HYQVIA (HYALURONIDASE + IMMUNE GLOBULIN 10%) INFUSION ORDERS

  • PRESCRIPTION FOR GENEVA WOODS INFUSION PHARMACY]

  • HyQvia Hyaluronidase Dose:

  • Standard based on IG dose

  • Infuse Hyaluronidase (160 units/mL) subcutaneously in 1 or 2 sites at 1 – 2 mL/minute/site as tolerated. For each vial of IG to be infused, administer the entire contents of the associated Hyaluronidase vial.

  • HyQvia Immune Globulin (IG) Dose:
    (Dose will be rounded to nearest 2.5-gram
    or 5-gram dose based on product availability)


  • Every
  • EveryInfuse total dose of IG subcutaneously in 1 or 2 sites viainfusion pump as tolerated per manufacturer guidelinesusing dose ramp-up schedule. Begin within 10 minutes of completing Hyaluronidase.

  • Every
  • .
  • RAMP-UP
    SCHEDULE:

  • Treatment Interval

    1st Infusion                 1st Week
    2nd Infusion                 2nd Week
    3rd Infusion                   4th Week
    4th Infusion                  7th Week

  • Every 4 weeks

    Total grams x 0.25
    Total grams x 0.5
    Total grams x 0.75
    Give total dose

  • Every 3 weeks

    Total grams x 0.33
    Total grams x 0.67
    Give total dose

  • * For patients previously on a different IG therapy, HyQvia should be started about one week after last infusion of previous therapy for uninterrupted treatment.

  • • Sodium Chloride 0.9% 100-mL bag as needed to flush infusion line upon completion of infusion.
    • Needles, syringes, and all ancillary supplies per Geneva Woods Pharmacy protocol, to include infusion pump and other home medical equipment as needed.
  • _____________________________________________________________________________________________________________________________________________________________________________________________________
  • Pre-Medication Orders:


  • Acetaminophen

  • mg PO x 1 dose
  • .

  • Diphenhydramine

  • mg PO x 1 dose
  • NURSING & LABORATORY ORDERS

  • Geneva Woods nurse to obtain baseline vital signs prior to the start of each immunoglobulin infusion. Additional vital signs will be obtained with each titration during the infusion. The patient may be discharged when the infusion is complete if no side effects are noted
    Geneva Woods nurse to titrate rate of infusion as recommended per manufacturer recommendations.

  • Adverse Side Effect Orders:
    • For IG reaction with no significant change in vital signs: Reduce the infusion to previous rate. May increase rate as patient tolerates. Give the following medications: (1) diphenhydramine 25 – 50 mg PO x 1 dose AND (2) acetaminophen 325 – 650 mg PO x 1 dose
    • For IG reaction that is severe, is accompanied by a significant change in vital signs, or does not subside with above interventions: Stop infusion, initiate hypersensitivity protocol (below), and contact prescriber.
  • • Acetaminophen 650 mg PO q4 hours PRN fever, chills, headache
    • Diphenhydramine 20 – 50 mg IV q4 hours PRN urticaria, pruritis, SOB
    • Oxygen by nasal cannula at 2 – 4 LPM as needed for chest pain, SOB
  • • Solu-Medrol 125 mg IV x 1 dose PRN urticaria, pruritis, SOB
    • Epinephrine 0.2 mg – 0.5 mg IV or IM x 1 dose for
    anaphylaxis
  • Please fax completed form to Geneva Woods Infusion Pharmacy
    907.334.8587