD 10 Code: G35
  • Other required documentation:
    • Clinical documentation of Relapse remitting MS or Primary progressive MS
    • Clinical documentation of any previous drug therapies used, how long they were received & when they were stopped

Onpattro

Patisiran (Onpattro)

Dose IV <100 kg: 0.3mg/kg once every 3 weeks IV

Dose IV > or equal 100 kg: 30mg once every 3 weeks IV

Monitoring Parameters:

Infusion-related reactions; ocular symptoms indicative of vitamin A deficiency.

Supplement with the recommended daily allowance of vitamin A.

Refer to an ophthalmologist if ocular symptoms suggestive of vitamin A deficiency occur.

Standard Pre-medications to be given: Tylenol, Benadryl, Decadron, Pepcid

Procrit

Epoetin-alfa (Procrit)

* Initiate SQ administration when Hemoglobin is <10g/dL

Dose SQ Chronic Renal Failure: 50-100 units/kg 3 times a week or 20000 units once weekly

Dose SQ Chemotherapy induced anemia: 150 units/kg 3 times a week or 40000 units once weekly

Dose SQ MDS: 40000 units once weekly

Monitoring Parameters: Hemoglobin; serum chemistry (CKD patients); blood pressure (notify provider if SBP>160); Evaluate iron status in all patients before and during treatment. Give supplemental iron if serum ferritin is <100mg/mL or serum transferrin saturation (TSAT) is <20%

Prolastin-C

Prolastin-C

Dose IV: 60mg/kg once weekly

  • 1st cycle administration at infusion center, remaining infusion can be administered at home with Homecare infusion services if appropriate
  • Use with caution in patients at risk of fluid overload
  • ICD Code: E88.01

Prolia

Denosumab (Prolia)

Dose SQ: 60mg SQ every 6 months

Monitoring Parameters:

Serum creatinine, electrolytes (Ca, Phos, Mg, K), and CBC.

Monitor for symptoms of ONJ, including pain, numbness, swelling or drainage from the jaw/mouth/teeth.

Standard pre-medications to be given: None needed

***Dental clearance or dental waiver will be obtained before administration of this medication

 

Reclast

Zoledronic Acid (Zometa, Reclast)

Dose IV:

- Zometa: 4mg IV every 3-4 week

- Reclast: 5mg IV every 1-2 years

- Dose adjustments for renal impairment advised

Monitoring Parameters: Serum creatinine, electrolytes (Ca, Phos, Mg, K), and CBC.  We confirm that patient is taking a daily supplement of Calcium and Vitamin D.

***Dental clearance or dental waiver will be obtained before administration of this medication

Remicade

Infiximab (Inflectra, Renflexis, Remicade)

Dose IV: 5 mg/kg IV at 0, 2, and 6 weeks, followed by 5 mg/kg every 8 weeks thereafter

Monitoring Parameters: CBC with differential; hepatitis B serology; tuberculin skin test

Standard pre-medications to be given: Tylenol and Benadryl; Hydrocortisone may be added to manage reactions.

Rituxan

Rituximab (Rituxan, Ruxience, Truxima)

Dose IV:

-        NHL: 375 mg/m2

-        CLL: 375 mg/m2 in the first cycle and 500 mg/m2 in cycles 2−6, every 28 days.

-        Rheumatoid Arthritis: 1000 mg every 2 weeks x 2 doses; may repeat every 24 weeks

-        Granulomatosis polyangiitis (GPA) & Microscopic polyangiitis (MPA): 375 mg/m2 once weekly for 4 weeks

-        Off Label: per referring physician as ordered

Monitoring Parameters:

               CBC with differential, platelets, serum creatinine and electrolytes

Confirm hepatitis B screening is negative prior to starting infusion

If circulating lymphocytes count is high, starting allopurinol and hydration is advised.

Consider holding antihypertensive medications 12 hours prior to infusion as transient hypotension may occur.

Standard pre-medications to be given:

Tylenol 1000mg PO and Benadryl 50mg IV; allopurinol should be prescribed by referring office if indicated

 

  • ICD10 Codes:
    • For Medicare- N02.0, Recurrent/persistent hematuria
    • For Medicare- N04.0, nephrotic syndrome with minor glomerular abnormality
    • For other insurance carriers please refer to the policy medical benefits for authorized codes

 

Stelara

Ustekinumab (Stelara)

Dose & Route: Varies with diagnosis; weight based. Induction dose followed by maintenance

Monitoring Parameters: Tuberculosis screening (prior to initiating and periodically during therapy); CBC; ustekinumab-antibody formation

Tepezza

Teprotumumab (Tepezza)

Dose IV: 10mg/kg x1 dose IV, then 20mg/kg every 3 weeks x7 doses IV

Standard pre-medications to be given: Tylenol 1000mg PO, diphenhydramine 25mg PO, dexamethasone 10mg IV.

If patient has no reaction during the initial 2 infusions, premedication is optional for subsequent infusions.

Monitoring Parameters: Monitor for infusion reactions, exacerbation of IBD and elevated blood glucose.

               ***Ensure proper glucose control in patients with pre-existing DM prior to initiation.

-Finger stick > 180-250:  Non-Oncology AP & referring MD will be notified of the result for review further advisement prior to next administration

-Finger stick > 250:  Non-oncology AP will be notified PRIOR TO administering Tepezza

 

  • ICD10 Diagnosis Code: E05.00, Thyrotoxicosis with diffuse goiter without thyrotoxic crisis or storm
  • Other required documentation:
    • Clinical Activity Score Patient Record
    • Horizon patient services Tepezza enrollment form/confirmation

Tysabri

Natalizumab (Tysabri)

* Provide baseline MRI brain scan prior to initiating therapy

Dose IV: 300mg every 4 weeks IV

Monitoring Parameters: Liver function tests; anti-JCV antibody (prior to therapy and periodically during therapy).

Antibody formation (occurs in about 10% of patients) is associated with a decrease in natalizumab levels and a decrease in the efficacy of natalizumab. Antibody testing should be performed in any patient when there is a suspicion of persistent antibodies and should be considered in patients that resume therapy following a period of dosage interruption

Standard pre-medications to be given: Tylenol and Benadryl

 

  • Other required documentation:
    • REMS Program: Patients must be enrolled in the TOUCH Program (800-456-2255)
    • Baseline MRI brain scan prior to initiating therapy

Xolair

Omalizumab (Xolair)

Dose SQ: Administration based on body weight and pre-treatment IgE levels

Standard pre-medications to be given: None needed

 

 

*List is not comprehensive; please contact us if the infused medication is not on this list.

Patients will have a yearly visit with a provider for updating medical history and current healthcare needs supporting best practices.

Easy Scheduling with 66 Chairs Across Three Locations: M-F 7:30 a.m. – 4:30 p.m.

 

Including:

  • Private Area for Each Patient
  • Free Parking
  • On-site CLIA-certified Laboratory

 

Decades of Expertise with Nationally Certified Safety

  • All nurses nationally certified in Chemotherapy Immunotherapy
  • Annual medical review with infusion specialists reported to your office
  • On-site pharmacists, physicians, NPs and PAs
    • Infra-red vein light for difficult vein access
    • Medication preparation only in USP 797 cleanroom by licensed pharmacists and certified technicians
    • Patient education and teaching available
      • Accreditation Commission for Health Care (ACHC) Specialty Pharmacy with Oncology Distinction
      • The only ASCO Certified Quality Oncology Practice Initiative in CNY

 

 

Offer your patients a quiet, relaxed environment with reclining chairs for their infusions with staff you can trust!