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Entyvio (Vedolizumab) Order Form - ARJ Infusion Services

Entyvio (Vedolizumab) Order Form - ARJ Infusion Services 2026

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The document is a provider order form for Vedolizumab (Entyvio), detailing patient and provider information, therapy administration guidelines, nursing care protocols, laboratory orders, pre-medication instructions, and fax numbers for various locations. It outlines the treatment regimen for administering Vedolizumab, including dosage, frequency, and observation requirements.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the patient information, including the date, referral status, patient name, and ICD-10 code. Ensure all required fields are filled accurately.
Next, provide details about the patient's weight, height, and status regarding therapy. This section is crucial for determining appropriate treatment.
In the provider information section, fill in the referral coordinator's name and email, along with the ordering provider's details. Make sure to include contact information for seamless communication.
Complete the nursing therapy administration section by checking off necessary items such as TB status and infusion details. Specify dosage and frequency of Vedolizumab administration.
Fill out laboratory orders as needed and include any special instructions or pre-medication orders relevant to the patient's treatment plan.
Finally, ensure that all fax numbers are correctly noted before signing and dating the form at the bottom.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Is Entyvio a high risk medication?

1.2 Vedolizumab should be given until it stops working or surgery is needed. At 12 months after the start of treatment, people should be reassessed to see whether treatment should continue. Treatment should only continue if there is clear evidence of ongoing clinical benefit.

What is the generic name for vedolizumab?

ENTYVIO (vedolizumab) for Ulcerative Colitis and Crohns Disease.

What does Entyvio infusion do?

Entyvio is a brand of vedolizumab. This injection treats ulcerative colitis and Crohns disease. A healthcare provider will give you this medication in a hospital or clinic setting.

Is vedolizumab an infusion or injection?

Vedolizumab injection comes as a powder to be mixed with sterile water and injected intravenously (into a vein) over 30 minutes by a doctor or nurse. It is usually given in a doctors office once every 2 to 8 weeks, more often in the beginning of your treatment and less often as your treatment continues.

Is vedolizumab a chemo drug?

In rare cases, Entyvio can cause severe, life-threatening infections, anaphylaxis, or liver problems. Before starting Entyvio, talk with your healthcare provider about the risks and benefits of this medication.

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What is the schedule for vedolizumab?

The recommended dose regimen of intravenous vedolizumab is 300 mg administered by intravenous infusion at 0, 2 and 6 weeks and then every 8 weeks thereafter. Therapy for patients with ulcerative colitis should be discontinued if no evidence of therapeutic benefit is observed by week 10 (see section 5.1).

Is vedolizumab the same as Entyvio?

Vedolizumab (Entyvio) is an integrin receptor antagonist indicated for the treatment of adult patients with moderately to severely active Crohns disease who have had an inadequate response with, lost response to, or were intolerant to immunomodulators or a tumour necrosis factor (TNF) alpha antagonist; or who have had

Entyvio (Vedolizumab) Order Form - ARJ Infusion Services 2026

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