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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 0.2µm to 1.2µm). 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

IV Guide Type