Pharmacy specific orders / instructions always supersede the Agency guidance provided below. If in doubt, do not guess, call our office, or tag @TeamHelp-CareCoordination and ask for Clinical Support.
ALWAYSÂ make sure you have everything you need to complete infusion before you begin
ALWAYSÂ confirm your medication dose against the medication label and orders
ALWAYSÂ reach out to us first (not the Pharmacy) with any questions
NEVERÂ tell a Pt you have not given a particular medication before Â
SCHEDULING
1.   Scheduling patient: Read orders carefully when scheduling patient.Â
2.   Vyvgart has specific orders and IS not to be given early. Use the following site to help schedule next visit.
·      Vyvgart Dosing CalendarÂ
Differences between Non-prefilled syringe (vials) and PFS (Prefilled Syringe)
1.   Removal from fridge
·      Non-prefilled syringe remove 15 minutes prior to injection
·      PFS remove 30 minutes prior to injection
2.   Injection AngleÂ
·      Non-prefilled syringe Inject at 90 degrees
·       PFS Inject at an angle of 45 – 90 degrees
3.   Rate of InjectionÂ
·      Non-prefilled syringe give over 90 seconds
·      PFS inject over 20 – 30 seconds Â
MIXING
Obtain a clear/clean space to prepare Vyvgart Hytrulo.
Be sure all the necessary supplies are available to complete infusion from beginning to end.Â
You will need IV start supplies, syringe, 18 G stainless still transfer needle, and a winged infusion set.
Withdraw the entire content of VYVGART HYTRULO from the vial using a polypropylene syringe and an 18G stainless steel transfer needle.
Remove large air bubbles, if present
Each vial contains overfill to compensate for liquid loss during preparation and to compensate for the priming volume of the winged infusion set.
Administer immediately after preparation.
ADMINISTRATION
Take baseline vitals and document basic assessment.
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.
Choose an injection site on the abdomen (at least 2 to 3 inches away from the navel).
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.
Inject VYVGART HYTRULO vial subcutaneously into a pinched skin area at an angle of about 45 degrees over 30 to 90 seconds.
Localized injection site reactions may occur after VYVGART HYTRULO is administered
Discard any unused portions of medicine remaining in the vial, the syringe and the winged infusion set.
Record vitals prior to injection AND 5-10 minutes post infusion.
Record lot numbers and expiration dates for vials used.
Place bandage at site if needed.
Monitor patient for 30 minutes after administration and document vital signs in narrative.
Clean and dispose of used supplies.