Histrelin (Systemic)

Brand name(s): Supprelin

Proper Use of This Medicine

You will be given a fact sheet with your prescription for histrelin that explains how to prepare and give the injection. Carefully read the fact sheet. If you have any questions about using histrelin, ask your health care professional.

There are several important steps that will help you successfully prepare the histrelin injection. To draw the histrelin up into the syringe correctly, you need to follow these steps:

• Remove a bottle of medicine from the refrigerator and allow it to warm to room temperature before injecting it.
• Wash your hands with soap and water.
• Open the syringe packaging.
• Look at the medicine to make sure it is clear and colorless. Do not use it if it seems to be even a little discolored.
• Remove the colored protective cap on the bottle. Do not remove the rubber stopper.
• Wipe the top of the bottle with an alcohol swab.
• Pull the plunger on the syringe back until it is at the amount you were asked to inject.
• Remove the needle cover from the syringe.

How to prepare the histrelin dose:

• Gently push the needle through the top of the rubber stopper with the bottle standing upright.
• Push plunger in all the way to inject air into the bottle.
• Turn the bottle with syringe upside down in one hand. Be sure the tip of the needle is covered by the histrelin. With your other hand, draw the plunger back slowly to draw the correct dose of histrelin into the syringe.
• Check the dose. Hold the syringe with the scale at eye level to see that the proper dose is withdrawn and to check for air bubbles. To remove air bubbles, tap gently on the measuring scale of the syringe to move any bubbles to the top of the syringe near the needle. Then, push the histrelin slowly back into the bottle and draw up the dose again.
• If the dose measures too low in the syringe, withdraw more solution from the bottle. If there is too much histrelin in the syringe, put some back into the bottle. Then check the dose again.
• Remove the needle from the bottle and re-cover the needle with its plastic cap.

Choose the proper area of the body, such as the upper arms, thighs, or abdomen, to inject the dose of histrelin. The site should be changed between injections as directed by your doctor.

How to inject the histrelin dose:

• After you have prepared the syringe and chosen the area of the body to inject, you are ready to inject the histrelin into the fatty part of the skin.
  • Clean the area where the injection is to be given with an alcohol swab or with soap and water. Let the area dry.
  • Pinch up a large area of skin and hold it firmly. With your other hand, hold the syringe like a pencil. Push the needle straight into the pinched-up skin at a 45-degree angle for a child. Be sure the needle is all the way in. It is not necessary to draw back on the syringe each time to check for blood (also called routine aspiration).
  • Push the plunger all the way down, using less than 5 seconds to inject the dose. Let go of the skin. Hold an alcohol swab near the needle and pull the needle straight out of the skin in the same direction that you inserted it.
  • Press the alcohol swab against the injection area for several seconds. Do not rub.
  • Throw away the vial with any remaining medicine in it. It does not have a preservative and will not keep until the next day.

For patients using disposable syringes:

• Manufacturers of disposable syringes recommend that they be used only once, because the sterility of a reused syringe cannot be guaranteed. The syringe should be thrown away safely. It should not be used even once if the needle is bent or has come into contact with any surface other than the cleaned, swabbed area of the skin. Do not wipe the needle with alcohol.
• Used syringes and needles should be destroyed. Be careful when you recap, bend, or break a needle, because these actions increase the chances of a needle-stick injury. It is best to put used syringes and needles in a disposable container that is puncture-resistant (such as an empty plastic liquid laundry detergent or bleach bottle) or to use a needle-clipping device. The chance of a syringe being reused by someone else is lower if the plunger is taken out of the barrel and broken in half when you dispose of a syringe.

Use this medicine only as directed by your doctor. Do not use more or less of it, and do not use it more often than your doctor ordered. The exact amount of medicine you need has been carefully worked out. Using too much may increase the chance of unwanted side effects, while using too little may not control the onset of puberty.

Many boys and girls who have central precocious puberty will not feel sick or will not understand the importance of using the medicine regularly. It is very important that the medicine is used exactly as directed and that the proper amount is used at the proper time. It works best when there is a constant amount in the blood. To help keep the amount of histrelin in the blood constant, histrelin must be given on a regular schedule.

Dosing-

The dose of histrelin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of histrelin. If your dose is different, do not change it unless your doctor tells you to do so.

• For injection dosage form:
  • Central precocious puberty:
    • Children up to 2 years of age-Use and dose must be determined by the doctor.Children 2 years of age and older-10 micrograms (mcg) per kilogram (kg) (4.5 micrograms per pound) of body weight injected under the skin once a day and given every twenty-four hours.

Missed dose-

Check with your doctor if you miss a dose of this medicine.

Storage-

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Store in the refrigerator. However, keep the medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

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