Hemlibra is provided in single-use vials as ready to use solution which does not need to be diluted. A doctor qualified to care for patients with haemophilia will start you on treatment with Hemlibra. Always use this medicine exactly as your doctor has told you. Check with your healthcare provider if you are not sure.
Each time you use Hemlibra, record the name and batch number of the medicine.
The dose of Hemlibra depends on your weight and your doctor will calculate the amount (in mg) and corresponding amount of Hemlibra solution (in mL) to be injected:
- Loading dose regimen: Weeks 1 to 4: The dose is 3 milligrams for every 1 kilogram you weigh, injected once a week.
- Maintenance dose regimen: Week 5 and onwards: The dose is either 1.5 milligrams for every 1 kilogram you weigh, injected once a week, 3 milligrams for every 1 kilogram you weigh, injected every 2 weeks, or 6 milligrams for every 1 kilogram you weigh, injected every 4 weeks.
The decision, to use either the 1.5 mg/kg once weekly, 3 mg/kg every two weeks, or 6 mg/kg every four weeks maintenance dose, should be made in consultation with your doctor and, where applicable, with your caregiver.
Different Hemlibra concentrations (30 mg/mL and 150 mg/mL) should not be combined in a single injection when making up the total volume to be injected.
The amount of Hemlibra solution given in each injection must not be more than 2 mL.
If you inject Hemlibra yourself or if your caregiver injects it, you or your caregiver must carefully read and follow the instructions in section 7, “Instructions for use”.
- Hemlibra is given by injection under the skin (subcutaneously).
- Your doctor or nurse will show you how to inject Hemlibra.
- Once you have been trained, you should be able to inject this medicine at home, by yourself or with the help of a caregiver.
- To correctly insert the needle under the skin, pinch a fold of loose skin at the clean injection site with your free hand. Pinching the skin is important to ensure that you inject under the skin (into fatty tissue) but not any deeper (into muscle). Injecting into a muscle could cause discomfort.
- Prepare and give the injection in clean and germ-free conditions using aseptic technique. Your doctor or nurse will give more information about this.
- Your doctor will show you which areas of the body are suitable for injecting Hemlibra.
- The recommended places to give an injection are: the front of the waist (lower abdomen), upper outer arms, or the front of the thighs. Use only recommended places for injection.
- For each injection, use a different area of the body to the one you used last time.
- Do not give injections where the skin is red, bruised, tender, hard, or areas where there are moles or scars.
- When using Hemlibra, any other medicine injected under the skin should be given in a different area.
- A syringe, a transfer needle with 5 micrometre filter or a vial adaptor with 5 micrometre filter, and an injection needle are used to draw up the Hemlibra solution from the vial into the syringe and to inject it under the skin.
- Syringes, transfer needles with filter or vial adaptor with filter, and injection needles are not provided in this pack. For more information, see in section 6 “What is needed for Hemlibra administration and is not contained in this pack”.
- Make sure that you use a new injection needle for each injection and dispose of it after a single use.
- A 1 mL syringe should be used for an injection up to 1 mL of Hemlibra solution.
- A 2 to 3 mL syringe should be used for an injection greater than 1 mL and up to 2 mL of Hemlibra solution.
Hemlibra can be used in adolescents and children of all ages.
- A child can self-inject the medicine provided the child’s healthcare provider and the parent or caregiver agree. Self-injection for children below the age of 7 years is not recommended.
If you use more Hemlibra than you are supposed to, tell your doctor immediately. This is because you may be at risk of developing side effects such as blood clots. Always use Hemlibra exactly as your doctor has told you, and check with your doctor, pharmacist or nurse if you are not sure.
- If you forget your scheduled injection, inject the forgotten dose as soon as possible before the day of the next scheduled dose. Then, continue to inject the medicine as scheduled. Do not inject two doses on the same day to make up for a forgotten dose.
- If you are not sure what to do, ask your doctor, pharmacist or nurse.
Do not stop using Hemlibra without talking to your doctor. If you stop using Hemlibra, you may no longer be protected against bleeding.
If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the carton and the vial label after “EXP”. The expiry date refers to the last day of that month.
Store in a refrigerator (2°C - 8°C). Do not freeze.
Store in the original pack in order to protect from light.
