◾Always place the used syringes in the proper disposal unit.

B) Getting ready to inject

◾Choosing an injection site

Before preparing your injection, decide where you are going to inject. You should inject Extavia into the fatty layer between the skin and muscle (that is, subcutaneously, about 8 to 12 mm under the skin). The best places for injections are where the skin is loose and soft, and away from joints, nerves, bones, for example the abdomen, arm, thigh or buttocks.

Important: Do not use any area where you can feel lumps, bumps, firm knots, pain or an area that is discoloured, indented, scabbed, or where the skin is broken. Talk to your doctor or healthcare professional about these or any other unusual conditions you may find.

You should rotate the injection site at every injection. If some areas are too difficult for you to reach, you may need a family member or friend to help you with these injections. Follow the sequence described in the schedule at the end of the Annex (see II) Rotating injection sites) and you will come back to your first injection site area after 8 injections (16 days). This will give each injection site a chance to fully recover before receiving another injection.

Please refer to the rotation schedule at the end of this Annex to learn how to choose an injection site. An example of a medication record is also included. This should give you an idea of how you can keep track of your injection sites and dates.

◾Medicine

You will need the medicine:

◾1 Extavia vial (with powder for solution for injection)

◾1 pre-filled syringe of solvent for Extavia (sodium chloride solution (0.54% (w/v))

To reconstitute and inject your medicine you will need the following components:

◾a needle suitable for reconstitution

◾30-gauge needle for injection

◾alcohol wipes You will also need a disposal unit for used syringes and needles.

Alternatively, you can use an application kit for the administration of Extavia (supplied separately from your medicine), which contains vial adapters for reconstituting your medicine, 30-gauge needles for injecting your medicine and alcohol wipes, as well as instructions on how to use these components.

The 30-gauge needles provided with the application kit for the administration of Extavia can be used either for manual injection OR with an ExtaviJect 30G auto-injector.

For skin disinfection use an appropriate disinfectant.

C) Reconstituting the solution, step by step

1 - Wash your hands thoroughly with soap and water before beginning this process.

2 - Open the Extavia vial and put it on the table. It is best to use your thumb rather than your nail as it could break.

3 - Clean the top of the vial with an alcohol wipe, moving the wipe in one direction only. Leave the wipe on top of the vial.

4 Take out the pre-filled solvent syringe from its package. Remove the tip cap from the pre-filled syringe by twisting it off. Be careful not to touch the exposed end of the syringe. Do not push the plunger.

5 - Take the needle suitable for reconstitution out of its wrapping and place it firmly onto the tip (nozzle) of the syringe. Remove the needle guard from the needle. Do not touch the needle.

6 - Holding the Extavia vial on a stable surface, slowly insert the needle of the syringe (containing 1.2 ml of liquid) all the way through the stopper of the vial.