OHSU Knight Cancer Institute

Infusion Orders

  1. Click on the desired infusion order to download and print the PDF.
  2. Fill in all fields and sign infusion order request form with ink.
  3. Fax the signed infusion order and face sheet to the clinic location.

Abatacept (ORENCIA)
Generic: Abatacept

Acute Infusion Reaction Algorithm
Generic: Acute Infusion Reaction Algorithm (CHO)

Acute Infusion Reaction - Adult Treatment Algorithm
Generic: Acute Infusion Reaction - Adult Treatment

Acute Infusion Reaction - Pediatric Treatment Algorithm 
Generic: Acute Infusion Reaction - Pediatric Treatment

Agalsidase Beta (FABRAZYME) 
Generic: Agalsidase Beta

Alglucosidase Alpha (LUMIZYME) Infusion 
Generic: Alglucosidase alpha

Alpha-1 Proteinase Inhibitor (Prolastin C) 
Generic: Alpha-1 Proteinase Inhibitor

Amphotericin B (AMBISOME) Infusion
Generic: Amphotericin B liposomal

Antibiotic Therapy (Cephalosporin, Fluoroquinolone, and Others) 
Generic: Antibiotic Therapy

Antibiotic Therapy (Daptomycin, Vancomycin, and Aminoglycosides) 
Generic: Antibiotic Therapy

Antibiotic Therapy (Penicillins and Carbapenems) 
Generic: Antibiotic Therapy

Antiviral Therapy 
Generic: Antiviral Therapy (CHO)

Avalglucosidase (NEXVIAZYME)
Generic: Avalglucosidase

Belatacept (NULOJIX) 
Generic: Belatacept

Belimumab (Benlysta)
Generic: Belimumab

Benralizumab (FASENRA) 
Generic: Benralizumab

Blank document 

Blood Transfusion Orders 
Generic: Blood Transfusion Orders (CHO)

Capped Catheter Flush 
Generic: Capped Catheter Flush (CHO)

Certolizumab (Cimzia) 
Generic: Certolizumab

Cosyntropin (CORTROSYN) Stimulation Test
Generic: Cosyntropin

Cyclophosphamide (CYTOXAN) Non-Oncology 
Generic: Cyclophosphamide

Cupric Chloride 
Generic: Darbepoetin Alfa

Darbepoetin Alfa (ARANESP)
Generic: Darbepoetin Alfa

Deferoxamine (DESFERAL) 
Generic: Deferoxamine

Denosumab (PROLIA) Injection Osteoporosis
Generic: Denosumab

Dialysis Catheter TPA (Alteplase) 
Generic: Dialysis Catheter TPA

Dupilumab (DUPIXENT) 
Generic: Dupilumab

Eculizumab (SOLIRIS)
Generic: Eculizumab

Edaravone (RADICAVA) infusion 
Generic: Edaravone

Efgartigimod Alfa-fcab (VYGART)
Generic: Efgartigimod

Epoetin Alfa-epbx (RETACRIT) 
Generic: Epoetin Alfa

Eptinezumab-jjmr (VYEPTI) Infusion
Generic: Eptinezumab

Factor, Antithrombotics, and Albumin 
Generic: Factor, Antithrombotics, Albumin

Ferric Carboxymaltose (INJECTAFER) 
Generic: Ferric Carboxymaltose

Ferric Derisomaltose (MONOFERRIC) Infusion
Generic: Ferric Derisomaltose

Ferumoxytol (FERAHEME) Infusion 
Generic: Ferumoxytol

Filgrastim-Sndz (ZARXIO) 
Generic: Filgrastim

Filgrastim-Sndz (ZARXIO) for Hepatitis C 
Generic: Filgrastim

Filgrastim-Sndz (ZARXIO) for Stem Cell Mobilization 
Generic: Filgrastim

Golimumab (Simponi Aria)
Generic: Golimumab

Guselkumab (TREMFYA) 
Generic: Guselkumab

Hydration for Hyperemsis Gravidarum 
Generic: Hydration for Hyperemsis Gravidarum (CHO)

Hydration With Electrolytes
Generic: Hydration With Electrolytes (CHO)

Ibandronate (BONIVA) Injection
Generic: Ibandronate

Inclisiran (LEQVIO)
Generic: Inclisiran

Generic: Infliximab

Intravenous Immune Globulin (IVIG) 
Generic: Immune Globulin

Iron Dextran (INFED) 
Generic: Iron Dextran

Iron Sucrose (VENOFER) 
Generic: Iron Sucrose

Mepolizumab (NUCALA) 
Generic: Mepolizumab

Methotrexate for Ectopic Pregnancy 

Generic: MethylPREDNISolone

Natalizumab (TYSABRI) 
Generic: Natalizumab

Ocrelizumab (OCREVUS) Infusion
Generic: Ocrelizumab

Omalizumab (XOLAIR) 
Generic: Omalizumab

Other Therapy 
Generic: Other Therapy (CHO)

Pamidronate (AREDIA) 
Generic: Pamidronate

Pegfilgrastim (UDENYCA)
Generic: Pegfilgrastim

Pegloticase (KRYSTEXXA) infusion 
Generic: Pegloticase

Pentamidine (PENTAM) 
Generic: Pentamidine

Ravulizumab-cwvz (ULTOMIRIS)
Generic: Ravulizumab-cwvz

Risankizumab-rzza (SKYRIZI) Infusion
Generic: Risankizumab-rzza

Rituximab-abbs (TRUXIMA)
Generic: Rituximab

Romosozumab-aqqg (EVENITY) Injection
Generic: Romosozumab-aqqg

Saline Challenge Test

Sodium Ferric Gluconate Complex (FERRLECIT)
Generic: Ferrlecit

Sodium Thiosulfate Infusion
Generic: Sodium Thiosulfate

Teprotumumab-trbw (TEPEZZA)
Generic: Teprotumumab-trbw

Testosterone Cypionate (DEPO-TESTOSTERONE) 
Generic: Testosterone Cypionate

Tezepelumab-ekko (TEZSPIRE) injection
Generic: Tezepelumab-ekko

Therapeutic Phlebotomy 
Generic: Therapeutic Phlebotomy (CHO)

Tildrakizumab (ILUMYA)
Generic: Tildrakizumab

Tocilizumab (ACTEMRA) 
Generic: Tocilizumab

Ustekinumab (STELARA) 
Generic: Ustekinumab

Ustekinumab (STELARA) IV (Crohn's Disease) 
Generic: Ustekinumab

Generic: Vaccines (CHO)

Vedolizumab (ENTYVIO)
Generic: Vedolizumab

Voriconazole (VFEND) 
Generic: Voriconazole

Zoledronic Acid (RECLAST) 
Generic: Zoledronic Acid

Zoledronic Acid (ZOMETA) 
Generic: Zoledronic Acid