Introduction to ENBREL Prefilled Syringe

STEP 1

Setting up for an injection

• Select a clean, well-lit, flat working surface, such as a table.
• Take the ENBREL carton containing the prefilled syringes out of the refrigerator and place it on your flat working surface.
• Remove one prefilled syringe and set it on your working surface. Do NOT shake the prefilled syringe of ENBREL.
• Place the carton containing any remaining prefilled syringes back into the refrigerator (2°C to 8°C). Do NOT freeze. You may also store the carton of unused prefilled syringes at room temperature, up to 27°C for up to 60 days. If you have any questions about storage, contact your doctor, nurse or pharmacist for further instructions.

Do NOT use the prefilled syringe if the needle cover is missing or not securely attached. Call 1.877.9ENBREL (1.877.936.2735), weekdays 8:00 am to 8:00 pm EST.

Check expiration date

• Check the expiration (Exp.) date on the prefilled syringe.
• The date should be the current month and year or later.
• If the expiration date has passed, or if it has been stored at room temperature beyond 60 days (whichever comes first), do NOT use the prefilled syringe and contact your pharmacist or call 1.877.9ENBREL (1.877.936.2735) for assistance, weekdays 8:00 am to 8:00 pm EST.

Allow contents in syringe to reach room temperature

• For a more comfortable injection, allow the ENBREL in the prefilled syringe to reach room temperature (approximately 15 to 30 minutes).
• Do NOT remove the needle cover while allowing it to reach room temperature.
• Do NOT warm ENBREL in any other way (for example, do NOT warm it in a microwave oven or in hot water).

Gather additional supplies

• Assemble the additional supplies you will need for your injection.
• These include an alcohol swab, a cotton ball or gauze, and a sharps disposal container.

Wash your hands

• Wash your hands thoroughly with soap and warm water.

Check solution

• Make sure the solution in the prefilled syringe is clear and colourless. You may notice small white particles in the solution. These particles are formed from ENBREL and this is acceptable. However, do NOT inject the solution if it is cloudy or discoloured, or contains large or coloured particles or if the prefilled syringe appears cracked or broken. Call 1.877.9ENBREL (1.877.936.2735) for assistance, weekdays 8:00 am to 8:00 pm EST.
• You are now ready to inject ENBREL

STEP 2

Choosing and preparing an injection site

• Choose an injection site. Three recommended injection sites for ENBREL include:
  1. Front of the middle thigh
  2. Belly, except for a 2-inch area right around your belly button
  3. Outer area of upper arm (only if someone else is giving you the injection)

Rotate sites

• Rotate the site for each injection.
• Make sure that the new injection is given at least one inch from sites of recent injections.
• Do NOT inject into areas where the skin is tender, bruised, red, or hard. Avoid areas with scars or stretch marks.
• If you have psoriasis, you should try not to inject directly into any raised, thick, red or scaly skin patches (psoriasis skin lesions).

Prepare the injection site

• To prepare the area of skin where ENBREL is to be injected, wipe the injection site with an alcohol swab.
• Do NOT touch this area again before giving the injection.

STEP 3

Injecting ENBREL using a prefilled syringe

• Do NOT remove the needle cover from the prefilled syringe until you are ready to inject.
• Pick up the prefilled syringe from your flat working surface.
• Hold the barrel of the prefilled syringe with one hand and pull the needle cover straight off. To avoid damaging the needle, do NOT twist or bend the needle cover while you are removing it, and do NOT try to put the needle cover back onto the prefilled syringe.When you remove the needle cover, there may be a drop of liquid at the end of the needle; this is normal. Do NOT touch the needle or allow it to touch any surface. Do NOT touch or bump the plunger. Doing so could cause liquid to leak out.

Check for air bubbles

• Holding the syringe with the needle pointing up, check the syringe for air bubbles
• Gently tap the syringe with your finger until the air bubbles rise to the top of the syringe.
• Then slowly push the plunger up to force the bubbles out of the syringe.

Pinch the injection site

• Hold the syringe in one hand like a pencil.
• Use the other hand to gently pinch a fold of skin at the cleaned injection site and hold it firmly.

Push needle into skin

• Insert the needle at a slight angle (45 degrees) to the skin.
• With a quick, "dart-like" short motion, push the needle into the skin.
• After the needle is inserted, let go of the skin.

Push plunger down

• Slowly push the plunger all the way down to inject ENBREL.

Pull needle out

• When the syringe is empty, remove the needle from the skin, being careful to keep it at the same angle it was when it was inserted.
• Slight bleeding may occur. If needed, press a cotton ball or gauze over the injection site for 10 seconds. Do NOT rub the injection site. If needed, you may cover the injection site with a bandage.
• Remember: If you have problems, please call 1.877.9ENBREL (1.877.936.2735) for assistance, weekdays 8:00 am to 8:00 pm EST.

STEP 4

Disposing of Supplies

• The syringe should NEVER be reused.
• NEVER recap a needle.
• Immediately throw away the used syringe in a sharps disposal container. A container made specifically for disposing of used syringes and needles may be used. Do NOT recycle the container.
• Keep the container out of the reach of children.
• When the container is about two-thirds full, dispose of it as instructed by your/your child's doctor, nurse, or pharmacist.
• Follow any special provincial or local laws regarding the proper disposal of needles and syringes.
• Used alcohol swabs should be placed in the trash.

If you have any questions, contact a doctor, nurse, or pharmacist familiar with ENBREL. A toll-free information service is also available. Call Enliven to speak to a nurse at 1.877.9ENBREL (1.877.936.2735), weekdays 8:00 am to 8:00 pm EST.