Once removed from the refrigerator, unopened vials may be kept at room temperature (below 30°C) for up to 7 days. After storage at room temperature, unopened vials may be returned back to the refrigerator. The total time the medicine is stored at room temperature should not be more than 7 days.
Discard vials that have been kept at room temperature for more than 7 days or exposed to temperatures above 30°C.
Once transferred from the vial to the syringe, use Hemlibra straight away. Do not refrigerate the solution in the syringe.
Before using the medicine, check the solution for particles or discoloration. The solution should be colourless to slightly yellow. Do not use this medicine if it is cloudy, discoloured, or contains visible particles.
Throw away any unused solution appropriately. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
Option
(for transfer of medicine from vial to syringe)
Instructions for Use
Hemlibra
Injection
Single-Dose Vial(s)
You must read, understand and follow the Instructions for Use before injecting Hemlibra. Your healthcare provider should show you how to prepare, measure, and inject Hemlibra properly before you use it for the first time. Ask your healthcare provider if you have any questions.
Do not use these instructions when using a Vial Adaptor to withdraw Hemlibra from the vial. These instructions are for use with the Transfer Needle only.
- Do not inject yourself or someone else unless you have been shown how to by your healthcare provider.
- Make sure the name Hemlibra is on the box and vial label.
- Before opening the vial, read the vial label to make sure you have the correct medicine strength(s) to give the dose prescribed for you. You may need to use more than 1 vial to give yourself the correct dose.
- Check the expiry date on the box and vial label. Do not use if the expiry date has passed.
- Only use the vial once. After you inject your dose, throw away any unused Hemlibra left in the vial. Do not save unused medicine in the vial for later use.
- Only use the syringes, transfer needles and injection needles that your healthcare provider prescribes.
- Use the syringes, transfer needles and injection needles only once. Throw away any used caps, vial(s) and syringes and needles.
- If your prescribed dose is more than 2 mL, you will need to have more than one subcutaneous injection of Hemlibra; contact your healthcare provider for the injection instructions.
- You must inject Hemlibra only under the skin.
- Keep the vial in the refrigerator (2°C to 8°C). Do not freeze.
- Keep the vial in the original box to protect the medicine from light.
- Once removed from the refrigerator, the unopened vial can be kept at room temperature (below 30°C) for up to 7 days. After storage at room temperature unopened vials may be returned to the refrigerator. The total amount of time outside cold storage and at room temperature should not exceed 7 days.
- Discard vials that have been kept at room temperature for more than 7 days or have been in temperatures above 30°C.
- Keep the vials, out of the sight and reach of children.
- Take the vial out of the refrigerator 15 minutes before use and allow it to reach room temperature (below 30°C) before preparing an injection.
- Do not shake the vial.
- Keep the transfer needle, injection needle and syringe dry.
- Keep the transfer needle, injection needle and syringe out of the sight and reach of children.
- Collect all supplies listed below to prepare and give your injection.
- Check the expiry date on the box, on the vial label and on the supplies listed below. Do not use if the expiry date has passed.
- Do not use the vial if:
- the medicine is cloudy, hazy or coloured.
- the medicine contains particles.
- the cap covering the stopper is missing.
- Inspect the supplies for damage. Do not use if they appear damaged or if they have been dropped.
- Place the supplies on a clean, well-lit flat work surface.
- Vial containing the medicine
- Hemlibra Instructions for Use
- Alcohol wipes
Note: If you need to use more than 1 vial to inject your prescribed dose, you must use a new alcohol wipe for each vial. - Gauze
- Cotton ball
- Syringe
- For injection amount up to 1 mL use a 1 mL syringe.
- For injection amount between 1 mL and 2 mL use a 2 mL or 3 mL syringe.
- Note: Do not use 2 or 3 mL syringe for doses up to 1 mL.
- 18G Transfer needle with 5 micrometre filter
Note: If you need to use more than 1 vial to inject your prescribed dose, you must use a new transfer needle for each vial. - Do not use the transfer needle to inject the medicine.
- Injection needle with safety shield (Used to inject medicine).
- Do not use the injection needle to withdraw medicine from vial.
- Sharps disposal container
- Before use, allow the vial(s) to reach room temperature for about 15 minutes on a clean flat surface away from direct sunlight.
- Do not try to warm the vial by any other way.
- Wash your hands well with soap and water.
