Why an infusion?
Some of the most effective medications in rheumatology are given by intravenous (IV) infusion rather than as a pill or self-injection. Drugs like infliximab, rituximab, and Reclast (zoledronic acid) are delivered directly into your bloodstream, which allows precise dosing and rapid distribution throughout your body.
Our on-site infusion center at Synergy Rheumatology means you receive treatment right here in our office — no hospital visit, no separate infusion center. Your nurse manages your infusion from start to finish.
Before your visit
A little preparation goes a long way toward a smooth infusion day.
- Eat a real meal before you arrive — infusions on an empty stomach can make nausea more likely
- Stay well-hydrated the day before and the morning of — it makes your veins easier to access and reduces the chance of a headache afterward
- Wear comfortable clothing with easy access to your arms — short sleeves or a loose top that can be pushed above the elbow
- Bring something to pass the time — a book, tablet, headphones, your phone charger — infusions can take anywhere from 30 minutes to several hours depending on the medication
- Take your pre-medications if we’ve prescribed any (such as acetaminophen, diphenhydramine, or a steroid) — follow the timing instructions we gave you
- Don’t skip your appointment over a mild cold — but do call us if you have a fever, active infection, or were recently on antibiotics, as we may need to reschedule
When you arrive
After checking in at the front desk, our nursing team will take your vital signs — blood pressure, heart rate, temperature, and oxygen saturation. These serve as your baseline for the visit.
Your nurse will review how you’ve been doing since your last infusion, ask about any new symptoms or medication changes, and confirm your pre-medications. Then they’ll place your IV catheter — typically in the forearm or hand. A quick stick, a small piece of tape, and you’re set.
Your medication has already been mixed by a specialty pharmacy or prepared according to your specific dose. We verify everything — drug, dose, and your identity — before the drip starts.
During the infusion
Once the IV is running, the hardest part is already behind you.
- Infusion times vary by medication — some run in 30 minutes, others take 2–3 hours, and first-time infusions are sometimes run more slowly as a precaution
- Your nurse monitors you at regular intervals — checking vitals, watching for any changes, and adjusting the infusion rate as needed
- You can eat, drink, read, work, nap, or scroll your phone — the infusion chair is yours for the duration
- Let us know immediately if you feel anything unusual — even if it seems minor — so we can address it right away
Infusion reactions
Infusion reactions are uncommon and almost always manageable, but it’s important to know what to look for.
Tell your nurse right away if you notice any of the following during or shortly after your infusion: flushing or warmth, itching or hives, throat tightness, chest tightness, shortness of breath, dizziness, or a sudden change in how you feel.
If a reaction occurs, we slow or temporarily stop the infusion, administer medications to counteract the reaction — such as antihistamines, steroids, or acetaminophen — and monitor you closely. Most reactions resolve quickly and many patients are able to resume the infusion at a slower rate.
True severe reactions (anaphylaxis) are rare. Our infusion suite is equipped to handle them, and our nursing staff is trained in emergency response. The most important thing you can do is speak up early — catching a reaction when it’s mild makes it easy to manage.
After your infusion
Once the infusion is complete, we’ll observe you for a short period — typically 15 to 30 minutes — to make sure you’re feeling well before you head home. Your IV is removed, a bandage goes on, and you’re free to drive yourself home and resume normal activities.
In the 24 hours after your infusion, watch for:
- Fever or chills
- Rash, hives, or itching
- Chest tightness or shortness of breath
- Unusual fatigue, headache, or body aches
Mild fatigue or a headache the day after is common with some medications and usually resolves on its own. More significant symptoms — especially fever, rash, or breathing difficulty — warrant a call to our office right away.
If you experience a serious reaction after hours, go to your nearest emergency room and let them know what medication you received. Then call our office the next business day so we can update your chart.
Scheduling and insurance
We handle the logistics so you don’t have to.
- Prior authorization — most infusion medications require insurance approval before each infusion or series of infusions, and we manage that process for you
- Scheduling — our team will schedule your next infusion before you leave, keeping you on the interval your medication requires
- Arrival time vs. infusion time — plan to be here longer than just the infusion itself, as check-in, IV placement, and post-infusion observation add time to your visit. We’ll give you a realistic time estimate for your specific medication
- Specialty pharmacy coordination — for certain insurances, we may ask a specialty pharmacy to coordinate copay and cost-sharing with you directly. The specialty pharmacy will then either ship the medication to our office for administration (a process called “white-bagging”) or ship it to you at home (“brown-bagging”). If the pharmacy ships the medication to you, follow all handling instructions carefully — including keeping it refrigerated — and only remove it to bring it to our office on the day of your infusion. Call our office if you have any questions about handling or transport
If you ever have questions between visits — about timing, pre-medications, side effects, or insurance — call us. That’s what we’re here for.
This handout is provided for educational purposes and does not replace individualized medical advice. Always follow the specific instructions given by your rheumatologist.