NBREL®.
If there is enough solution left in the ENBREL® vial for another dose, write the date you mixed the powder and liquid in the area marked “Mixing Date:” on the sticker supplied with these instructions, and attach the sticker to the ENBREL® vial. Refrigerate the ENBREL® vial (in the dose tray) after use. Prepare additional doses from the ENBREL® vial as described in STEP 3. Otherwise, discard the ENBREL® vial and any remaining solution.
GO TO STEP 4: CHOOSING AND PREPARING AN INJECTION SITE.
STEP 3: Preparing Additional Doses from a Single ENBREL® Vial
Select a clean, well-lit, flat work surface, such as a table.
The needles and syringes supplied with ENBREL® should not be reused. You will need new ones for each additional dose. Your healthcare provider will tell you what type of syringes (1 mL) and needles (25- and 27-gauge) to use. Alcohol swabs are available at the drug store. Place the sterile syringe with a 25-gauge needle (for withdrawing ENBREL®), a 27-gauge needle (for injecting ENBREL®) and two alcohol swabs on your flat work surface.
Take the vial of ENBREL® solution that is stored in the dose tray out of the refrigerator and place it on your flat work surface.
Check the mixing date you wrote on the sticker on the ENBREL® vial. Discard the ENBREL® vial if more than 14 days have passed since the ENBREL® solution was mixed.
Wash your hands with soap and warm water.
Use one alcohol swab to clean the gray stopper on the ENBREL® vial. Do not touch the stopper with your hands.
If the syringe and the 25-gauge needle are not pre-assembled, assemble them as instructed by your healthcare provider.
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 of ENBREL®.
Hold the syringe and pull the needle cover straight off. Do not touch the needle or allow it to touch any surface. 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 the plunger to pull a small amount of air into the syringe. Then, insert the 25-gauge needle straight down through the center ring of the gray stopper. 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 proper withdrawal of ENBREL® solution from the vial.
Keep the needle in the ENBREL® vial and turn the vial upside down. Hold the syringe at eye level, and slowly pull the plunger down to the unit markings on the syringe that correspond to your child’s dose. As the amount of solution in the ENBREL® vial drops, you may need to pull the needle back just enough to keep the tip of the needle in the solution.
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 ENBREL® vial, slowly pull back on the plunger to again draw the correct amount of solution back into the syringe |
