SYLVANT (siltuximab)

OFFICE ADMINISTRATION

Indications for Prior Authorization:

  • Patients with multicentric Castleman’s disease who are HIV negative and human herpesvirus-8 negative

The following indications do not meet the criteria for use established by the Western Health Advantage Pharmacy and Therapeutics Committee:

  • Any other diagnosis not listed in the approved indications

Dosing:

  • The dose is 11 mg/Kg IV infusion over one hour every three weeks

Monitoring:

  • Patients often have serious infections, fevers, weight loss, fatigue and nerve damage (weakness and numbness)

Approval:

One year


  

Last review date: July 21, 2016

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