HUMIRA syringe instructions

Read through these instructions before handling the syringe. Note that you can only use the syringe once. The syringe comes preloaded with the exact dose of medicine inside, ready to inject. Do not mix the injection in the same syringe with any other medicine. Do not attempt to self-inject until you are sure that you understand how to prepare and give the injection.

 
 

1. Remove the syringe from the refrigerator

  • Gently place on a flat, clean surface.
  • Allow the medicine to warm to room temperature (around 15 minutes).
  • Wash your hands with soap and water.
 

2. Check the medicine is okay to use.

  • Check the medicine is not past its expiry date.
  • The expiry date is located on the side of the syringe.

    Do not use the medicine if it is past this date.

  • Check the syringe has the right amount of liquid in it. Turn the syringe so the needle cap points upwards as shown. The liquid should reach the white band, with an air bubble above it. If it’s a lot lower or higher than the white band, do not use the syringe.
  • Check the medicine is clear and colourless.

    Do not use the medicine if the liquid is cloudy or discoloured or has flakes or particles in it.

    Do not use it if the solution has been frozen (even if thawed).

    Instead, put the syringe back into the refrigerator. Then call us on 0800 900 030 to arrange for the medicine’s return and replacement.

 

3. Choose an injection site

  • Choose from an area, as shown, around your stomach or top of the thigh – as shown
  • Do not choose an injection site within 3 cm of any previous injection site or your navel.
  • Do not choose an injection site where the skin is reddened, bruised, scarred or hard.
  • Wipe the injection site with an alcohol pad, using a circular motion.
  • Allow the site to air dry (1-2 minutes).
  • Do not touch the site again before injecting.

    If you do, you will need to cleanse it again.

 

4. Remove the cap from the needle

  • Do not put the syringe down, or touch the needle, or let it touch any surface.
  • Do not shake the syringe.
 

5. Give yourself the injection

  • Gently squeeze a sizable area of skin around the injection site (4-6 cm).
    This will create a firm section of fat to inject the medicine into.
  • Keep holding and squeezing the skin until you have completed the injection.
  • Hold the syringe like a pencil, at a 90 degree angle to the skin, with the flat edge facing up.
  • With a quick, short, ‘dart-like’ motion, push the needle all the way into the skin.
  • Slowly push the plunger all the way in until no liquid remains in the syringe.
  • Remove the syringe by gently pulling it away from your body at a 90 degree angle.
    You can now stop squeezing the skin around your injection site and put the syringe down.
 

6. Press a cotton ball or gauze strip over the injection site and hold it firmly for ten seconds

You may get a spot of blood or a small bruise at the injection site – This is normal.

  • Do not rub the injection site.
    It may cause bleeding, bruising, or infection.

Do not re-cap the needle. You may prick yourself.

 

7. Dispose of the used syringe in your sharps container

  • The syringe should never be reused.
  • Keep your sharps container out of reach of children at all times.
  • When the sharps container is two-thirds full, take it back to your pharmacist, nurse or doctor for disposal.

    Never dispose of injection syringes or sharps containers in the household rubbish bin.

 

Please review the full instructions provided with your HUMIRA pre-filled syringe for complete directions.

Please also review the Consumer Medicine Information at: http://www.medsafe.govt.nz/consumers/cmi/h/humira.pdf.

You can also speak to your Healthcare Professional for further information.

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What is the most important safety information I should know about HUMIRA?

You should discuss the potential benefits and risks of HUMIRA with your doctor, even though not everyone will experience side effects.

Because of the way HUMIRA works on your immune system, you may become more likely to develop infections. It is important to tell your doctor if you get symptoms of infections such as fever, wounds, feeling tired, dental problems, or burining on urination. Usually these infections are mild – like a cold or a sinus infection, but occasionally they can be very serious, even life-threatening, for example tuberculosis (TB) or hepatitis B. That’s why doctors monitor patients carefully for serious infections while they are taking HUMIRA and why your specialist and general practitioner (GP) may encourage you to get treatment early for any infection, even a minor one, like a cold or a graze, so they don’t become serious infections.

You should also not receive some types of vaccines (live vaccines) whilst taking HUMIRA. Speak to your doctor about vaccines whilst taking HUMIRA.

There have been cases of certain kinds of cancer (such as lymphoma, leukaemia, and some others) in patients taking Humira. If you take HUMIRA your risk may increase.  On rare occasions, a specific and severe (life-threatening) type of lymphoma, hepatosplenic T-cell lymphoma, has been observed in patients taking HUMIRA.  In addition cases of skin cancer have been observed in patients taking HUMIRA. If new skin lesions appear during or after therapy or if existing lesions change appearance, tell your doctor as soon as possible.  Speak to your doctor for more information on your specific situation.

