PEGFILGRASTIM-JMDB (FULPHILA) SQ INJECTION		version 3/1/2024		

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	
	☐	Administer 24 hours after chemotherapy	Every visit	S	Until discont'd	
		No details available for preview		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	Provider communication	Every visit	S	Until discont'd	
		In an outpatient setting, Fulphila is the system-approved choice (a biosimilar alternative for the on-body injection kit is not currently available).  If, for insurance or patient-specific contraindications, a different medication is needed, contact your pharmacist.		
	☐	pegfilgrastim-jmdb (FULPHILA) injection (RESTRICTED)-For use in Therapy Plans	Every visit	S	Until discont'd	
		6 mg, subcutaneous, once, Starting when released		
	☐	pegfilgrastim (NEULASTA) on-body injection kit 6 mg	Every visit	S	Until discont'd	
		6 mg, subcutaneous, once, Starting when released
	Apply to intact, nonirritated skin on the back of the arm or abdomen (only use the back of the arm if caregiver is available to monitor On-body injection status).
	Neulasta on-body injector can be damaged if exposed to X-ray, MRI, CT, ultrasound or radiation. VERIFY THAT PATIENT IS NOT SCHEDULED FOR DIAGNOSTIC IMAGING OR RADIATION THERAPY ON THE DAY OF AND THE DAY AFTER APPLICATION. If scheduled, contact provider before application

	RESTRICTED FOR OUTPATIENT USE ONLY. Pharmacists please do NOT verify if ordered for inpatient.