Selecting and preparing an injection site:
- Clean the chosen injection site area using an alcohol wipe.
- Let the skin dry for about 10 seconds.
- Do not touch, fan or blow on the cleaned area before your injection.
For your injection, you can use your:
- Thigh (front and middle).
- Stomach area (abdomen), except for the 5 cm around the navel (belly button).
- Outer area of the upper arm (only if a caregiver is giving the injection).
- You should use a different injection site for each injection, at least 2.5 cm away from the area you used for any previous injection.
- Do not inject into areas that could be irritated by a belt or waistband.
- Do not inject into moles, scars, bruises, or areas where the skin is tender, red, hard or the skin is broken.
- Once the syringe has been filled with the medicine, the injection must be given immediately.
- Once the injection needle cap has been removed, the medicine in the syringe must be injected under the skin within 5 minutes.
- Do not touch exposed needles or place them on a surface once the cap has been removed.
- Do not use the syringe if the needle touches any surface.
- If you see drops of blood at the injection site, you can press a sterile cotton ball or gauze over the injection site for at least 10 seconds, until bleeding has stopped.
- If you have bruising (small area of bleeding under the skin), an ice pack can also be pressed gently on the site. If bleeding does not stop, please contact your healthcare provider.
- Do not rub the injection site after injection.
Important: Always keep the sharps disposal container out of reach of children.
- Throw away any used caps, vial(s), needles and syringes in a sharps or puncture-proof container. Put your used needles and syringes in a sharps disposal container straight away after use. Do not throw away any loose caps, vials, needles and syringes in your household waste.
- If you do not have a sharps disposal container, you may use a household container that is:
- made of heavy-duty plastic.
- can be closed with a tight-fitting, puncture resistant lid, without sharps being able to come out.
- upright and stable during use.
- leak-resistant.
- properly labelled to warn of hazardous waste inside the container.
- When your sharps disposal container is almost full, you will need to follow your local guidelines for the right way to throw away of your sharps disposal container.
- Do not throw away any used sharps disposal container in your household waste unless your local guidelines permit this. Do not recycle your used sharps disposal container.
Step 1. Remove vial cap and clean top
- Take the cap off the vial(s).
- Throw away the vial cap(s) into the sharps disposal container.
- Clean the top of the vial(s) stopper with an alcohol wipe.
Step 2. Attach transfer needle with filter to syringe
- Push and twist the transfer needle with filter clockwise on to the syringe until it is fully attached.
- Slowly pull back on the plunger and draw air into the syringe that is the same amount as your prescribed dose.
Step 3. Uncap transfer needle
- Hold the syringe by the barrel with the transfer needle pointing up.
- Carefully pull the transfer needle cap straight off and away from your body. Do not throw the cap away. Place the transfer needle cap down on a clean flat surface. You will need to recap the transfer needle after transferring the medicine.
- Do not touch the needle tip or place it on a surface after the needle cap has been removed.
Step 4. Inject air into vial
- Keep the vial on the flat working surface and insert the transfer needle and syringe straight down into the centre of the vial stopper.
- Keep the needle in the vial and turn the vial upside down.
- With the needle pointing upwards, push on the plunger to inject the air from the syringe above the medicine.
- Keep your finger pressed down on the syringe plunger.
- Do not inject air into the medicine as this could create air bubbles or foam in the medicine.
Step 5. Transfer medicine to syringe
- Slide the tip of the needle down so that it is within the medicine.
- With the syringe pointing upwards, slowly pull back the plunger to fill the syringe with more than the amount of medicine needed for your prescribed dose.
- Hold the plunger firmly to ensure it does not pull back in
- Be careful not to pull the plunger out of the syringe.
Important: If your prescribed dose is more than the amount of Hemlibra in the vial, withdraw all medicine and go to the “Combining Vials” section now.
Step 6. Remove air bubbles
- Keep the needle in the vial and check the syringe for larger air bubbles. Large air bubbles can reduce the dose you receive.
- Remove the larger air bubbles by gently tapping the syringe barrel with your fingers until the air bubbles rise to the top of the syringe. Move the tip of the needle above the medicine and slowly push the plunger up to push the air bubbles out of the syringe.
- If the amount of medicine in the syringe is now at or below your prescribed dose, move the tip of the needle to within the medicine and slowly pull back the plunger until you have more than the amount of medicine needed for your prescribed dose.
