Rituxan (rituximab)

  • 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
  • Granulomatosis with Polyangiitis (Wegener’s), Microscopic Polyangiitis
  • Need Hep B S Ag, PPD or QuantiFERON


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: Rituxan (rituximab) – 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.