Nivestim Patient Counseling Information

Information on self-administration by the patient: This section contains information on how to give yourself an injection of Nivestim. It is important that you do not try to give yourself the injection unless you have received special training from your doctor or nurse. It is also important that you dispose of the syringe in a sharps disposal (puncture-proof) container. If you are not sure about giving yourself the injection or you have any questions, ask your doctor or nurse for help.
How do I administer my Nivestim?: Nivestim is usually given once a day by injection, usually into the tissue just under the skin. This is known as a subcutaneous injection.
Learning to give your own injections will mean that you will not have to wait at home for a nurse to call, nor will you have to go to the hospital or clinic every day to receive your injections.
You will need to have your injections at about the same time every day. The most suitable places for injection are: the front of the thighs, the abdomen, except for the area around the navel.
It is better to change the injection site every day to avoid the risk of soreness at any one site.
Equipment required for administration: To give yourself a subcutaneous injection you will need the following items: A new pre-filled syringe of Nivestim; A sharps disposal (puncture proof container) for disposing of used syringes safely; Antiseptic wipes (if recommended by your doctor or nurse).
How do I give my subcutaneous Nivestim injection?: 1. Try to self-inject at approximately the same time every day.
2. Remove the carton containing the Nivestim pre-filled syringe from the refrigerator.
3. Remove the blister tray containing the pre-filled syringe from the carton. When the carton contains blister trays with more than one pre-filled syringe, tear off the blister tray containing one pre-filled syringe along the perforated part, and return the rest of the blister trays containing pre-filled syringes to the carton and return the carton to the refrigerator.
4. Open the blister tray containing the pre-filled syringe by peeling away the lid from the blister tray. Remove the pre-filled syringe from the blister tray by grasping from the syringe body.
Do not grasp the grey needle cover or the plunger rod.
Check the syringe to make sure that the needle guard is covering the barrel of the pre-filled syringe. Do not push the needle guard over the needle cover before the injection. This may activate or lock the needle guard. If the needle guard is covering the needle that means it has been activated.
Check that the solution is clear, colourless and practically free from visible particles. Do not inspect the product through the plastic of the safety device.
Check the date on the label to make sure that the medicine has not passed the expiry date.
Make sure you have your sharps disposal (puncture-proof) container nearby.
Allow the pre-filled syringe to reach room temperature (approximately 25°C). This will take 15-30 minutes.
Do not remove the syringe's needle cover while allowing the pre-filled syringe to reach room temperature.
Do not shake the syringe.
Do not use the Nivestim syringe if: The carton is open or damaged.
The needle guard is missing, detached or has been activated.
The medicine is cloudy or discoloured or the liquid has particles floating in it.
Any part of the pre-filled syringe appears cracked or broken or any of the liquid has leaked out of the syringe.
The pre-filled syringe has been dropped. The pre-filled syringe may be broken even if you cannot see the break.
The needle cover is missing or not securely attached.
The expiration date printed on the label has passed.
In all cases mentioned, discard the pre-filled syringe and use a new pre-filled syringe.
5. Find a comfortable well-lit working place to give your injection and check the dose that you have been prescribed.
6. Wash your hands thoroughly with soap and water.
7. Hold the pre-filled syringe by the body of the needle guard with the needle cover pointing upwards.
Do not hold by the plunger head, plunger or needle cover.
Do not pull back on the plunger at any time.
Do not remove the needle cover from the pre-filled syringe until you are ready to inject your medicine.
8. Take the needle cover off the syringe by holding the barrel and pulling the needle cover straight off and away from your body carefully without twisting it. Throw away the needle cover. Do not recap the needle. Do not push the plunger, touch the needle or shake the syringe.
9. The syringe is now ready for use. You may notice a small air bubble in the syringe. You do not have to remove the air bubble before injecting. Injecting the solution with an air bubble present is harmless.
10. Decide where to inject Nivestim - find a place on the front of your abdomen or the front of your thigh. Choose a different injection site each time. Do not choose an area which is tender, red, bruised or scarred. Clean the area of skin with an antiseptic wipe.
11. Pinch a large area of skin, taking care not to touch the area you have cleaned.
12. With your other hand, hold the pre-filled syringe like you would hold a pencil. Use a quick "dart-like" motion to insert the needle at an approximate 45° angle into the skin.
13. Pull the plunger back slightly to check if any blood appears in the syringe. If you do see blood inside the syringe, remove the needle and re-insert it in a different site. Slowly push down the plunger until all the contents of the syringe have been emptied.
14. After injecting the solution remove the needle from the skin.
15. Ensure the needle guard covers the needle according to the instructions for active needle guard or passive needle guard as follows.
16. Do not try to replace the needle cover Place the syringe in the sharps disposal (puncture proof) container.
Keep used syringes out of the reach and sight of children
Never put used syringes into your normal household waste bin.
Remember: Most people can learn to give themselves a subcutaneous injection, but if you are experiencing a lot of difficulty, do not be afraid to ask for help and advice from your doctor or nurse.
Use of UltraSafe Passive Needle Guard for Nivestim 30 MU/0.5 ml solution for injection/infusion: The pre-filled syringe has an UltraSafe Passive Needle Guard attached in order to protect from needle stick injury. When handling the pre-filled syringe, keep hands behind the needle.
1. Perform the injection using the technique described previously.
2. Depress the plunger while grasping the finger flange until the entire dose has been given. The passive needle guard will NOT activate unless the ENTIRE dose has been given.
3. Remove the needle from your skin, then let go of the plunger and allow the syringe to move up until the entire needle is guarded and locks into place.