- Be careful not to pull the plunger out of the syringe.
- Repeat the steps above until you have removed the larger air bubbles.
Note: Ensure you have enough medicine in the syringe to complete your dose before moving onto the next step. If you cannot remove all medicine, turn the vial upright to reach the remaining amount.
Do not use the transfer needle to inject medicine as this may cause pain and bleeding.
Step 7. Recap transfer needle
- Remove the syringe and transfer needle from the vial.
- Using one hand, slide the transfer needle into the cap and scoop upwards to cover the needle.
- Once the needle is covered, push the transfer needle cap towards the syringe to fully attach it with one hand to prevent accidentally injuring yourself with the needle
Step 8. Clean injection site
- Select and clean your injection site with an alcohol wipe.
Step 9. Remove the used transfer needle from the syringe
- Remove the used transfer needle from the syringe by twisting anticlockwise and gently pulling.
- Throw away the used transfer needle into a sharps disposal container.
Step 10. Attach injection needle to syringe
- Push and twist the injection needle clockwise onto the syringe until it is fully attached.
Step 11. Move safety shield
- Move the safety shield away from the needle and towards the syringe barrel.
Step 12. Uncap injection needle
- Carefully pull the injection needle cap straightaway from the syringe.
- Throw away the cap into a sharps disposal container.
- Do not touch the needle tip or allow it to touch any surface.
- After the injection needle cap has been removed, the medicine in the syringe must be injected within 5 minutes.
Step 13. Adjust plunger to prescribed dose
- Hold the syringe with the needle pointing up and slowly push the plunger to your prescribed dose.
- Check your dose, ensure the top rim of the plunger is in line with the mark on the syringe for your prescribed dose.
Step 14. Subcutaneous (under the skin) injection
- Pinch the selected injection site and fully insert the needle at a 45° to 90° angle with a quick, firm action. Do not hold or push on the plunger while inserting the needle.
- Hold the position of the syringe and let go of the pinched injection site.
Step 15. Inject the medicine
- Slowly inject all of the medicine by gently pushing the plunger all the way down.
- Remove the needle and syringe from the injection site at the same angle as inserted.
Step 16. Cover needle with safety shield
- Move the safety shield forward 90°, away from the syringe barrel.
- Holding the syringe with one hand, press the safety shield down against a flat surface with a firm, quick motion until you hear a “click”.
- If you do not hear a click, look to see that the needle is fully covered by the safety shield.
- Keep your fingers behind the safety shield and away from the needle at all times.
- Do not detach the injection needle.
Step 17. Throw away the syringe and needle
- Put your used needles and syringes in a sharps disposal container right away after use. For further information refer to the section “Disposing of the medicine and supplies”.
- Do not try to remove the used injection needle from the used syringe.
- Do not recap the injection needle with the cap.
- Important: Always keep the sharps disposal container out of reach of children.
- Throw away any used caps, vial(s), needles and syringes in a sharps or puncture-proof container
If you need to use more than 1 vial to get to your prescribed dose, follow these steps after you have drawn up the medicine from the first vial as described in step 5. You must use a new transfer needle for each vial.
Step A. Recap transfer needle
- Remove the syringe and transfer needle from the vial.
- Using one hand, slide the transfer needle into the cap and scoop upwards to cover the needle.
- Once the needle is covered, push the transfer needle cap towards the syringe to fully attach it with one hand to prevent accidentally injuring yourself with the needle
Step B. Remove the used transfer needle from the syringe
- Remove the used transfer needle from the syringe by twisting anticlockwise and gently pulling.
- Throw away the used transfer needle into a sharps disposal container.
Step C. Attach a new transfer needle with filter to the syringe
- Push and twist a new transfer needle clockwise onto the syringe until it is fully attached.
- Slowly pull back the plunger and draw some air into the syringe.
Step D. Uncap transfer needle
- Hold the syringe by the barrel with the transfer needle pointing up.
- Carefully pull the transfer needle cap straight off and away from your body. Do not throw the cap away. You will need to recap the transfer needle after transferring the medicine.
- Do not touch the needle tip.
Step E. Inject air into vial
- With the new vial on the flat working surface, insert the new transfer needle and syringe, straight down into the centre of the vial stopper.
