SECUKINUMAB (COSENTYX) INFUSION		version 2/27/2025		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☑	Referral to IV Infusion Room Appointment request for initial dose.	Once	S	1 treatment	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine
	Appointment request for initial dose.		
	☑	Referral to IV Infusion Room Appointment request for subsequent doses.	Every 4 weeks	S	 treatments	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine
	Appointment request for subsequent doses.		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Nursing communication	Once	S	1 treatment	
		Prior to therapy initiation:
	o  Evaluate for malignancy (especially skin cancer, especially for patients who have a history of skin cancer or UV phototherapy), current or latent infection, lymphadenopathy, signs and symptoms of inflammatory bowel disease, and ensure age-appropriate vaccinations are up to date. 
	o  Ensure no live vaccines are administered within 4 weeks of starting therapy.
	o  Evaluate for infections, infusion / injection site reactions.  
	o  Evaluate for exacerbation or development of inflammatory bowel disease.
	o  Refer to institutional protocols for vaccination and monitoring requirements prior to initiating therapy.		
	☐	Nursing communication	Once	S	1 treatment	
		Prior to therapy initiation:
	o   Ensure the patient has completed the following testing for tuberculosis (TB) infection:  QuantiFERON Gold and Interferon Gamma.  These are required prior to initiation and then annually while on treatment. 
	o   Ensure the patient has completed the following testing for Hepatitis B / Hepatitis C / HIV:  Hepatitis B Surface Antibody, Hepatitis B Surface Antigen, Hepatitis B Core Total Antibody, Hepatitis C Antibody, HIV 1 / 2 antigen/antibody.  
	o   Ensure the patient has obtained testing for C-reactive protein.
	o   For women of childbearing potential, an appropriate pregnancy screening lab.		
	☐	Nursing communication	Every visit	S	Until discont'd	
		During treatment ensure that the following are being monitored:
	o   CBC, CMP, ESR and CRP every 3 months.
	o   Pregnancy test for women of childbearing potential with each injection.
	o   QuantiFERON Gold and Interferon Gamma annually.
	o   Hepatitis:
	-  As needed in those patients without a history of hepatitis.
	-  Patients with a history of hepatitis, Hepatitis B Surface Ag every 3 months.		
	☐	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		
	☐	sodium chloride 0.9% flush 10 mL	Every visit	S	Until discont'd	
		10 mL, intravenous, PRN, line care, Starting when released, for 10 doses		
	☐	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		
	☐	HEParin, porcine injection 500 Units	Every visit	S	Until discont'd	
		500 Units, intra-catheter, once PRN, line care, Starting when released, Until Discontinued
	Heparin flush for Implanted Vascular Access Device Maintenance.		
	☐	Discontinue IV	Every visit	S	Until discont'd	
		No details available for preview		

Labs 	

	
	Interval	Defer Until	Duration	
	☐	Hepatitis B surface antigen	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Prior to treatment initiation.		
	☐	Hepatitis B surface antibody	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Prior to treatment initiation.		
	☐	Hepatitis B core antibody total	Once	S	1 treatment	
		Routine, Normal, Clinic Collect
	Prior to treatment initiation.		
	☐	Hepatitis C antibody	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Prior to treatment initiation.		
	☐	HIV 1/2 antigen/antibody, fourth generation, with reflexes	Once	S	1 treatment	
		Normal, Clinic Collect
	Prior to treatment initiation.		
	☐	QuantiFERON-TB Gold Plus, 4 tube	Day 1 of every 12 months	S	Until discont'd	
		STAT, Normal, Clinic Collect
	Prior to treatment initiation, then annually.		
	☐	Interferon gamma	Day 1 of every 12 months	S	Until discont'd	
		STAT, Normal, Clinic Collect
	Prior to treatment initiation, then annually. For TB patients who have had Bacillus Calmette-Guerin (BCG) vaccine.		
	☐	CBC with platelet and differential	Quarterly	S	Until discont'd	
		STAT, Normal, Clinic Collect
	Prior to treatment initiation, then every 3 months.		
	☐	Comprehensive metabolic panel	Quarterly	S	Until discont'd	
		STAT, Normal, Clinic Collect
	Prior to treatment initiation, then every 3 months.		
	☐	Sedimentation rate	Quarterly	S	Until discont'd	
		STAT, Normal, Clinic Collect
	Prior to treatment initiation, then every 3 months.		
	☐	C-reactive protein	Quarterly	S	Until discont'd	
		STAT, Normal, Clinic Collect
	Prior to treatment initiation, then every 3 months.		
	☐	hCG qualitative, serum screen	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect
	Prior to treatment initiation (for women of child bearing potential), then with every visit.		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	secukinumab (COSENTYX) 6 mg/kg in sodium chloride 0.9% 100 mL IVPB - Loading Dose (RESTRICTED)	Once	S	1 treatment	
		6 mg/kg, intravenous, Administer over: 30 Minutes, once, Starting when released
	Loading Dose: Infuse through a 0.22-micron filter. After infusion is complete, flush line with >/= 50 mL of NS. Do not infuse in the same line with other medications.
	Do NOT shake.		
	☐	secukinumab in NS (COSENTYX) IVPB (RESTRICTED) 1.75 mg/kg	Every 4 weeks	S	Until discont'd	
		1.75 mg/kg, intravenous, Administer over: 30 Minutes, once, Starting when released
	Maintenance Dose (max 300 mg) in NS 100 mL for weight > 52 kg or in NS 50 mL for weight </= 52 kg. Infuse through a 0.22-micron filter. After infusion is complete, flush line with >/= 50 mL of NS. Do not infuse in the same line with other medications.
	Do NOT shake.		

Hypersensitivity 	

	
	Interval	Defer Until	Duration	
	☐	acetaminophen (TYLENOL) tablet 650 mg	PRN	S	Until discont'd	
		650 mg, oral, every 4 hours PRN, mild pain (score 1-3), 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) tablet 25 mg	PRN	S	Until discont'd	
		25 mg, oral, every 6 hours PRN, itching, Starting when released, Until Discontinued		
	☐	diphenhydrAMINE (BENADRYL) injection 25 mg	PRN	S	Until discont'd	
		25 mg, intravenous, once PRN, for minor 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 0.5 mg	PRN	S	Until discont'd	
		0.5 mL, subcutaneous, once PRN, anaphylaxis, Starting when released, Until Discontinued		
	☐	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	PRN	S	Until discont'd	
		100 mg, intravenous, once PRN, for infusion reaction, Starting when released, Until Discontinued		
	☐	promethazine (PHENERGAN) tablet 25 mg	PRN	S	Until discont'd	
		25 mg, oral, every 6 hours PRN, nausea, vomiting, Starting when released, Until Discontinued		
	☐	sodium chloride 0.9% infusion 250 mL	PRN	S	Until discont'd	
		250 mL, intravenous, once PRN, Hydration, Starting when released, Until Discontinued