he cap. This is normal. Place the cap on your flat work surface. Do not touch the syringe tip.
Continue to hold the barrel of the syringe. With your free hand, twist the 25-gauge needle onto the tip of the syringe until it fits snugly. Place the syringe on your flat work surface.
Open the wrapper that contains the 27-gauge needle by peeling apart the tabs and set the needle aside for later use. The 27-gauge needle will be used to inject the dose.
Pick up the syringe from your flat work surface. Hold the barrel of the syringe with one hand, and pull the needle cover straight off. Do not touch the needle or allow it to touch any surface. Do not touch or bump the plunger. Doing so could cause the liquid to leak out.
Place the needle cover (open side up) in the round space marked “N” in the ENBREL® dose tray.
Place the ENBREL® vial on your flat work surface. Hold the syringe with the needle facing up, and gently pull back on the plunger to pull a small amount of air into the syringe. Then, insert the needle straight down through the center ring of the gray stopper (see illustrations). You should feel a slight resistance and then a “pop” as the needle goes through the center of the stopper. Look for the needle tip inside the open stopper window. If the needle is not correctly lined up with the center of the stopper, you will feel constant resistance as it goes through the stopper and no “pop”. The needle may enter at an angle and bend, break or prevent you from adding diluent into the ENBREL® vial.
Push the plunger down VERY SLOWLY until all liquid from the syringe is in the ENBREL® vial. Adding the liquid too fast will cause foaming (bubbles).
Leave the syringe in place. Gently swirl the ENBREL® vial in a circular motion to dissolve the powder.
DO NOT SHAKE. Wait until all the powder dissolves (usually less than 10 minutes). The solution should be clear and colorless. After the powder has completely dissolved, foam (bubbles) may still be present. This is normal. Do not inject the solution if it is discolored, contains lumps, flakes, or particles. If all the powder in the ENBREL® vial is not dissolved or there are particles present after 10 minutes, call 1-888-4ENBREL (1-888-436-2735) for assistance.
With the needle in the ENBREL® vial, turn the vial upside down. Hold the syringe at eye level and slowly pull the plunger down to the unit markings on the side of the syringe that correspond with the correct dose. Make sure to keep the tip of the needle in the solution. Some white foam may remain in the ENBREL® vial. This is normal.
With the needle still inserted in the ENBREL® vial, check for air bubbles in the syringe. Gently tap the syringe to make any air bubbles rise to the top of the syringe. Slowly push the plunger up to remove the air bubbles. If you push solution back into the vial, slowly pull back on the plunger to draw the correct amount of solution back into the syringe.
Remove the syringe and needle from the ENBREL® vial. Keep the needle attached to the syringe and insert the 25-gauge needle straight down into the needle cover in the ENBREL® dose tray.
You should hear a “snap” when the needle is secure in the needle cover. Once the needle is secure in the needle cover, untwist the 25-gauge needle from the syringe and dispose of the needle in your SHARPS container.
Twist the 27-gauge needle onto the syringe until it fits snugly. Do not remove the needle cover from the syringe. Place the syringe on your flat work surface until you are ready to inject E |
