ROMOSOZUMAB (EVENITY) SQ EVERY 4 WEEKS		version 2/27/2025		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☑	Referral to IV Infusion Room	Every 4 weeks	S	 treatments	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine		

Labs 	

	
	Interval	Defer Until	Duration	
	☐	Vitamin D 25 hydroxy level	Once	S	1 treatment	
		STAT, Normal, Clinic Collect		
	☐	Basic metabolic panel	Quarterly	S	Until discont'd	
		STAT, Normal, Clinic Collect		
	☐	Albumin level	Quarterly	S	Until discont'd	
		STAT, Normal, Clinic Collect		
	☐	hCG quantitative, serum	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect		
	☐	Ionized calcium	Quarterly	S	Until discont'd	
		STAT, 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	Every visit	S	Until discont'd	
		o Verify lab results quarterly: Serum Ca2+. 
	o Notify provider if corrected Ca level is LESS than or EQUAL  to 8.5.
	o HOLD for ionized calcium  LESS than 1.11 mmol/L or LESS than 4.7 mg/dL.		
	☐	Nursing communication	Every visit	S	Until discont'd	
		Proceed with treatment prior to Vitamin D resulting.		
	☐	Nursing communication	Every visit	S	Until discont'd	
		Verify patient is on calcium and vitamin D supplementation. Notify provider if the patient is not on calcium and vitamin D supplementation or the patient's calcium level is outside the normal range.		
	☐	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		
	☐	Discontinue IV	Every visit	S	Until discont'd	
		Normal		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	romosozumab (EVENITY) 210mg/2.34mL ( 105mg/1.17mLx2) subcutaneous injection (RESTRICTED) 210 mg	Every 4 weeks	S	Until discont'd	
		210 mg, subcutaneous, once, Starting when released
	Prepare 2 injection sites. Recommended injection sites include the thigh, abdomen, or outer area of the upper arm. Rotate injection sites with each dose. If using the same injection site, ensure that it is not the same spot on the injection site used for a previous injection. Do not inject into areas where the skin is tender, bruised, red, or hard. Avoid injecting into areas with scars or stretch marks.		

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) 1 mg/mL injection FOR IM/SQ USE 0.5 mg	PRN	S	Until discont'd	
		0.5 mg, subcutaneous, once PRN, anaphylaxis, Starting when released, Until Discontinued		
	☐	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	PRN	S	 treatments	
		100 mg, intravenous, 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