VEDOLIZUMAB (ENTYVIO) INFUSION		version 2/27/2025		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☑	Referral to IV Infusion Room	Every 8 weeks	S	 treatments	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine		

Labs 	

	
	Interval	Defer Until	Duration	
	☐	CBC with platelet and differential	PRN	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	Comprehensive metabolic panel	PRN	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	Sedimentation rate	PRN	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	C-reactive protein	PRN	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	Zinc level, serum	PRN	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	Ferritin level	PRN	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	Iron level	PRN	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	Total iron binding capacity	PRN	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	Vitamin D 25 hydroxy level	PRN	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	Vitamin B12 level	PRN	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	Vitamin A level, plasma or serum	PRN	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	Folate level	PRN	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	TB GOLD Quantiferon	PRN	S	Until discont'd	
		Routine, Normal, Clinic Collect		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Insert Peripheral IV or Access Portacath	Every visit	S	Until discont'd	
		No details available for preview		
	☐	Vital signs - T/P/R/BP Per Unit Protocol	Every visit	S	Until discont'd	
		No details available for preview		
	☐	Nursing communication: Monitor patient for any signs of MINOR INFUSION REACTION	Every visit	S	Until discont'd	
		Monitor patient for signs of *MINOR INFUSION REACTION*: fever, chills, pruritis, uticaria, chest pain, mild hypotension, hypertension, or mild dyspnea. For minor infusion reaction take the following steps: stop or slow infusion rate by 50%. If symptoms do not resolve within 5-10 minutes give Benadryl as ordered. Notify MD if symptoms do not resolve within 5-10 minutes. With MD approval, give Solu-medrol as ordered. When symptoms resolve, restart medication at 25% of the original rate. After 15-30 minutes gently increase rate and monitor patient closely until completion.		
	☐	Nursing communication: Monitor patient for signs of SEVERE INFUSION REACTION	Every visit	S	Until discont'd	
		Monitor patient for signs of *SEVERE INFUSION REACTION*: severe dyspnea, wheezing, stridor, angioedema, or marked hypotension. For severe infusion reaction take the following steps; STOP Infusion and start normal saline solution. Notify physician and administer Benadryl as ordered. Monitor vital signs. Administer Epinephrine as ordered. Consult MD for further orders.		
	☐	sodium chloride 0.9% flush 10 mL	Every visit	S	Until discont'd	
		10 mL, intravenous, PRN, line care, Starting when released, Until Discontinued		
	☐	sodium chloride 0.9% infusion 250 mL	Every visit	S	Until discont'd	
		250 mL, intravenous, at 30 mL/hr, PRN, Flush bag, Starting when released, Until Discontinued		
	☐	Discontinue IV	Every visit	S	Until discont'd	
		No details available for preview		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	vedolizumab (ENTYVIO) 300 mg in sodium chloride 0.9% 250 mL IVPB (RESTRICTED)	Every 8 weeks	S	Until discont'd	
		300 mg, intravenous, at 500 mL/hr, Administer over: 30 Minutes, once, Starting when released
	After infusion is complete, flush with 30 mL of NS.
	An FDA-approved patient medication guide must be dispensed with this medication.		

Hypersensitivity 	

	
	Interval	Defer Until	Duration	
	☐	promethazine (PHENERGAN) injection 10 mg	PRN	S	Until discont'd	
		10 mg, injection, every 4 hours PRN, nausea, vomiting, Starting when released, Until Discontinued		
	☐	promethazine (PHENERGAN) tablet 25-50 mg	PRN	S	Until discont'd	
		25-50 mg, oral, every 4 hours PRN, nausea, vomiting, Starting when released, Until Discontinued		
	☐	diphenhydrAMINE (BENADRYL) injection 25 mg	PRN	S	Until discont'd	
		25 mg, intravenous, once PRN, itching, Starting when released, Until Discontinued		
	☐	diphenhydrAMINE (BENADRYL) tablet 25 mg	PRN	S	Until discont'd	
		25 mg, oral, once PRN, itching, Starting when released, Until Discontinued		
	☐	acetaminophen (TYLENOL) tablet 650 mg	PRN	S	Until discont'd	
		650 mg, oral, every 4 hours PRN, headaches, fever, myalgia, Starting when released, Until Discontinued
	Maximum of 4 grams of acetaminophen per day from all sources. (Cirrhosis patients maximum: 2 grams per day from all sources).