Instructions on how to use: It is important that patients do not try to give themselves the injection unless they have received special training from doctor or nurse. Filgrastim (Zarzio) is provided with a needle safety guard and patients will be shown how to use this by the doctor or nurse. If patients are not sure about giving the injection or they have any questions, patients should ask the doctor or nurse for help.
1. Wash hands.
2. Remove one syringe from the pack and remove the protective cap from the injection needle. Syringes are embossed with graduation rings in order to enable partial use if required. Each graduation ring corresponds to a volume of 0.1 mL. If partial use of syringe is required, remove unwanted solution before injection.
3. Clean the skin at the injection site using an alcohol wipe.
4. Form a skin fold by pinching the skin between thumb and forefinger.
5. Insert the needle into the skin fold with a quick, firm action. Inject filgrastim (Zarzio) solution.
6. Always keeping the skin pinched, depress the plunger slowly and evenly until the entire dose has been given and the plunger cannot be depressed any further.
Do not release the pressure on the plunger.
7. After injecting the liquid, remove the needle while maintaining pressure on the plunger and then let go of the skin.
8. Let go of the plunger. The needle safety guard will rapidly move to cover the needle.
9. Discard any unused product or waste material. Only use each syringe for one injection.
Special precautions for disposal and other handling: The solution should be visually inspected prior to use. Only clear solutions without particles should be used.
Accidental exposure to freezing temperatures does not adversely affect the stability of filgrastim.
Filgrastim (Zarzio) contains no preservative. In view of the possible risk of microbial contamination, Filgrastim (Zarzio) syringes are for single use only.
Dilution prior to administration (optional):
If required, filgrastim may be diluted in glucose 50 mg/ml (5%) solution.
Dilution to a final concentration <0.2 MU/mL (2 μg/mL) is not recommended at any time.
For patients treated with filgrastim diluted to concentrations <1.5 MU/mL (15 μg/mL), human serum albumin (HSA) should be added to a final concentration of 2 mg/mL.
Example: In a final volume of 20 ml, total doses of filgrastim less than 30 MU (300 μg) should be given with 0.2 mL of human serum albumin 200 mg/mL (20%) solution Ph. Eur. added.
When diluted in glucose 50 mg/mL (5%) solution, filgrastim is compatible with glass and a variety of plastics including polyvinylchloride, polyolefin (a copolymer of polypropylene and polyethylene) and polypropylene.
Using the pre-filled syringe with a needle safety guard: The needle safety guard covers the needle after injection to prevent needle stick injury. This does not affect normal operation of the syringe. Depress the plunger slowly and evenly until the entire dose has been given and the plunger cannot be depressed any further. While maintaining pressure on the plunger, remove the syringe from the patient. The needle safety guard will cover the needle when releasing the plunger.
Disposal: Any unused product or waste material should be disposed of in accordance with local requirements.
Incompatibilities: Filgrastim must not be diluted with sodium chloride solution.
This medicinal product must not be mixed with other medicinal products except those mentioned in Special precautions for disposal and other handling.
Diluted filgrastim may be adsorbed to glass and plastic materials, unless it is diluted in glucose 50 mg/ml (5%) solution.