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

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

Antiemetics and Acid Suppresants 
Generic: Antiemetics and Acid Suppresants

Antiviral Therapy 
Generic: Antiviral Therapy (CHO)

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) 
Generic: Cosyntropin

Cyclophosphamide (CYTOXAN) Non-Oncology 
Generic: Cyclophosphamide

Darbepoetin Alfa (ARANESP) Initiation 
Generic: Darbepoetin Alfa

Darbepoetin Alfa (ARANESP) Maintenance for Anemia of CKD 
Generic: Darbepoetin Alfa

Darbepoetin Alfa (ARANESP) Maintenance for Oncology Patients 
Generic: Darbepoetin Alfa

Deferoxamine (DESFERAL) 
Generic: Deferoxamine

Denosumab (PROLIA) Osteoporosis 
Generic: Denosumab

Dialysis Catheter TPA (Alteplase) 
Generic: Dialysis Catheter TPA

Dupilumab (DUPIXENT) 
Generic: Dupilumab

Eculizumab (SOLIRIS) 
Generic: Eculizumab

Edaravone (RADICAVA) infusion 
Generic: Edaravone

Epoetin Alfa (RETACRIT) Initiation 
Generic: Epoetin Alfa

Epoetin Alfa (RETACRIT) Maintenance for Oncology Patients 
Generic: Epoetin Alfa

Epoetin Alfa (RETACRIT) Maintenance Non-Oncology 
Generic: Epoetin Alfa

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

Ferric Carboxymaltose (INJECTAFER) 
Generic: Ferric Carboxymaltose

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)

​​​​​​​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) 
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

PICC Placement 
​​​​​​​Generic: PICC Placement (CHO)

Ravulizumab-cwvz (ULTOMIRIS)

Rituximab-abbs (TRUXIMA) for Kidney Transplant Rejection
Generic: Rituximab

Rituximab-abbs (TRUXIMA) for Rheumatoid Arthritis
Generic: Rituximab

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

Sodium Thiosulfate Infusion
Generic: Sodium Thiosulfate

Teprotumumab-trbw (TEPEZZA)
Generic: Teprotumumab-trbw

Testosterone Cypionate (DEPO-TESTOSTERONE) 
Generic: Testosterone Cypionate

Therapeutic Phlebotomy 
Generic: Therapeutic Phlebotomy (CHO)

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