Rituxan (rituximab) [Genentech]

  • Rheumatoid Arthritis
    • Initial dose: 1000mg IV at Day 1 and Day 15
    • Subsequent doses: 1000mg IV q 24 weeks, can be given as early as 16 weeks
  • Non-Hodgkin’s Lymphoma, Chronic Lymphocytic Leukemia, Granulomatosis with Polyangiitis (Wegener’s), Microscopic Polyangiitis
    • Very complex. Check before submitting.
  • Given in combination with methotrexate
  • Need Hep 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:
    Rituximab – CXR
  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.