Cimzia

Cimzia (certolizumab pegol)

UCB

  • Rheumatoid Arthritis
  • Psoriatic Arthritis Ankylosing Spondylitis, Non-Radiographic Axial Spondyloarthritis  
    • 400 mg SC initially and at week 2 and 4, followed by 200 mg SC every other week or 400mg SC every 4 weeks; for maintenance dosing.
  • Crohn’s Disease 
    • 400 mg SC initially and at Weeks 2 and 4, followed by 400 mg SC every four weeks  
  • Plaque Psoriasis 
    • 400 mg SC every other week. For some patients (with body weight ≤ 90 kg), a dose of 400 mg SC initially and at weeks 2 and 4, followed by 200 mg SC every other week may be considered.

Instructions

1 – Please open authorization forms (above). Fill out the forms on your computer, save and print.

2 – Open Physician Orders for the office of your choice (above). Save to your computer, print and fill out.

3 – The following tests should be performed and test results faxed to Pacific Infusion before the patient’s first visit: Cimzia (certolizumab pegol) – PPD or QuantiFERON test, Hep B S Ag

4 – Fax the following to Pacific Infusion Center (310) 297-9222:

ㅤ• Completed and signed forms/order

ㅤ• Copy of the patient’s insurance card(s)

ㅤ• Demographics

ㅤ• OV notes

ㅤ• Tried and failed medications

ㅤ• Labs

ㅤ• Drug Enrollment Forms

5 – After the patient’s infusion appointment, our nurses will fax a copy of the infusion notes to your office.