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: 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.
