Interferon beta-1a Intramuscular Injection

Avonex® Logo

Brand name(s): Avonex®

How should this medicine be used?

Interferon beta-1a intramuscular injection comes as a powder to be mixed into a solution for injection, and a prefilled injection syringe. This medication is injected into a muscle, usually once a week, on the same day each week. It is best to give the injection around the same time of day on your injection days, usually in the late afternoon or evening. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use interferon beta-1a exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Interferon beta-1a controls the symptoms of MS, but does not cure it. Continue to take interferon beta-1a even if you feel well. Do not stop taking interferon beta-1a without talking to your doctor.

You will receive your first dose of interferon beta-1a in your doctor's office. After that, you can inject interferon beta-1a yourself or have a friend or relative perform the injections. Before you use interferon beta-1a yourself the first time, read the written instructions that come with it. Ask your doctor or pharmacist to show you or the person who will be injecting the medication how to inject it.

Always use a new, unopened vial or prefilled syringe and needle for each injection. Never reuse vials, syringes, or needles. Throw away used syringes in a puncture-resistant container, kept out of reach of children. Talk to your doctor or pharmacist about how to throw away the puncture-resistant container.

You can inject interferon beta-1a in your upper arms or thighs. Use a different spot for each injection. Keep a record of the date and spot of each injection. Do not use the same spot two times in a row. Do not inject into an area where the skin is sore, red, bruised, scarred, infected, or abnormal in any way.

To prepare interferon beta-1a powder for injection, follow these steps:

• Remove the vial from the refrigerator. Allow it to warm to room temperature for about 30 minutes before using. Do not use a heat source such as hot water or a microwave to warm the vial.
• Set up a clean, well lit, flat work surface, like a table, to collect all the supplies you will need. Assemble these supplies: vial of interferon beta-1a, vial of sterile water, sterile syringe, sterile needle, blue MICRO PIN (vial access pin), alcohol wipes and puncture-resistant container .
• Check the expiration date on the vials of interferon beta-1a powder and sterile water . Do not use if the medication or sterile water is expired. If either is expired, call your pharmacist.
• Wash your hands well with antibacterial soap.
• Remove the caps from the vials of interferon beta-1a powder and sterile water. Clean the rubber stopper on the top of each vial with an alcohol wipe.
• Remove the small light blue protective cover from the end of the syringe barrel with a counterclockwise (toward the left) turn.
• Attach the blue MICRO PIN to the syringe by turning clockwise (toward the right) until it is tight. Do not overtighten.
• Pull the MICRO PIN cover straight off, without twisting. Save the cover for later use.
• Pull back the syringe plunger to the 1.1-mL mark on the syringe.
• Firmly push the MICRO PIN on the syringe down through the center of the rubber stopper of the sterile water vial.
• Push down on the plunger of the syringe until it cannot be pushed down any farther.
• Keep the MICRO PIN in the vial and turn the vial and syringe upside down.
• Slowly pull back on the syringe plunger to the 1.1-mL mark.
• Gently tap the syringe with your finger to make any air bubbles rise to the top. If there are bubbles, slowly press the plunger in just enough to push the bubbles (but not liquid) out of the syringe. Make sure there is still 1.1 mL of sterile water in the syringe.
• Slowly pull the MICRO PIN out of the sterile water vial.
• Carefully push the MICRO PIN through the center of the rubber stopper of the interferon beta-1a powder vial. Pushing the MICRO PIN through the vial stopper off-center can cause the stopper to fall into the vial. If the stopper falls into the vial, do not use that vial. Get a new vial and continue to prepare your dose.
• Slowly push down on the plunger until the syringe is empty. Do not aim the stream of water directly on the medication powder . A forceful stream of liquid on the powder will cause foaming and make it difficult to withdraw the medication.
• Without removing the syringe, gently swirl the vial until the interferon beta-1a powder is dissolved. Do not shake. The solution should be clear to slightly yellow and should not have any particles. Do not use the vial if the solution is cloudy, has particles in it, or is another color.
• Turn the vial and syringe upside down. Slowly pull back on the plunger of the syringe until it is full to the 1.0-mL mark. If bubbles appear, push the solution slowly back into the vial and try again.
• Continue to hold the vial and syringe upside down. Tap the syringe gently to make any air bubbles rise to the top. Press the plunger in until the solution moves up to the top of the syringe and there is still 1.0 mL of solution left in the syringe. Pull the MICRO PIN out of the vial.
• Hold the syringe upright and carefully replace the cover on the MICRO PIN. Then remove the MICRO PIN from the syringe with a counterclockwise (to the left) turn.
• Attach the sterile needle for injection to the syringe by turning the needle clockwise (to the right) until it is tight.
• Throw away the blue MICRO PIN properly. See below for injection instructions.

To prepare a prefilled syringe of interferon beta-1a intramuscular injection, follow these steps:

• Remove the prefilled syringe from the refrigerator and allow it to warm to room temperature for about 30 minutes before using. Do not use a heat source such as hot water or a microwave to warm the syringe.
• Check the syringe to be sure it is safe to use. The syringe should be labeled with the correct name of the medication and an expiration date that has not passed and should contain a clear, colorless solution filled to the 0.5-mL mark. If the syringe is expired, if the syringe contains a different amount of solution, or if the solution is cloudy, discolored, or contains any particles, do not use the syringe and call your pharmacist.
• Wash your hands well with antibacterial soap.
• Hold the prefilled syringe upright, with the rubber cap facing up.
• Remove the rubber cap by turning and gently pulling the cap in a clockwise (toward the right) direction.
• Open the needle package and attach the needle to the syringe by firmly pressing it onto the syringe and turning it a half-turn clockwise (toward the right). Be sure to attach the needle tightly so medication will not leak.

To inject an intramuscular dose of interferon beta-1a, follow these steps:

• Set up a clean, well-lit, flat work surface, such as a table, to collect all the supplies you will need to inject your medication. Assemble these supplies: prefilled syringe, sterile needle, alcohol wipe, gauze pad, adhesive bandage, and puncture-resistant container.
• Use a new alcohol wipe to clean the skin in the spot where you will inject interferon beta-1a.
• Pull the protective cover straight off the needle without twisting.
• Use one hand to stretch the skin out around the spot where you will inject the medication. Use your other hand to hold the syringe like a pencil. Use a quick motion to stick the needle in the skin at a 90-degree angle (straight up and down) and push the needle through the skin and into your muscle.
• Let go of the skin and use that hand to gently pull back slightly on the syringe plunger. If you see blood come into the syringe, pull the needle out of the injection spot and put pressure on the spot with a gauze pad. You will need to replace the needle with a new needle, and choose a new spot for injection. If no blood comes into the syringe, slowly push the syringe plunger down until the syringe is empty.
• Hold a gauze pad near the needle at the injection spot and pull the needle straight out from the skin. Use the gauze pad to apply pressure to the spot for a few seconds or rub gently in a circular motion.
• If there is slight bleeding at the spot, wipe it off with the gauze pad, and, if necessary, apply an adhesive bandage.
• Throw away the used syringe and needle properly.
• After 2 hours, check the injection site for redness, swelling, or tenderness. If you have redness, swelling, or tenderness that does not go away in a few days or is severe, call your doctor.

Last Revised: 04/01/2004

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