Keytruda 100 mg IV Injection (Merck)

– Infuse over 30 minutes through a 0.2 to 5 micron sterile, non-pyrogenic, low-protein binding inline or add-on filter
– Do not infuse other medications through the same infusion line.

– Withdraw appropriate volume from vial and transfer to IV bag containing NS or D5W; final concentration should be between 1 to 10 mg/mL
– Mix by gently inverting bag
– Discard unused portion of the vial.

– When administering as monotherapy, pre-medicate with dexamethasone 4 mg orally or IV when infusing carfilzomib over 10 minutes or with dexamethasone 8 mg orally or IV when infusing carfilzomib over 30 minutes.

– When using combination therapy, administer the recommended dexamethasone dose (refer to prescribing information).

– Pre-medicate 30 minutes to 4 hours prior to all doses in cycle 1, and as needed with future cycles to reduce the incidence and severity of infusion reaction.

– Store intact vials refrigerated at 2°C to 8°C (36°F to 46°F)
– Protect injection solution vials from light and do not shake or freeze.

– Reconstituted solutions and solutions diluted for infusion in NS or D5W may be stored at room temperature for up to 6 hours (infusion must be completed within 6 hours of reconstitution) or refrigerated at 2°C to 8°C (36°F to 46°F) for no more than 24 hours from the time of reconstitution.
– Do not freeze
– If refrigerated, allow to reach room temperature prior to administration.

– PD-L1 expression status in patients with gastric cancer or non-small cell lung cancer (NSCLC, when used as single-agent therapy)

– Liver function tests (AST, ALT, and total bilirubin)

– Renal function

– Thyroid function (at baseline, periodically during treatment and as clinically indicated)

– Glucose

– CBC with differential (in patients with Hodgkin lymphoma)

– Signs/symptoms of colitis, dermatologic toxicity, hypophysitis, thyroid disorders, pneumonitis, infusion reactions.