- Keep the needle in the vial and turn the vial upside down.
- With the needle pointing upwards, push on the plunger to inject the air from the syringe above the medicine.
- Keep your finger pressed down on the syringe plunger.
- Do not inject air into the medicine as this could create air bubbles or foam in the medicine.
Step F. Transfer medicine to syringe
- Slide the tip of the needle down so that it is within the medicine.
- With the syringe pointing upwards, slowly pull back the plunger to fill the syringe with more than the amount of medicine needed for your prescribed dose.
- Hold the plunger firmly to ensure it does not pull back in
- Be careful not to pull the plunger out of the syringe.
Note: Ensure you have enough medicine in the syringe to complete your dose before moving onto the next steps. If you cannot remove all medicine, turn the vial upright to reach the remaining amount.
Do not use the transfer needle to inject medicine as this may cause pain and bleeding.
Repeat steps A to F with each additional vial until you have more than the amount of medicine needed for your prescribed dose. Once completed, keep the transfer needle inserted in the vial and return to Step 6 “Remove air bubbles”. Continue with the remaining steps.
Option
(for transfer of medicine from vial to syringe)
Instructions for Use
Hemlibra
Injection
Single-Dose Vial(s)
You must read, understand and follow the Instructions for Use before injecting Hemlibra. Your healthcare provider should show you how to prepare, measure, and inject Hemlibra properly before you use it for the first time. Ask your healthcare provider if you have any questions.
Do not use these instructions when using a transfer needle to withdraw Hemlibra from the vial. These instructions are for use with the Vial Adaptor only.
- Do not inject yourself or someone else unless you have been shown how to by your healthcare provider.
- Make sure the name Hemlibra is on the box and vial label.
- Before opening the vial, read the vial label to make sure you have the correct medicine strength(s) to give the dose prescribed for you. You may need to use more than 1 vial to give yourself the correct dose.
- Check the expiry date on the box and vial label. Do not use if the expiry date has passed
- Only use the vial once. After you inject your dose, throw away any unused Hemlibra left in the vial. Do not save unused medicine in the vial for later use.
- Only use the syringes, vial adaptors, and injection needles that your healthcare provider prescribes.
- Use the syringes, vial adaptors and injection needles only once. Throw away any used caps, vial(s) and syringes and needles.
- If your prescribed dose is more than 2 mL, you will need to have more than one subcutaneous injection of Hemlibra; contact your healthcare provider for the injection instructions.
- You must inject Hemlibra only under the skin.
- Store the vial in the refrigerator (2°C to 8°C). Do not freeze.
- Keep the vial in the original box to protect the medicine from light.
- Once removed from the refrigerator, the unopened vial can be kept at room temperature (below 30°C) for up to 7 days. After storage at room temperature unopened vials may be returned to the refrigerator. The total amount of time outside cold storage and at room temperature should not exceed 7 days.
- Discard vials that have been kept at room temperature for more than 7 days or have been in temperatures above 30°C.
- Keep vials out of the sight and reach of children.
- Take the vial out of the refrigerator 15 minutes before use and allow it to reach room temperature (below 30°C) before preparing an injection.
- Do not shake the vial.
- Keep the vial adaptor, injection needle and syringe dry.
- Keep the vial adaptor, injection needle and syringe out of the sight and reach of children
- Collect all supplies listed below to prepare and give your injection.
- Check the expiry date on the box, on the vial label, and on the supplies listed below. Do not use if the expiry date has passed.
- Do not use the vial if:
- the medicine is cloudy, hazy or coloured.
- the medicine contains particles.
- the cap covering the stopper is missing.
- Inspect the supplies for damage. Do not use if they appear damaged or if they have been dropped.
- Place the supplies on a clean, well-lit flat work surface.
- Vial containing the medicine
- Hemlibra Instructions for Use
- Alcohol wipes
Note: If you need to use more than 1 vial to inject your prescribed dose, you must use a new alcohol wipe for each vial. - Gauze
- Cotton ball
- Vial adaptor with filter (To be added on top of vial).
Note: Used for withdrawing medicine from the vial to the syringe. If you need to use more than 1 vial to inject your prescribed dose, you must use a new vial adaptor for each vial.
Do not insert injection needle into vial adaptor.
