Kisunla (Donanemab-azbt)
Eli Lilly
- Alzheimer’s Disease
- The recommended dosage of Kisunla is 700 mg administered as an intravenous infusion over approximately 30 minutes every four weeks for the first three doses, followed by 1400 mg every four weeks.
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 (to be done/pt to be cleared by Neuro) should be performed and test results faxed to Pacific Infusion before the patient’s first visit: Baseline brain MRI prior to Day 0, MRI prior to 2nd, 3rd, 4th and 7th infusions, Consider premeds: Tylenol/antihistamines or CS
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.
