Cimzia (certolizumab pegol) [UCB]

  • Crohn’s Disease & Ankylosing Spondylitis
    • 400 mg initially and at weeks 2 and 4, then 400 mg q4w
  • Rheumatoid Arthritis & Psoriatic Arthritis
    • 400 mg initially and at Weeks 2 and 4, followed by 200mg q4w. For maintenance dosing, 400mg q4w can be considered.
  • Need Hepatitis B S Ag, PPD or QuantiFERON


  1. Please open authorization forms at left. Fill out the forms on your computer, save and print.
  2. Open Physician Orders for the office of your choice (at left). 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 – CXR, PPD
  4. Fax the following to Pacific Infusion Center (310) 297-9222:
    • Completed and signed forms/order
    • Copy of the patient’s insurance card(s)
    • Demographics
    • OV notes
    • Tried and failed medications
    • Labs
    • Drug Enrollment Forms
  5. After the patient’s infusion appointment, one of our nurses will fax a copy of the infusion notes to your office.