Shared By Denise Bruen, ANP-BC, MSN, MSCN (University of Va Health System)

POSTED DATE: JUNE 22, 2020

LEMTRADA PROTOCOL


Starting 2-3 days before your infusion, make sure to drink lots of fluids and stay well hydrated. Hydration can prevent infusion reactions during Lemtrada.


One day before you start Lemtrada, start the following OTC medications to help prevent infusion reactions. You can stop them after your last infusion is complete.


-Pepcid 20 mg daily
-Zyrtec 10 mg daily
-Benadryl 25 mg at night
-We are also giving you a prescription for a medication called hydroxyzine, which you can take as needed if you have itching or a rash while on Lemtrada.


Additionally, one day before the infusion, also start Valtrex 500 mg daily, which you will need to continue until you are told to stop.


We will arrange follow up after Lemtrada is coordinated.


Lemtrada® Diet Recommendations:


Why are there dietary changes recommended for Lemtrada®?
Lemtrada is an immunosuppressive medicine which can put you at an increased risk of infection. This includes an increased risk of food borne illness, such as Listeria.


What is Listeria?
Listeria is a bacteria that can be present on contaminated food.


What foods are associated with Listeria?
Ready-to-eat deli meats and hot dogs
Refrigerated meat spreads
Unpasteurized (raw) milk and dairy products
Soft cheeses made with unpasteurized milk, such as queso fresco, Feta, Brie, Camembert
Refrigerated smoked seafood
Raw sprouts


How should I change my diet?
Do not drink unpasteurized (raw) milk
Rinse raw produce thoroughly under running tap water before eating
Wash hands, knives, countertops and cutting boards after handling and preparing uncooked foods
Keep uncooked meats and seafood separate from vegetables, fruits, cooked and ready-to-eat foods
Thoroughly cook raw food from animal sources
Consume perishable and ready-to-eat foods as soon as possible
Heat hot dogs, cold cuts and deli meats before eating them


When should I change my Diet?
As soon as you decide to start Lemtrada® and continue for at least 3 months after your infusion.