Actemra

Actemra (Tocilizumab)

Genentech

  • Rheumatoid Arthritis (IV)
    • 4mg/kg every 4 weeks up to 8mg/kg every 4 weeks
  • Giant Cell Arteritis
    • 6 mg per kg IV every 4 weeks 
    • 162mg SC q week, in combination with tapering corticosteroids
    • Can be used with or without methotrexate

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: Patient’s current weight, PPD or QuantiFERON test, Hep B S Ag, Hep C Ab, LFTs, CBC.

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.