Abatacept Intravenous infusion for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

• Should not be initiated in patients with active infections until infections are controlled
• Before the administration of each dose, the patient should be examined for the presence of infection, and consideration given to delaying treatment should infection be present
• In order to improve the traceability of biological medicinal products, the name and the batch number of the administered product should be clearly recorded.
• Monitoring requirements - see below
• Note:  This drug is also available as a subcutaneous injection- doses are not interchangeable for the different formulations

Available preparations

Orencia 250 mg powder for concentrate for solution for infusion

Reconstitution

Water for Injection

10mL per 250mg vial

• MUST USE the silicone-free disposable syringe provided with each vial and an 18-21 gauge needle. 
• Rotate with gentle swirling until the contents are completely dissolved
• DO NOT SHAKE
• Vent the vial with a needle to dissipate any foam that may be present
• Only use the solution if it is clear and colourless to pale yellow 

Infusion fluids

Sodium chloride 0.9% 

Methods of intravenous administration

Intermittent Intravenous Infusion

• From a 100mL bag of Sodium Chloride 0.9%, withdraw a volume equal to the volume of the dose (for 2 vials remove 20mL, for 3 vials remove 30mL, for 4 vials remove 40mL).
• Maximum permitted concentration is 10mg per mL
• Slowly add the reconstituted abatacept from each vial into the infusion bag using the same silicone-free disposable syringe provided with each vial, and gently mix
• Administer using an infusion set with a sterile, non-pyrogenic, low protein binding filter (pore size 0.2 to 1.2micron). e.g. Baxter RMC 9614 line with an extension set plus a Braun Sterifix 0.2micrometer infusion filter ref. no. 4099303.
• Administer required dose over 30 minutes

Dose in adults

Indication: Rheumatoid arthritis, Psoriatic arthritis

Dosing information
Body weight	Dose	Number of vials
Less than 60kg	500mg	2
60 to 100kg	750mg	3
Greater than 100kg	1000mg	4

• The dose should be repeated two and four weeks after the first infusion, then every 4 weeks thereafter

Monitoring

• Please also consult Medication Protocol: Management of Infusion Related Patient Reactions in nurse-led infusion settings in GUH. QPulse
• Monitor patient for infusion related reactions for one hour from the start of the infusion ^{(ref 1)}

Further information

• Can interfere with some readings of blood glucose monitor ^{(ref 2)}

Storage

• Store vials at 2-8⁰C in the original packaging to protect from light

References

SPC Orencia 01 February 2022
1:  Abatacept Prescription sheet - Rheumatology day ward Updated February 2014
2:  Injectable medicines information guide Medusa September 26 2022

Therapeutic classification

Immunosuppressant