Prolia

Prolia (Denosumab)

AMGEN

Postmenopausal osteoporosis male osteoporosis, glucocorticoid-induced osteoporosis, high risk for fracture with androgen deprivation therapy and nonmetastatic prostate cancer high risk of fracture receiving aromatase inhibitor therapy for breast cancer.

Postmenopausal Osteoporosis Treatment

    • 210 mg subcutaneously once every month for 12 doses. 

Instructions

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 – Need past and present DXA report with T-score of spine and hip, documentation of any fracture of vertebrae, hip, femur, tibia, forearm, or humerus. Serum Ca++ and Creatinine.

4 – Send list of medications tried and failed.

5 – 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

6 – After the patient’s infusion appointment, our nurses will fax a copy of the infusion notes to your office.