About the NIVESTYM prefilled syringe |
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- NIVESTYM prefilled syringes come in two strengths. Depending on your prescription, you will receive NIVESTYM prefilled syringes that contain 300 mcg/0.5 mL or 480 mcg/0.8 mL of medicine. Your healthcare provider will determine the dose in milliliters (mL) that you will need to give based on your body weight.
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- When you receive your NIVESTYM prefilled syringes, always check to see that the:
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- name NIVESTYM appears on the carton and prefilled syringe label.
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- expiration date on the prefilled syringe label has not passed. You should not use a prefilled syringe after the date on the label.
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- strength of NIVESTYM (number of micrograms on the carton containing the prefilled syringe) is the same as what your healthcare provider prescribed.
NIVESTYM prefilled syringe parts (see Figure A). NIVESTYM 300 mcg/0.5 mL prefilled syringe is shown as an example. |
Figure A |
What you need for your injection |
Included in the carton: - •
- 1 new NIVESTYM prefilled syringe (see Figure A above)
Not included in the carton (see Figure B) - •
- 1 adhesive bandage
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- 1 alcohol wipe
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- 1 cotton ball or gauze
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- sharps disposal container
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Figure B |
Preparing the NIVESTYM prefilled syringe |
Step 1: | Find a clean, well-lit flat work surface. |
Step 2: | Take the carton containing the NIVESTYM prefilled syringe out of the refrigerator and leave it unopened on your work surface for at least 30 minutes so that it reaches room temperature. Put the original carton with any unused prefilled syringes back in the refrigerator. - •
- Do not shake the prefilled syringe.
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- Do not leave the prefilled syringe in direct sunlight.
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Step 3: | Wash your hands with soap and water. |
Step 4: | Remove the prefilled syringe from the carton by the needle guard only. Do not remove the prefilled syringe by its plunger or needle cover. See Figure C. Check to make sure that the needle guard is covering the barrel of the prefilled syringe. |
Figure C |
Do not push the needle guard over the needle cover before the injection. This may activate or lock the needle guard. See Figure D that shows a needle guard that has not yet been activated. This is how the prefilled syringe looks before use. |
Figure D |
If the needle guard is covering the needle that means it has been activated. See Figure E that shows a needle guard that has been activated. This is how the prefilled syringe looks after use. Do not use the NIVESTYM prefilled syringe. Get another prefilled syringe that has not been activated and is ready to use. |
Figure E |
Step 5: | Check the expiration date on the NIVESTYM prefilled syringe. Do not use the NIVESTYM prefilled syringe if the expiration date has passed. |
Step 6: | Inspect the medicine and prefilled syringe. Turn the prefilled syringe so you can see the medicine and markings in the window. Make sure that you look at the medicine only through the viewing window on the prefilled syringe (see Figure F). Do not inspect the medicine through the plastic of the needle guard. Make sure the medicine in the prefilled syringe is clear and colorless. |
Figure F |
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- Do not use the prefilled syringe if:
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- The medicine is cloudy or discolored or contains flakes or particles.
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- Any part of the prefilled syringe appears cracked or broken.
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- The prefilled syringe has been dropped.
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- The needle cover is missing or not securely attached.
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- The expiration date printed on the label has passed.
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- In all cases, use a new prefilled syringe and call your healthcare provider.
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Step 7: | Choose the injection site - •
- When giving your injections, follow your healthcare provider's instructions about changing the site for each injection.
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- Areas of your body that you may use as injection sites include (see Figure G):
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- front of your thigh
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- stomach area (abdomen), except for a 2-inch area around your navel (belly button)
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- outer area of upper arm, only if a caregiver is giving you the injection
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- upper outer area of your buttocks, only if a caregiver is giving you the injection
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Figure G |
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- Choose a different site for each injection of NIVESTYM.
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- Do not inject into areas where the skin is tender, bruised, red, or hard. Avoid injecting into areas with scars or stretch marks.
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Step 8: | Clean your injection site with an alcohol wipe. See Figure H. - •
- Let your skin dry.
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- Do not touch this area again before injecting.
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| Figure H |
Step 9: | Hold the prefilled syringe by the needle guard with the needle cover pointing up. Carefully pull the needle cover straight off and away from your body. Throw away the needle cover. Do not recap the needle. See Figure I. |
| Figure I |
| Your healthcare provider has prescribed either a "full" syringe dose or a "partial" syringe dose. - •
- If you are prescribed a partial dose of NIVESTYM, follow Steps 10 through 18.
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- If you are prescribed a full dose, you will inject all of the medicine from your prefilled syringe. For a full dose, skip Steps 10 and 11, and follow Steps 12 through 18.
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Partial dosing |
Step 10: | Point the needle up and tap gently until the air rises to the top. See Figure J. |
| Figure J |
Step 11: | Holding the prefilled syringe as shown, slowly push up on the plunger rod to push out the extra air and medicine until the end of the conical base (edge) of the plunger stopper lines up with the syringe marking for your prescribed dose. See Figure K for an example of a dose of 0.3 mL. Your dose may be different than the example shown. Be careful not to activate the needle guard before use. Do not use a NIVESTYM prefilled syringe that has been activated. See Figure E above. Check again to make sure the correct dose of NIVESTYM is in the prefilled syringe. |
| Figure K |
Giving the NIVESTYM prefilled syringe injection |
Step 12: | With one hand, gently pinch a fold of skin at the injection site. Hold the pinch. See Figure L. |
| Figure L |
Step 13: | With your other hand, hold the prefilled syringe like you would hold a pencil. Use a quick "dart-like" motion to insert the needle at a 45 to 90 degree angle into the skin as shown. See Figure M. |
| Figure M |
Step 14: | Using slow and constant pressure, press down on the plunger rod until it reaches the bottom. See Figure N. |
| Figure N |
Step 15: | Keep the plunger rod fully pressed down while you carefully pull the needle straight out from the injection site. See Figure O. |
| Figure O |
Step 16: | As you let go of the plunger rod, the needle guard will automatically slide over the needle until the needle is completely covered and the needle guard locks into place. Do not recap the needle. See Figure P. |
| Figure P |
Step 17: | There may be a small amount of blood at the injection site. You can press a cotton ball or gauze over the injection site and hold it for 10 seconds. Do not rub the injection site. You may cover the injection site with a small adhesive bandage, if needed. See Figure Q. |
| Figure Q |
Step 18: | Throw away (dispose of) the syringe as instructed by your healthcare provider or by following the instructions below. See Figure R. |
| Figure R |
Disposing of (throw away) used NIVESTYM prefilled syringes |