- Syringe with Low Dead Space (LDS) Plunger
Important:
- For injection amount up to 1 mL use 1 mL LDS syringe
- For injection amount over 1 mL use 2 or 3 mL LDS syringes.
Note: Do not use 2 or 3 mL LDS syringes for doses up to 1 mL
- Injection needle with safety shield (Used to inject medicine).
- Do not insert the injection needle into vial adaptor or use the injection needle to withdraw medicine from vial.
- Sharps disposal container
- Before use, allow the vial(s) to reach room temperature for about 15 minutes on a clean flat surface away from direct sunlight.
- Do not try to warm the vial by any other way.
- Wash your hands well with soap and water.
Selecting and preparing an injection site:
- Clean the chosen injection site area using an alcohol wipe.
- Let the skin dry for about 10 seconds.
- Do not touch, fan or blow on the cleaned area before your injection.
For your injection, you can use your:
- Thigh (front and middle).
- Stomach area (abdomen), except for the 5 cm around the navel (belly button).
- Outer area of the upper arm (only if a caregiver is giving the injection).
- You should use a different injection site for each injection, at least 2.5 cm away from the area you used for any previous injection.
- Do not inject into areas that could be irritated by a belt or waistband.
- Do not inject into moles, scars, bruises, or areas where the skin is tender, red, hard or the skin is broken.
- Once the syringe has been filled with the medicine, the injection must be given immediately.
- Once the injection needle cap has been removed, the medicine in the syringe must be injected under the skin within 5 minutes.
- Do not touch exposed needles or place them on a surface once the cap has been removed.
- Do not use the syringe if the needle touches any surface.
- If you see drops of blood at the injection site, you can press a sterile cotton ball or gauze over the injection site for at least 10 seconds, until bleeding has stopped.
- If you have bruising (small area of bleeding under the skin), an ice pack can also be pressed gently on the site. If bleeding does not stop, please contact your healthcare provider.
- Do not rub the injection site after injection.
Important: Always keep the sharps disposal container out of reach of children.
- Throw away any used caps, vial(s), vial adaptors, needles and syringes in a sharps or puncture-proof container.
- Put your used vial adaptors, needles and syringes in a sharps disposal container straight away after use. Do not throw away any loose caps, vials, needles and syringes in your household waste.
- If you do not have a sharps disposal container, you may use a household container that is:
- made of heavy-duty plastic.
- can be closed with a tight-fitting, puncture resistant lid, without sharps being able to come out.
- upright and stable during use.
- leak-resistant.
- properly labelled to warn of hazardous waste inside the container.
- When your sharps disposal container is almost full, you will need to follow your local guidelines for the right way to throw away of your sharps disposal container.
- Do not throw away any used sharps disposal container in your household waste unless your local guidelines permit this. Do not recycle your used sharps disposal container.
Step 1. Remove vial cap and clean top
- Take the cap off the vial(s).
- Throw away the vial cap(s) into the sharps disposal container.
- Clean the top of the vial(s) stopper with an alcohol wipe.
Step 2. Insert vial adaptor onto vial
- Peel off back to open the blister pack.
Do not remove the vial adaptor from the clear plastic blister pack.
- Firmly press down the plastic blister pack with the vial adaptor onto the new vial, until you hear a “click”.
- Remove and throw away the plastic blister pack.
- Do not touch the tip of vial adaptor.
Step 3. Connect syringe to vial adaptor
- Remove syringe cap (if required).
- Push and twist the syringe clockwise on to the vial adaptor until it is fully attached.
Step 4. Transfer medicine to syringe
- Keep the vial adaptor attached to the syringe and turn the vial upside down.
- With the syringe pointing upwards, slowly pull back the plunger to fill the syringe with more than the amount of medicine needed for your prescribed dose.
- Hold plunger firmly to ensure it does not pull back in.
- Be careful not to pull the plunger out of the syringe.
Important: If your prescribed dose is more than the amount of Hemlibra in the vial, withdraw all medicine and go to the “Combining Vials” section now.
Step 5. Remove air bubbles
- Keep the vial attached to the syringe and check the syringe for larger air bubbles. Large air bubbles can reduce the dose you receive.
- Remove the larger air bubbles by gently tapping the syringe barrel with your finger until the air bubbles rise to the top of the syringe. Slowly push the plunger to push the large air bubbles out of the syringe.
