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. 
 
- Do not use vial if vacuum is not present
 
- 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 (ref 1)
 
- 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 24/06/2024
1:  Abatacept Prescription sheet - Rheumatology day ward Updated February 2014
2:  Injectable medicines information guide Medusa downloaded 27/02/2025
      
  
        Therapeutic classification
  
                  Immunosuppressant