This information will teach you how to give yourself a subcutaneous (below the skin) injection with filgrastim (Neupogen®) or pegfilgrastim (Neulasta®) in a prefilled syringe. Your nurse will review this information with you.
Name of medication: ______________________________
Medication schedule: ______________________________
Storing Your Medication
- Store your prefilled syringes in the refrigerator. Do not store them in the freezer. If the medication inside the syringe becomes frozen by accident, allow it to thaw in the refrigerator. If it becomes frozen a second time, do not use it. Call your doctor or nurse for further instructions.
- A syringe can be left out at room temperature for up to 24 hours. Do not leave it in direct sunlight.
- If you have any questions about how to store or carry the syringes when you travel, talk with your doctor, nurse, or pharmacist.
Gather Your Materials
- Prefilled syringe with a clear plastic needle guard attached
- Alcohol pads
- Disposable sharps container or other puncture-resistant container, such as a laundry detergent bottle or coffee can
- The container should be strong enough that needles cannot poke through the sides and it should not be breakable.
- Do not store your sharps in glass bottles or paper or plastic bags.
- 2 x 2 gauze pad or cotton ball
- Other: _________________________________
Prepare the Injection
- Remove the prefilled syringe from the refrigerator 30 minutes before you give the injection so that it can reach room temperature.
- Prepare a clean area to work where you can lay out all of your materials. You can work in the bathroom if it is private and there is enough space.
- Do not shake the syringe. Shaking it may damage the medication. If it has been shaken, the medication may look foamy and should not be used.
- Check to make sure that the medication name on the package or syringe label matches what your doctor prescribed for you.
- Check to make sure that the expiration date on the syringe has not passed. If the date has passed, discard the syringe in the sharps container.
- Check to make sure that the strength of the medication is what your doctor prescribed. The strength is listed on the colored dot on the package.
- Check to make sure that the medication in the syringe is clear and colorless. Do not use it if it looks discolored or cloudy, or if it has crystals in it.
- Wash your hands well with soap and water or use an alcohol-based hand sanitizer.
Choose an Injection Site
Choose an injection site from one of the following areas (see Figure 1):
- The outer area of your upper arms
- Your abdomen (belly), except for the 2-inch area around your belly button
- The front of your middle thighs
- The upper areas of your buttocks
Keep track of which site was used last and rotate the sites. Choosing a new site can help avoid soreness at any one site. Do not inject into an area that is tender, red, bruised, or hard. Do not inject into an area that has scars or stretch marks.
Figure 1: Injection sites
- Fold back any clothing that is covering the injection site.
- Tear off any 3 edges on a sealed alcohol pad. Hold the packet at the edge you did not tear. Carefully open the packet to expose the alcohol pad, but do not take it out. Set the open packet on your work area. You will use this alcohol pad to clean the skin at the injection site just before you give yourself the injection.
Give the Injection
Figure 2: Removing the cover
Remove the syringe from the package.
- Hold the syringe around the middle like a pen or dart. Carefully pull the needle cover straight off (see Figure 2). Do not let anything, including your fingers, touch the needle. If anything touches the needle, you must discard it in the sharps container. Call your doctor or nurse for instructions on what to do next.
- Check the syringe for air bubbles. If there are air bubbles, gently tap the syringe with your fingers until the air bubbles rise to the top of the syringe. Slowly push the plunger up to force the air bubbles out of the syringe.
- Pick up the alcohol pad with your other hand. Using firm pressure, clean the skin on the injection site. Start at the center of the site and move outward in a circular motion. Allow your skin to dry before giving the injection.
Figure 3: Inserting the needle at 90-degree angle
Hold the syringe in the hand you will use to give the injection. Hold it like you would a pen or a pencil when you are ready to write. Use your other hand to pinch a fold of skin at the injection site.
Figure 4: Pushing the plunger
Insert the needle into your skin in one quick motion at a straight up and down angle (90 degrees; see Figure 3) or at a slight angle (45 degrees). Do not place your thumb on the plunger yet.
- After the needle is inserted, let go of your skin. Use your thumb to slowly push the plunger all the way down (see Figure 4). Push it until all the medication is injected.
- When the syringe is empty, pull it straight out of your skin. Place a cotton ball or gauze over the injection site and press it for several seconds. If needed, apply a Band-Aid®.
- Do not recap the needle. Be careful to not stick yourself. While holding the clear plastic finger grips on the sides of the syringe with one hand, grasp the needle guard with your other hand (see Figure 5). Slide the needle guard over the needle cap until it is completely covered (see Figure 6). You will hear the needle guard click into place.
- Place the syringe and cover into the sharps container. Do not use a prefilled syringe more than once.
Figure 5: Grasping the needle guard
Figure 6: Sliding the needle guard
How to Store and Dispose Your Home Medical Sharps
Storing your sharps
- Clearly label the sharps container “Home Sharps.” Keep it away from children and pets.
- Keep the container separate from recyclables.
- Do not overfill the container. When it is more than half full, put on the lid and reinforce the cap with strong tape to create a more secure seal and prevent leakage.
Disposing your sharps
- If you live in New York City, you can place the sealed container in with your regular trash for collection. Do not put it in with your recyclables. If you live in a different county or state, check with your local department of health for instructions.
- You can also bring the sealed container to:
- Your nurse at your next clinic visit
- Any nonfederal hospital in New York State
- A local pharmacy