Cetrotide Caution For Usage

Instructions for use and handling, and disposal: HOW TO MIX AND INJECT CETROTIDE: Before starting to use this medicine, read these instructions the whole way through first.
This medicine is only for the patient - do not let anyone else use it.
Use each needle, vial and syringe only once.
Before starting Cetrotide: 1. This medicine must be at room temperature prior to injection. Remove from the refrigerator approximately 30 minutes before use.
2. Wash hands: It is important that the hands and the things used are as clean as possible.
Lay out everything needed on a clean surface: one vial of powder; one pre-filled syringe with sterile water (solvent); one needle with a yellow mark - for injecting the sterile water into the vial and drawing the made up medicine out from the vial; one needle with a grey mark - for injecting into the belly; two alcohol swabs.
Mixing the powder and water to make the medicine: 1. Remove the plastic cap from the vial: There will be a rubber stopper underneath - keep this in the vial.
Wipe the rubber stopper and metal ring with the first alcohol swab.
2. Adding the water from the pre-filled syringe to the powder in the vial: Unwrap the needle with the yellow mark on it.
Remove the cap from the pre-filled syringe and screw the yellow needle onto it. Remove the cap from the needle.
Push the yellow needle through the centre of the rubber stopper of the vial.
Slowly push in the plunger of the syringe to inject the water into the vial. Do not use any other sort of water.
Leave the syringe in the rubber stopper.
3. Mixing the powder and water in the vial: While carefully holding the syringe and vial, swirl gently to mix the powder and water together. When it is mixed, it will look clear and have no particles in it.
Do not shake or it will create bubbles in the medicine.
4. Re-filling the syringe with the medicine from the vial: Turn the vial upside down.
Then, gently pull back the plunger, in order to draw the medicine from the vial into the syringe. Take care not to pull out completely the plunger with the attached plunger stopper. In case the plunger was pulled out with the plunger stopper by mistake, make sure to discard the dose as sterility will be lost, and prepare a new dose (and restart from step 1).
If any medicine is left in the vial, pull out the yellow needle until the end of the needle is just inside the rubber stopper. Looking from the side through the gap in the rubber stopper can control the movement of the needle and the liquid.
Make sure to collect all of the medicine from the vial.
Put the cap back on the yellow needle. Unscrew the yellow needle from the syringe and lay down the syringe.
Preparing the injection site and injecting the medicine: 1. Removing air bubbles: Unwrap the needle with the grey mark on it. Screw the grey needle onto the syringe and remove the cap from the grey needle.
Hold the syringe with the grey needle pointing upwards and check for any air bubbles.
To remove air bubbles, gently flick the syringe until all the air collects at the top - then slowly push the plunger in until the air bubbles are gone.
Do not touch the grey needle and do not let the needle touch any surface.
2. Clean the injection site: Choose an injection site on the belly. It is best around the belly button (navel). To reduce skin irritation, select a different part of the belly each day.
Clean the skin at the chosen injection site with the second alcohol swab - use a circular motion.
3. Piercing the skin: Hold the syringe in one hand - like holding a pencil.
Gently pinch up the skin surrounding the site of injection and hold this firmly with the other hand.
Slowly push the grey needle completely into the skin at an angle of about 45 to 90 degrees - then let go of the skin.
4. Injecting the medicine: Gently pull back the plunger of the syringe. If blood appears, follow Step 5 as follows.
If no blood appears, slowly push the plunger in to inject the medicine.
When the syringe is empty, take out the grey needle slowly at the same angle.
Use the second alcohol swab to gently apply pressure where the needle was inserted.
5. If blood appears: take out the grey needle slowly at the same angle; use the second alcohol swab to gently apply pressure to the injection site; empty the medicine into a sink and follow Step 6 as follows; wash the hands and start again with a new vial and pre-filled syringe.
6. Disposal: Use each needle, vial and syringe only once.
Put the cap back on the needles so that they are safe to be thrown away.
Ask the pharmacist how to safely dispose of used needles, vial and syringe.
Missing a dose: If the patient missed to administer Cetrotide 0.25 mg on one day, contact the doctor immediately and ask for advice.
Ideally Cetrotide 0.25 mg should be administered at 24 hours intervals. But if the patient missed to administer Cetrotide 0.25 mg at the right time it is no problem to administer this dose at a different time of the same day.
Incompatibilities: As cetrorelix is incompatible with several substances of common parenteral solutions it should be dissolved only by using water for injections.