RITUXIMAB-ABBS (TRUXIMA) ONCE		version 1/23/2025		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☑	Referral to IV Infusion Room	Once	S	1 treatment	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine		
	☑	Nursing communication	Every visit	S	Until discont'd	
		Please continue to schedule subsequent infusion appointments manually as appropriate.		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Nursing communication	Once	S	1 treatment	
		Please verify Hepatitis Panel results within the last 6 months to Rituxan therapy.		
	☐	Insert Peripheral IV or Access Portacath	Once	S	1 treatment	
		No details available for preview		
	☐	Vital signs - T/P/R/BP Per Unit Protocol	Once	S	1 treatment	
		Obtain vital signs, prior to Rituximab infusion, then every 15 minutes for 1 hour, then every 30 minutes for 1 hour, then every hour until infusion complete.		
	☐	sodium chloride 0.9% flush 10 mL	Once	S	1 treatment	
		10 mL, intravenous, PRN, line care, Starting when released, Until Discontinued		
	☐	sodium chloride 0.9% infusion 250 mL	Once	S	1 treatment	
		250 mL, intravenous, at 30 mL/hr, PRN, Flush bag, Starting when released, Until Discontinued		
	☐	Discontinue IV	Once	S	1 treatment	
		No details available for preview		
	☐	Notify physician	Once	S	1 treatment	
		Notify physician for temperature GREATER than 100 degrees, persistent chills, rigors, or SBP LESS than 100 or GREATER than 170.		

Pre-Medications 	

	
	Interval	Defer Until	Duration	
	☐	acetaminophen (TYLENOL) tablet 650 mg	Once	S	1 treatment	
		650 mg, oral, once, Starting when released
	Premedicate 30-60 minutes prior to infusion.
	Maximum of 4 grams of acetaminophen per day from all sources. (Cirrhosis patients maximum: 2 grams per day from all sources).		
	☐	diphenhydrAMINE (BENADRYL) injection 25 mg	Once	S	1 treatment	
		25 mg, intravenous, once, Starting when released
	Premedicate 30-60 minutes prior to infusion.		
	☐	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Once	S	1 treatment	
		100 mg, intravenous, once, Starting when released
	Premedicate 30-60 minutes prior to infusion.		

Provider Communication 	

	
	Interval	Defer Until	Duration	
	☐	Provider communication	Every visit	S	Until discont'd	
		Contact a pharmacist if an alternate rituximab product or biosimilar is required to be added to this therapy plan.		

Pharmacy Consult 	

	
	Interval	Defer Until	Duration	
	☐	Pharmacy consult to screen for rituximab administration method	Every visit	S	 treatments	
		Hospital Performed, Normal		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	riTUXimab-abbs (TRUXIMA) in sodium chloride 0.9% IVPB	Once	S	1 treatment	
		intravenous, once, Starting 30 minutes after treatment start time
	Initiate infusion at rate of 50 mg/hour. In the absence of infusion toxicity (SBP within 20 mmHG of baseline, PULSE between 60 and 120 and TEMP less than 38 degrees C, and no symptoms), then increase infusion rate by 50 mg/hour every 30 minutes, to a maximum rate of 400 mg/hour.		

Hypersensitivity 	

	
	Interval	Defer Until	Duration	
	☐	diphenhydrAMINE (BENADRYL) injection 25 mg	PRN	S	Until discont'd	
		25 mg, intravenous, once PRN, PRN infusion reaction, Starting when released, for 1 dose		
	☐	epINEPHrine (ADRENALIN) injection 1 mg/mL 0.5 mg	PRN	S	Until discont'd	
		0.5 mg, subcutaneous, once PRN, anaphylaxis, Starting when released, Until Discontinued		
	☐	famotidine (PEPCID) injection 20 mg	PRN	S	Until discont'd	
		20 mg, intravenous, once PRN, infusion reaction, Starting when released, Until Discontinued		
	☐	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	PRN	S	Until discont'd	
		100 mg, intravenous, once PRN, infusion reaction, Starting when released, Until Discontinued		
	☐	meperidine (DEMEROL) injection (RESTRICTED) 25 mg	PRN	S	 treatments	
		25 mg, intravenous, once PRN, Drug-induced rigors, Starting when released, for 1 dose
	SLOW IV Push
	
	Formulary approved non-pain management indication(s) : Drug-induced rigors