A small number of patients may have an allergic reaction to HUMIRA.

HUMIRA may increase the chance of diseases that affect the nervous system such as multiple sclerosis.

There have been cases of psoriasis and worsening of existing psoriasis.

For more information on what you need to tell your doctor before starting HUMIRA and other safety information, please refer to the safety information and what information you should share with your doctor before starting HUMIRA (see FAQ below).

Also refer to Consumer Medicine Information (CMI) which is available at Medsafe New Zealand and in the link at the bottom of this page.

Refer to your doctor for more information or to discuss any concerns.

Who shouldn’t use HUMIRA?
  • If you have an allergy to any medicine containing HUMIRA (adalimumab) or any of the product’s ingredients
  • If you currently have a severe active infection for example, tuberculosis
  • If you are already using anakinra (Kineret®) or other biologic DMARDs or TNF-inhibitors such as abatacept (Orencia®), etanercept (Enbrel®) or infliximab (Remicade®)
  • If you have moderate to severe heart failure

If you have any questions about any of this information, ask your doctor.

Speak to your doctor before starting Humira if you are pregnant or breastfeeding, or plan to become pregnant or to breastfeed.

Orencia is a registered trade mark registered to Bristol-Myers Squibb. Kineret is a registered trade mark licensed by Swedish Orphan Biovitrum. Enbrel is a registered trade mark registered to Pfizer New Zealand. Remicade is a registered trade mark registered to Janssen Cilag.

What information should I share with my doctor before starting HUMIRA?

Tell your doctor if you have, or have had, any of the following:

  • an infection, including a long-term or localised infection (for example, leg ulcer)
  • a history of recurrent infections or other conditions that increase the risk of infections
  • tuberculosis, or if you have been in close contact with someone who has had tuberculosis
  • hepatitis B virus, or you suspect you may be infected
  • a fungal infection
  • multiple sclerosis and other demyelinating disease
  • allergic reactions such as chest tightness, wheezing, dizziness, swelling or rash
  • blood disorders
  • a suppressed immune system or if you are taking any medicines that can lower your immune system
  • heart conditions including congestive heart failure, heart attack or worsening of existing heart conditions
  • cancer or autoimmune disease
  • a lung disease called chronic obstructive pulmonary disease (COPD)
  • kidney or liver problems

As cases of tuberculosis have been reported in patients treated with HUMIRA, your doctor will check you for signs and symptoms of tuberculosis before starting this medicine. This will include a thorough medical history, a chest x-ray and tuberculin test.

HUMIRA can cause reactivation of hepatitis B in people who carry this virus. In some rare cases, especially if you are taking other medicines that suppress the immune system, reactivation of hepatitis B virus can be life-threatening.

Tell your doctor if you are scheduled for any vaccines. It is recommended that patients be brought up to date with all immunisations in agreement with current immunisation guidelines prior to initiating HUMIRA therapy. Patients receiving HUMIRA should not receive live vaccines.

Tell your doctor if you are currently taking or have previously taken any medication that lowers the body’s resistance to disease. You might get infections more easily while you are receiving HUMIRA treatment. These infections may be serious and include tuberculosis, infections caused by viruses, fungi or bacteria, or other opportunistic infections and sepsis that may, in rare cases, be life-threatening.

If you get an infection your doctor may recommend temporary discontinuation of HUMIRA. Also tell your doctor if you live(d) or have travelled to countries where there is more risk for certain kinds of fungal infections (histoplasmosis, coccidioidomycosis, blastomycosis). These infections may develop or become more severe if you take HUMIRA.

Tell your doctor if you are a psoriasis sufferer who has undergone phototherapy.

You should tell your doctor if you are pregnant, become pregnant, or are thinking about becoming pregnant. Tell your doctor if you are breastfeeding, or plan to breastfeed.

If you have any questions about any of this information, ask your doctor, and refer to the Consumer Medicine Information available from the link at the bottom of this page.

What are the most common side effects with HUMIRA?

All medicines have risks and benefits. It is important to be aware of side effects, even though not everyone will experience them. If you have any questions about any of this information, ask your specialist, GP or pharmacist.

There are other possible side-effects with Humira, some serious, so you should review the Consumer Medicines Information (see below) for the full list. Remember to tell your doctor if you experience these or any other side-effects.

