**ALWAYS establish patent IV access and flush PRIOR to mixing medication**
Pharmacy specific orders / instructions always supersede the Agency guidance provided below. If in doubt, do not guess, call our office, or tag @TeamHelp-CareCoordination(Best Tag) and ask for Clinical Support.
ALWAYS establish IV access prior to mixing any meds
ALWAYS make sure you have everything you need to complete infusion before you begin
ALWAYS confirm your medication dose against the medication label and orders
ALWAYS reach out to us first (not the Pharmacy) with any questions
NEVER tell a Pt you have not given a particular medication before
MIXING
Obtain a clear/clean space to prepare the Ocrevus. Be sure all the necessary supplies are available to complete infusion from beginning to end. You will need IV/port access supplies, syringe, needle, and 500ml bag of NS, tubing (gravity tubing or pump tubing if using a pump).
Ocrevus comes as a liquid in a glass vial. Each vial contains 300mg which is 10ml of volume. 2 vials will equal the 600mg maintenance dose. Withdraw 10ml from each vial for a total of 20ml. Inject 20ml of Ocrevus into a 500ml bag of NS for reconstitution. Gently mix.
ADMINISTRATION
Take baseline vitals and document basic assessment.
Administer any ordered pre-medications. The most common pre-medications ordered are Acetaminophen, Diphenhydramine, and Methylprednisolone but this can vary from patient to patient.
Spike the bag of reconstituted Ocrevus and prime the line.
For Initial Dosing:
Start at a rate of 30ml/hr and increase by 30ml/hr every 30 minutes until max rate of 180ml/hr. 30ml/hr x 30 min, 60ml/hr x 30 min, 90ml/hr x 30 min, 120ml/hr x 30min, 150ml/hr x 30 min, 180ml/hr x remainder.
For Maintenance Dosing:
Start at a rate of 40ml/hr and increase by 40ml/hr every 30 minutes until max rate of 200ml/hr. 40ml/hr x 30 min, 80ml/hr x 30 min, 120ml/hr x 30 min, 160ml/hr x 30 min, 200ml/hr x remainder. Infusion should take approximately 3.5 hours
Record vitals at baseline, every 15 minutes for the first hour, then with every rate change and then hourly thereafter, AND 5-10 minutes post infusion.
Record lot numbers and expiration dates for vials used.
Disconnect patient and flush line. Do not remove until post infusion monitoring completed.
Stay one hour post infusion to monitor. Record vitals at end of post infusion monitoring period.
Remove IV/de-access port, placing a pressure bandage at site. Clean and dispose of used supplies
ADDITIONAL INFO
Website: https://www.ocrevus-hcp.com/
Medication Guide: https://www.gene.com/download/pdf/ocrevus_medguide.pdf