Giving Yourself an Injection of Filgrastim (Neupogen®) or Pegfilgrastim (Neulasta®) With a Prefilled Syringe

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.

Medication Information

Name of medication: ______________________________

Medication schedule: ______________________________

Dose: ____________

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How to Store Your Medication

  • Store your prefilled syringes in the refrigerator. Don’t store them in the freezer. If the medication inside the syringe freezes by accident, allow it to thaw in the refrigerator. If it freezes more than once, don’t use it. Call your doctor or nurse for further instructions.
  • A syringe can be left out at room temperature for up to 24 hours. Don’t 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.
 
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How to Give Yourself an Injection

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.
    • See the “How to Store and Dispose of Your Home Medical Sharps” section below for instructions on how to choose a sharps container.
  • 2 x 2 gauze pad or cotton ball
  • Band-Aid®

Prepare the Injection

  1. Take the prefilled syringe out of the refrigerator 30 minutes before you give the injection so that it can reach room temperature.
  2. Prepare a clean area to work where you can lay out all of your materials. You can work in the bathroom if it’s private and there’s enough space.
  3. Don’t shake the syringe. Shaking it may damage the medication. If it has been shaken, the medication may look foamy and shouldn’t be used.
  4. Check the medication:
    • Name – Make sure that the medication name on the package or syringe label matches what your doctor prescribed for you.
    • Expiration date – Make sure that the expiration date on the syringe hasn’t passed. If the date has passed, throw away the syringe in the sharps container.
    • Strength – Make sure that the strength of the medication is what your doctor prescribed. The strength is listed on the colored dot on the package.
    • Color – Make sure that the medication in the syringe is clear and colorless. Don’t use it if it looks discolored or cloudy, or if it has crystals in it.
  5. Wash your hands well with soap and water or use an alcohol-based hand sanitizer.

Choose an Injection Site

Injection sites
  1. 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 middle of the front of your thighs.
    • The upper areas of your buttocks.

    Keep track of which site you used last, and use a different site each time. Choosing a new site can help avoid soreness at any one site.

    Don’t inject into an area that’s tender, red, bruised, or hard. Don’t inject into an area that has scars or stretch marks.

  2. Fold back any clothing that’s covering the injection site.
  3. Tear off any 3 edges on a sealed alcohol pad packet. Hold the packet at the edge you didn’t tear. Carefully open the packet to expose the alcohol pad, but don’t take it out. Set the open packet on your clean work area. You will use this alcohol pad to clean the skin at the injection site just before you give yourself the injection.
Removing the needle cover

Give the Injection

  1. Take the syringe out of its package.
  2. Hold the syringe around the middle, like a pen or dart. Carefully pull the needle cover straight off (see Figure 2). Once the needle cover is off, don’t set the syringe down. Don’t let anything, including your fingers, touch the needle. If anything touches the needle, you must throw it out in the sharps container. Call your doctor or nurse for instructions on what to do next.
  3. Check the syringe for air bubbles. If there are air bubbles, hold the syringe upright, with the needle pointing up. Gently tap the syringe with your fingers until the air bubbles rise to the top of the syringe, near the needle. Slowly push the plunger up to force the air bubbles out of the syringe.
  4. 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. Let your skin dry before giving the injection.
  5. 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.
  6. Insert the needle into your skin in one quick motion at a 90 degree (straight up and down) angle. (see Figure 3). Don’t place your thumb on the plunger yet.
    Figure 3: Inserting the needle
  7. After the needle is inserted, let go of your skin. Use your thumb (whichever thumb is more comfortable) to slowly push the plunger all the way down. Push it until all the medication is injected.
  8. When the syringe is empty, pull it straight out of your skin. Place a cotton ball or gauze over the injection site and press down for several seconds. If needed, apply a Band-Aid®.
  9. Don’t put the cap back on the needle. Be careful to not poke yourself with the needle. 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 4). Slide the needle guard over the needle cap until it’s completely covered (see Figure 4). You will hear the needle guard click into place.
    Figure 4. Grasping and sliding the needle guard
  10. Place the syringe and cover into the sharps container. Don’t use a prefilled syringe more than once.
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How to Store and Dispose of Your Home Medical Sharps

Storing Your Medical Sharps

  • Use an empty plastic container with a screw-on cap, such as a laundry detergent bottle.
    • Pick a container that’s strong enough so that needles can’t poke through the sides.
    • Pick a container that’s not breakable.
    • Don’t store your sharps in glass bottles, soda bottles, milk jugs, aluminum cans, coffee cans, or paper or plastic bags.
  • Clearly label the container “Home Sharps – Not for Recycling.” Keep it away from children and pets.
  • Put the sharps in the container point-first as soon as you use them.
  • Don’t overfill the container. When it’s more than half full, stop using it. Wrap the cap with strong tape to create a more secure seal and prevent leakage.
  • Keep the container separate from trash that will be recycled.

Disposing of Your Medical Sharps

  • If you live in New York City, you can place the sealed container in with your regular trash for collection. Don’t put it in with your recyclables.
  • If you live in a different county of New York or another 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 hospital or nursing home in New York State
    • A local pharmacy
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