The most common side effects with HUMIRA are listed below:

  • Respiratory tract infections – upper (such as cold, sinus infection, sore throat) or lower (such as bronchitis, pneumonia)
  • Other infections – skin (such as cellulitis), ear, mouth (inflammation or ulcers), bacterial (such as urinary tract infection), fungal (such as thrush) and viral infections (such as influenza, cold sore blisters, chicken pox, shingles)
  • Injection site reactions
  • Headache
  • Nausea, diarrhoea and /or abdominal pain
  • Muscle ache
  • Rash
  • Lower than normal number of white blood cells (leukopaenia)
  • Lower than normal number of red blood cells (anaemia)
  • Increased lipids
  • Higher than normal liver enzymes
  • Fatigue

For more information refer to the Consumer Medicine Information (CMI) which is available in the link at the bottom of this page, and review the safety information section of this website.

How will I know if I’m allergic to HUMIRA?

Symptoms of an allergic reaction may include:

  • chest tightness
  • shortness of breath, wheezing or difficulty breathing or swallowing
  • swelling of the face, lips, tongue or other parts of the body, eg hands or feet
  • hives, itching or skin rash.

If you experience any of these symptoms you should seek urgent medical attention.

How often and for how long will I have to use HUMIRA?

The recommended dose of HUMIRA depends on the conditions being treated, and in the case of children, their age and weight.

You should talk to your specialist about the dosage and frequency of your injections. Do not inject HUMIRA more often than prescribed.

HUMIRA is available in either a pre-filled single-use syringe or, a pre-filled single-use pen. Both the syringe and pen come preloaded with the exact dose of medicine inside, ready for you to inject.

The duration of treatment with HUMIRA will depend on many factors. If you stop taking HUMIRA your immune system may, once again, become over-active and cause inflammation so it is important that you continue to use HUMIRA for as long as your specialist tells you to. If you need to stop HUMIRA for a medical reason, you should tell your specialist as soon as possible.

Can I use HUMIRA if I’m taking other medicines?

You can take other medicines if your doctor has told you it’s okay to take them while you’re using HUMIRA. You can still take some other types of medicines for your condition at the same time as HUMIRA, for example, methotrexate, steroids, non-steroidal anti- inflammatories and painkillers; this is something your specialist will advise you on.

However, you should not take HUMIRA if you are taking anakinra (Kineret®), or if you are taking any other biologic DMARDs or Anti-TNFs such as abatacept (Orencia®), etanercept (Enbrel®) or infliximab (Remicade®) as taking the two medicines together may increase the risk of infection.

You should not receive some types of vaccines (live vaccines) whilst taking HUMIRA. Tell your healthcare professional that you are taking HUMIRA before you are scheduled to have any vaccinations.

HUMIRA is supplied in a single-use, pre-filled syringe or single-use, pre-filled pen. It should NOT be mixed with any other medicine (such as insulin), nor should any other medicines be added to the syringe or pen.

Make sure to tell your specialist about all medicines you are taking including other prescription medicines, any medicines purchased from a pharmacy or supermarket, painkillers, herbal medicines, and vitamin and mineral supplements you are taking. If you have any questions, you should ask your specialist.

Orencia is a registered trade mark registered to Bristol-Myers Squibb. Kineret is a registered trade mark licensed by Swedish Orphan Biovitrum. Enbrel is a registered trade mark registered to Pfizer New Zealand. Remicade is a registered trade mark registered to Janssen Cilag.

Are there any foods that interact with HUMIRA?

Since HUMIRA is injected under the skin (subcutaneously), rather than taken by mouth, food and drink should not affect HUMIRA. If you have questions, talk to your doctor.

Can I drink alcohol when using HUMIRA?

There is insufficient information on the effects of alcohol on HUMIRA. If you have questions, talk to your doctor.

Should I get a flu vaccination (“flu shot”) if I am taking HUMIRA?

Tell your doctor if you are scheduled for any vaccines. It is recommended that patients be brought up to date with all immunisations in agreement with current immunisation guidelines prior to initiating HUMIRA therapy.

Your specialist or GP may encourage you to have vaccinations for flu annually and pneumonia to help protect you, or to try to reduce the severity of these infections.

Patients receiving HUMIRA should not receive live vaccines. Check with your doctor about which ones are ‘live’ vaccines.

If you have any questions about any of this information, ask your doctor.

Can I use HUMIRA if I’m pregnant or breastfeeding?

Tell your doctor if you are pregnant or planning to become pregnant. If you become pregnant while using HUMIRA, tell your doctor immediately.

If you use HUMIRA during pregnancy, your baby may have a higher risk of getting an infection. It is important that you tell your baby's doctors and other healthcare professionals about your HUMIRA use during your pregnancy before the baby receives any vaccine.

Tell your doctor if you are breastfeeding or plan to breastfeed. 

If you have any questions about any of this information, ask your doctor.