VYVGART HYTRULO WEEKLY SQ FOR CIDP		version 2/27/2025		

Appointment Requests 	

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

Provider Communication 	

	
	Interval	Defer Until	Duration	
	☐	Provider communication	Every visit	S	Until discont'd	
		Administer all vaccines according to immunization guidelines at least 4 weeks before initiation of treatment with VYVGART or VYVGART HYTRULO. For patients that are on treatment with VYVGART or VYVGART HYTRULO, vaccination with live or live attenuated vaccines is not recommended. For all other vaccines, vaccination should take place at least 2 weeks after the last infusion of a treatment cycle and 4 weeks before initiating the next cycle.		

Labs 	

	
	Interval	Defer Until	Duration	
	☐	CBC with platelet and differential	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect
	Prior to the CBC being resulted, pharmacy and nursing may proceed with verification and administration, respectively.  The CBC is for ongoing monitoring and should not impact the workflow on the treatment day.		
	☐	Comprehensive metabolic panel	Once	S	1 treatment	
		STAT, Normal, Clinic Collect		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Treatment conditions	Every visit	S	Until discont'd	
		Hold and notify physician of ANY critical values of WBC.		
	☐	Vital signs - T/P/R/BP Per Unit Protocol	Every visit	S	Until discont'd	
		No details available for preview		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	efgartigimod alfa 1008 mg-hyaluronidase 11,200 units qvfc (VYVGART HYTRULO) 5.6 mL subcutaneous injection (RESTRICTED)	1 time a week	S	 treatments	
		5.6 mL, subcutaneous, weekly, Starting S As Scheduled, Until Discontinued
	To administer Vyvgart Hytrulo®, use a winged infusion set made of polyvinyl chloride(PVC), 25G, 12 inches tubing, maximum priming volume of 0.4 mL. Remove the transfer needle from the syringe and connect the syringe to the winged infusion set. Prior to administration, fill the tubing of the winged infusion set by gently pressing the syringe plunger until the plunger is at 5.6 mL. There should be solution at the end of the winged infusion set needle. Inject Vyvgart Hytrulo® subcutaneously into an injection site on the abdomen (at least 2 to 3 inches away from the navel) over 30 to 90 seconds. Do not inject on areas where the skin is red, bruised, tender, hard, or into areas where there are moles or scars. Rotate injection sites for subsequent administrations. Localized injection site reactions may occur after Vyvgart Hytrulo® is administered. Healthcare professionals should monitor for clinical signs and symptoms of hypersensitivity reactions for at least 30 minutes after administration.
	DOSE=1,008 mg/11,200 units= 5.6 mL of VYVGART HYTRULO SQ Injection. Administer over 30-90 seconds.		

Hypersensitivity 	

	
	Interval	Defer Until	Duration	
	☐	acetaminophen (TYLENOL) tablet 650 mg	PRN	S	Until discont'd	
		650 mg, oral, every 4 hours PRN, 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