needle guard is covering the barrel of the glass syringe. DO NOT push the blue needle guard over the needle cover before injection. This may activate or lock the needle guard. If the blue needle guard is covering the needle that means it has been activated. DO NOT use that syringe. Dispose of that syringe in the puncture-proof disposal container. Use a new prefilled syringe. Do not activate the needle guard prior to injection.
6. Hold the syringe barrel through the needle guard windows with the needle pointing up. Holding the syringe with the needle pointing up helps to prevent medicine from leaking out of the needle. Carefully pull the needle cover straight off.
7. Check the syringe for air bubbles. If there are air bubbles, gently tap the syringe with your fingers until the air bubbles rise to the top of the syringe. Slowly push the plunger up to force the air bubbles out of the syringe.
8. Gently place the prefilled syringe with the window flat on your clean working surface so that the needle does not touch anything.
Selecting and preparing the injection site
9. Choose an injection site. Four recommended injection sites for Neulasta are:
The outer area of the upper arms
The abdomen, except for the two-inch area around the navel
The front of the middle thighs
The upper outer areas of the buttocks
10. Clean the injection site with an alcohol swab.
Injecting the dose of Neulasta
11. Pick up the prefilled syringe from your clean, flat working surface by grabbing the sides of the needle guard with your thumb and forefinger.
12. Hold the syringe in the hand you will use to inject Neulasta. Use the other hand to pinch a fold of skin at the cleaned injection site. Note: Hold the syringe barrel through the needle guard windows when giving the injection.
13. Holding the syringe like a pencil, use a quick “dart-like” motion to insert the needle either straight up and down (90 degree angle) or at a slight angle (45 degrees) into the skin.
14. Inject the prescribed dose subcutaneously as directed by your doctor, nurse, or pharmacist.
15. When the syringe is empty, pull the needle out of the skin and place a cotton ball or gauze over the injection site and press for several seconds.
16. Use a prefilled syringe with the needle guard only once.
Activating the Needle Guard after the injection has been given
17. After injecting Neulasta from the prefilled syringe, do not recap the needle. Keep your hands behind the needle at all times. While holding the clear plastic finger grip of the syringe with one hand, grasp the blue needle guard with your free hand and slide the blue needle guard over the needle until the needle is completely covered and the needle guard clicks into place. NOTE: If an audible click is not heard, the needle guard may not be completely activated.
18. Place the prefilled syringe with the activated needle guard into a puncture-proof container for proper disposal as described below.
Disposal of prefilled syringes and needle guards
You should always follow the instructions given by your doctor, nurse, or pharmacist on how to properly dispose of containers with used syringes and needle guards. There may be special state and local laws for disposal of used needles and syringes.
Do not throw the container in the household trash. Do not recycle.
DO NOT put the needle cover (the cap) back on the needle.
Place all used needle covers and syringes in a hard plastic container with a screw-o
