FERUMOXYTOL (FERAHEME) 510 MG INFUSION		version 2/27/2025		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☑	Referral to IV Infusion Room	1 time a week	S	2 treatments	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine		

Labs 	

	
	Interval	Defer Until	Duration	
	☐	CBC with platelet and differential	Once	S	1 treatment	
		STAT, Normal, Clinic Collect		
	☐	Comprehensive metabolic panel	Once	S	1 treatment	
		STAT, Normal, Clinic Collect		
	☐	Ferritin level	Once	S	1 treatment	
		STAT, Normal, Clinic Collect		
	☐	Total iron binding capacity	Once	S	1 treatment	
		Routine, Normal, Clinic Collect		
	☐	Iron level	Once	S	1 treatment	
		STAT, Normal, Clinic Collect		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Insert Peripheral IV or Access Portacath	1 time a week	S	 treatments	
		No details available for preview		
	☐	Vital signs - T/P/R/BP Per Unit Protocol	1 time a week	S	 treatments	
		No details available for preview		
	☐	Nursing communication: Monitor patient for any signs of MINOR INFUSION REACTION	1 time a week	S	 treatments	
		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	1 time a week	S	 treatments	
		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	1 time a week	S	 treatments	
		10 mL, intravenous, PRN, line care, Starting when released, Until Discontinued		
	☐	sodium chloride 0.9% infusion 250 mL	1 time a week	S+2	Until discont'd	
		250 mL, intravenous, at 30 mL/hr, PRN, Flush bag, Starting when released, Until Discontinued		
	☐	Discontinue IV	1 time a week	S	 treatments	
		No details available for preview		
	☐	For new patients, patients requiring pre-medication, and patients with previous reactions to IV iron, monitor 30 minutes following infusion for shortness of breath, wheezing, hypotension, tachycardia, or hives.	1 time a week	S	 treatments	
		No details available for preview		

Pre-Medications 	

	
	Interval	Defer Until	Duration	
	☐	Provider communication	1 time a week	S	2 treatments	
		Consider pre-medications in patients with a history of multiple drug allergies, moderate to severe asthma or immune-mediated diseases, or a prior reaction to another IV iron formulation.		
	☐	fexofenadine (ALLEGRA) tablet 180 mg	1 time a week	S	2 treatments	
		180 mg, oral, once, Starting when released
	Administer 30 minutes before infusion.		
	☐	methylPREDNISolone sodium succinate (Solu-MEDROL) injection 125 mg	1 time a week	S	2 treatments	
		125 mg, intravenous, once, Starting when released		
	☐	famotidine (PEPCID) injection 20 mg	1 time a week	S	2 treatments	
		20 mg, intravenous, once, Starting when released
	Administer 30 minutes before infusion.  Not covered for Medicare patients.  Dilute with 10 mL of 0.9% sodium chloride injection.  Administer IV push over at least 2 minutes.  Use only assigned diluent for reconstitution.  Do NOT use saline flush for reconstitution or dilution.		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	ferumoxytoL (FERAHEME) 510 mg in dextrose 5% 67 mL IVPB (RESTRICTED for therapy plans)	1 time a week	S	2 treatments	
		510 mg, intravenous, Administer over: 15 Minutes, once, Starting when released
	Administer over a MINIMUM of 15 minutes. Stable at room temperature for 4 hours.		

Hypersensitivity 	

	
	Interval	Defer Until	Duration	
	☐	acetaminophen (TYLENOL) tablet 650 mg	PRN	S	Until discont'd	
		650 mg, oral, every 6 hours PRN, mild pain (score 1-3), headaches, fever, 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).		
	☐	diphenhydrAMINE (BENADRYL) injection 25 mg	PRN	S	Until discont'd	
		25 mg, intravenous, once PRN, for mild to moderate infusion reaction, Starting when released, Until Discontinued		
	☐	diphenhydrAMINE (BENADRYL) injection 50 mg	PRN	S	Until discont'd	
		50 mg, intravenous, once PRN, for severe infusion reaction, Starting when released, Until Discontinued		
	☐	epINEPHrine (ADRENALIN) injection 1 mg/mL	PRN	S	Until discont'd	
		0.5 mg, subcutaneous, once PRN, anaphylaxis, Starting when released, Until Discontinued		
	☐	methylPREDNISolone sodium succinate (Solu-MEDROL) injection 40 mg	PRN	S	Until discont'd	
		40 mg, intravenous, once PRN, for infusion reaction, Starting when released, Until Discontinued
	Administer over 5 minutes.		
	☐	promethazine (PHENERGAN) tablet 25 mg	PRN	S	Until discont'd	
		25 mg, oral, every 6 hours PRN, nausea, vomiting, Starting when released, Until Discontinued