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