Find all your referral forms in one place! This is a small list of medications we offer. Don’t see your medication listed? Please call our office and we can answer any questions you might have.
Listed in alphabetical order
ACTEMRA® is a medication used for the treatment of Rheumatoid Arthritis (RA) with an insufficient response to one or more anti-rheumatic medications altering the condition (DMARDs), arteritis of Giant Cells (GCA), active idiopathic polyarticular juvenile arthritis, or active idiopathic systemic juvenile arthritis. Treatments with ACTEMRA® are usually given every two weeks, and each infusion lasts approximately 60 minutes.
Benlysta is a prescription medicine, given intravenously (IV) or subcutaneously, for adults with active systemic lupus erythematosus (SLE or lupus) or active lupus nephritis on other lupus medicines. Benlysta IV is approved in children aged 5 years and older with SLE on other lupus medicines. It is not known if Benlysta is safe and effective in people with severe active central nervous system lupus.
Blank referral order forms are for orders not listed on this page or custom orders.
CIMZIA® is a prescription medicine called a Tumor Necrosis Factor (TNF) blocker used in adults to Lessen the signs and symptoms of moderately to severely active Crohn’s disease (CD) in adults who have not been helped enough by usual treatments. Treat moderately to severely active rheumatoid arthritis (RA), psoriatic arthritis (PsA), active ankylosing spondylitis (AS), active non-radiographic axial spondyloarthritis (nr-axSpA) with measures of inflammation, moderate to severe plaque psoriasis (PsO) in adults who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet light alone or with pills).
CINQAIR® is a medication designed for the treatment of extreme asthma. For adults with a form of extreme asthma, CINQAIR® is an add-on maintenance drug that acts to minimize the number of cells that lead to elevated levels of eosinophils. Each dose of CINQAIR® is given every four weeks with a period of 20-50 minutes for each infusion.
CINRYZE was the first C1 esterase inhibitor (C1-INH) approved by the FDA to help prevent swelling attacks in children (6 years of age and older), teenagers and adults. Available since 2008, CINRYZE has successfully been used to help reduce the frequency, severity, and length of attacks in adolescent and adult patients. In pediatric patients (age 6 to 11), CINRYZE was shown to reduce the number of HAE attacks, lessen the severity of attacks, and reduce the use of acute treatment.
Dalvance® (dalbavancin) for injection is indicated for the treatment of adult and pediatric patients with acute bacterial skin and skin structure infections (ABSSSI) caused by designated susceptible strains of Gram-positive microorganisms: Staphylococcus aureus, Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus anginosus group and Enterococcus faecalis.
Entyvio® is a medication indicated for the treatment of Ulcerative Colitis (UC) or Crohn’s Disease (CD). Entyvio works by reducing inflammation. Treatments with Entyvio are usually given at one, two and six weeks and then every eight weeks thereafter, each infusion lasting approximately 30 minutes.
EVKEEZA is an injectable prescription medicine used along with other low-density lipoprotein (LDL) lowering medicines in people 5 years of age and older with a type of high cholesterol called homozygous familial hypercholesterolemia (HoFH).
Fabrazyme® is a biological infusion therapy indicated for the treatment of adult and pediatric patients <2 years or older with confirmed Fabry disease. It functions by reducing the amount of globotriaosylceramide (GL-3) that is absent or defective in people with Fabry’s disease by removing the enzyme responsible for reducing GL-3. Treatment with Fabrazyme® is usually performed every 2 weeks, with each infusion lasting approximately 2-3 hours.
FASENRA® is an asthma medicine used to treat adults with a particular type of asthma called eosinophilic asthma. It is used as an additional treatment in adults with severe asthma that is not adequately controlled by a combination of high-dose inhaled corticosteroids plus medicines called long-acting beta-agonists.
ILUMYA is a prescription medicine used to treat adults with moderate to severe plaque psoriasis who may benefit from taking injections, pills (systemic therapy), or phototherapy (treatment using ultraviolet or UV light).
Biosimilar to Remicade
Inflectra: Shown to be highly similar to Remicade, with no clinically meaningful differences in terms of efficacy, immunogenicity, safety, and purity.
Injectafer is a prescription iron replacement medicine administered only by or under the supervision of your healthcare provider. Injectafer is injected into your vein to treat iron deficiency anemia in adults and pediatric patients 1 year of age and older. Injectafer should be used only if you have not responded well to treatment with oral iron, or if you are intolerant to oral iron treatment. It is
also used to treat iron deficiency anemia in adults with chronic kidney disease who are not receiving dialysis.
Intravenous immune globulin (“IVIG”) is a product made up of human antibodies that can be given intravenously (through a vein). Antibodies are proteins your body makes to help you fight certain infections. Each antibody made by your body is slightly different because it fits like a lock and key to every foreign substance (such as a piece of a virus or bacterium) that gets into your body. Over the course of your life your body makes thousands of different antibodies as you are exposed to different infectious organisms that your body considers to be “foreign.”
Your body makes many different antibodies against different parts of the same foreign organisms, so IVIG can be very effective at preventing or treating infections in persons who do not have antibodies or who have low levels of antibodies. IVIG is prepared from the blood donated by thousands of people, to make a super-concentrated and very diverse collection of antibodies against many possible infectious organisms your body might encounter.