- If the amount of medicine in the syringe is now at or below your prescribed dose, slowly pull back the plunger until you have more than the amount of medicine needed for your prescribed dose.
- Be careful not to pull the plunger out of the syringe.
- Repeat the steps above until you have removed the large air bubbles.
Note: Ensure you have enough medicine in the syringe to complete your dose before moving on to the next step.
Step 6. Clean injection site
- Select and clean your injection site with an alcohol wipe.
Step 7. Remove syringe from vial adaptor
- Remove the syringe from the vial adaptor by twisting anticlockwise and gently pulling.
- Throw away the used vial/vial adaptor into a sharps disposal container.
Step 8. Attach injection needle to syringe
- Push and twist the injection needle clockwise onto the syringe until it is fully attached.
- Do not insert the injection needle into vial adaptor or use the injection needle to withdraw medicine from vial.
Step 9. Move safety shield
- Move the safety shield away from the needle and towards the syringe barrel.
Step 10. Uncap injection needle
- Carefully pull the injection needle cap straightaway from the syringe.
- Throw away the cap into a sharps disposal container.
- Do not touch the needle tip or allow it to touch any surface.
- After the injection needle cap has been removed, the medicine in the syringe must be injected within 5 minutes.
Step 11. Adjust plunger to prescribed dose
- Hold the syringe with the needle pointing up and slowly push the plunger to your prescribed dose.
- Check your dose, ensure the top rim of the plunger is in line with the mark on the syringe for your prescribed dose.
Step 12. Subcutaneous (under the skin) injection
- Pinch the selected injection site and fully insert the needle at a 45° to 90° angle with a quick, firm action. Do not hold or push on the plunger while inserting the needle.
- Hold the position of the syringe and let go of the pinched injection site.
Step 13. Inject the medicine
- Slowly inject all of the medicine by gently pushing the plunger all the way down.
- Remove the needle and syringe from the injection site at the same angle as inserted.
Step 14. Cover needle with safety shield
- Move the safety shield forward 90°, away from the syringe barrel.
- Holding the syringe with one hand, press the safety shield down against a flat surface with a firm, quick motion until you hear a “click”.
- If you do not hear a click, look to see that the needle is fully covered by the safety shield.
- Keep your fingers behind the safety shield and away from the needle at all times.
- Do not detach the injection needle.
Step 15. Throw away the needle and syringe
- Put your used needles and syringes in a sharps disposal container right away after use. For further information refer to the section “Disposing of the medicine and supplies”.
- Do not try to remove the used injection needle from the used syringe.
- Do not recap the injection needle with the cap.
- Important: Always keep the sharps disposal container out of reach of children.
- Throw away any used caps, vial(s), vial adaptors, needles and syringes in a sharps or puncture-proof container.
If you need to use more than 1 vial to get to your prescribed dose, follow these steps after you have drawn up the medicine from the first vial as described in step 4. You must use a new vial adaptor for each vial.
Step A. Insert new vial adaptor into new vial
- Peel off back to open the blister pack.
Do not remove the vial adaptor from the clear plastic blister pack.
- Firmly press down the plastic blister pack with the vial adaptor onto the new vial, until you hear a “click”.
- Remove and throw away the plastic blister pack.
- Do not touch the tip of vial adaptor.
Step B. Remove syringe from used vial adaptor
- Remove the syringe from the used vial adaptor by twisting anticlockwise and gently pulling.
- Throw away the used vial/vial adaptor into a sharps disposal container.
Step C. Connect syringe to new vial adaptor
- Push and twist the same syringe clockwise on to the next vial adaptor until it is fully attached.
Step D. Transfer medicine into syringe
- Keep the vial adaptor attached to the syringe and turn the vial upside down.
- With the syringe pointing upwards, slowly pull back the plunger to fill the syringe with more than the amount of the medicine needed for your prescribed dose.
- Hold plunger firmly to ensure it does not pull back in.
- Be careful not to pull the plunger out of the syringe.
Note: Ensure you have enough medicine in the syringe to complete your dose before moving on to the next step.
Repeat steps A to D with each additional vial until you have more than the amount of medicine needed for your prescribed dose. Once completed, keep the vial adaptor onto the vial and return to Step 5 “Remove air bubbles”. Continue with the remaining steps.