• Delray Beach, Hollywood & Miami Florida

    Delray Beach, Hollywood & Miami Florida

    PHONE: 833-435-6633 | FAX: 561-559-9801
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  • Fabrazyme (agalidase beta) If selected Solu-Medrol pre-medication, please provide the dosage amount   *   

  • Lumizyme (alglucosidase alfa) If selected Solu-Medrol pre-medication, please provide the dosage amount   *   

  • For Nulojix (belatacept) Initial dose & maintenance   

    *Day 1 (day of transplantation, prior to transplantation) and Day 5 (approx. 96 hours after Day 1 dose), at the end of week 2, week 4, week 8, and week 12 after transplantation. 

  • Then   * at the end of week 16 after transplantation and every 4 weeks (plus or minus 3 days) thereafter.

  • * Patient has received   *   doses thus far, next dose due on   Pick a Date*   .

    ***prescribed dose must be evenly divisible by 12.5mg
    ***The total infusion dose of Nulojix should be based on the patient's actual body weight at the time of transplantation and should not be modified during the course of therapy unless there is a change in the body weight of greater than 10%. If the patient has had >10% weight change, please notify the physician for dose change recommendations.

  • For Nulojix (belatacept) maintenance dose ONLY
    *mg/IV every 4 weeks.

    ***prescribed dose must be evenly divisible by 12.5mg
    ***The total infusion dose of Nulojix should be based on the patient's actual body weight at the time of transplantation and should not be modified during the course of therapy unless there is a change in the body weight of greater than 10%. If the patient has had >10% weight change, please notify the physician for dose change recommendations.

  • Qutenza (capsaicin) orders (max:4)
    Note* leave on each area for 60 min, every 3 months or longer
    Apply 1 patch to    area of the body
    Apply 1 patch to    area of the body
    Apply 1 patch to    area of the body
    Apply 1 patch to    area of the body

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  • Standard Documentation Required for Most Medications

    • Patient demographics
    • Patient medical insurance card copied front and back
    • Patient pharmacy card copied front and back (if they have one)
    • Most recent chart notes, diagnostic testings, and labs.
    • Proof of patient being concurrently treated with any other biologics
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