KRYSTEXXA® is a medication for the treatment of gout. KRYSTEXXA® is a biological infusion therapy that treats gout by reducing the level of uric acid and helping to remove the accumulation of uric acid crystals. Treatments with KRYSTEXXA® are usually given every two weeks and each infusion lasts approximately two hours.
LEMTRADA® is a disease modifying drug for very active relapsing-remitting MS.
LEQVIO® is a medicine used to reduce cholesterol in the blood. It is used in adults with primary hypercholesterolemia or mixed dyslipidemia.
Nucala is an add-on, prescription maintenance treatment for patients 6 and older with severe eosinophilic asthma.
Ocrevus® is a medication used for the treatment of multiple sclerosis in adults in relapsing or primary progressive types. The first Ocrevus® therapy is delivered as two separate infusions two weeks apart, each lasting approximately 2.5 hours. The remaining treatments are performed every six months, lasting about 3.5 hours for each infusion.
ORENCIA (abatacept) is a prescription biologic medicine for: Adult Rheumatoid Arthritis (RA). ORENCIA is used to reduce signs and symptoms of moderate to severe Rheumatoid Arthritis in adults 18 years and older. Taking ORENCIA may prevent further damage to your bones and joints, and may help your ability to perform daily activities. ORENCIA may help those who are not getting the results they need with other medicines for RA.
Prolia® is a prescription medicine used to treat osteoporosis in women after menopause who are at high risk for fracture or cannot use another osteoporosis medicine or other osteoporosis medicines did not work well.
Prolia® is a prescription medicine used to increase bone mass in men with osteoporosis who are at high risk for fracture.
Remicade® is a drug indicated for the treatment of Crohn’s Disease, Ulcerative Colitis, Rheumatoid Arthritis, Psoriatic Arthritis. It is one of the most widely used infusion therapies throughout the world. Remicade is recommended for a large variety of patients, including elderly and pediatric patients. An infusion with Remicade® lasts between two and three hours and is given every six to eight weeks.
RENFLEXIS is biosimilar to Remicade (infliximab). A biosimilar is a medicine approved by the Food and Drug Administration (FDA) as being highly similar to an already approved biologic medicine. The FDA refers to the already approved biologic as the reference product. It is also known as the originator or original biologic product.
RENFLEXIS treats the same autoimmune diseases as Remicade. It works the same way, has the same dosage and is taken the same way. This means you can expect similar safety and effectiveness from the biosimilar over the course of treatment as you would from the reference product. That’s one of the reasons why doctors prescribe RENFLEXIS.
Rituxan® is used to treat certain types of cancer (such as non-Hodgkin’s lymphoma, chronic lymphocytic leukemia). It works by slowing or stopping the growth of cancer cells. Some brands of Rituxan® are also used to treat rheumatoid arthritis and can decrease joint pain and swelling. Rituxan® is given every six months.
SIMPONI ARIA® is a prescription medicine used to treat: Moderate to severe rheumatoid arthritis (RA) in adults, used in combination with methotrexate. Active psoriatic arthritis (PsA) in people 2 years of age and older. Active ankylosing spondylitis (AS) in adults.
Stelara IV targets proteins that are known to be associated with plaque psoriasis, gastrointestinal, joint, and skin inflammation, IL-12 and IL-23. Stelara is given to Crohn’s patients by a single infusion, usually for at least one hour, followed by an injection once every eight weeks before six cumulative injections have been obtained.
TEPEZZA® is a medicine used for the treatment of Thyroid Eye Disease (TED), a disorder in which the muscles and fatty tissues behind the eye become inflamed. A total of eight infusions over twenty-one weeks are included in the therapy schedule for TEPEZZA®, which is equivalent to one infusion every three weeks. Each infusion is 60 to 90 minutes long.
Tysabri is a medication indicated for the treatment of adults with relapsing forms of multiple sclerosis (MS). It has been proven that Tysabri substantially delays the development of physical disability over a 12-week span. It also prevents the development of new active brain lesions and reduces the frequency of relapses in MS adults. Usually, patients undergo a Tysabri infusion every 28 days with a period of about 60 minutes for each infusion.
Vyepti® is recommended for the preventive treatment of migraine in adults. For adults receiving the 100 mg dose, an infusion is required every 3 months. Some patients can benefit from a 300 mg dose every 3 months.
XOLAIR® (omalizumab) for subcutaneous use is an injectable prescription medicine used to treat: moderate to severe persistent asthma in people 6 years of age and older whose asthma symptoms are not well controlled with asthma medicines called inhaled corticosteroids. A skin or blood test is performed to see if you have allergies to year-round allergens. It is not known if XOLAIR is safe and effective in people with asthma under 6 years of age.
nasal polyps in people 18 years of age and older when medicines to treat nasal polyps called nasal corticosteroids have not worked well enough. It is not known if XOLAIR is safe and effective in people with nasal polyps under 18 years of age.
chronic spontaneous urticaria (CSU, previously referred to as chronic idiopathic urticaria (CIU), chronic hives without a known cause) in people 12 years of age and older who continue to have hives that are not controlled with H1 antihistamine treatment. It is not known if XOLAIR is safe and effective in people with CSU under 12 years of age.
XOLAIR is not used to treat other allergic conditions, other forms of hives, or sudden breathing problems.
Zoledronic acid injection is used to treat hypercalcemia (high levels of calcium in the blood) that may occur in patients with some types of cancer.