Humira®, Enbrel®, Simponi®, and Cimzia® are medications commonly prescribed for rheumatoid arthritis, psoriatic arthritis, psoriasis, and ankylosing spondylitis.  All of these come in self-injectable pens or pre-filled syringes.  You will be asked to inject these yourself or by a love one, in the comfort of your home.  Today, we’re going to go over how to inject these self-injectable medications.

Preparing for your injection

• Keep your medication stored in the refrigerator until use
  • Before injecting medication, take the autoinjector out of the refrigerator.
  • Allow it to warm up to room temperature.
• Pick a place in your house that is clean and has room for your materials (such as the kitchen table).
• Wash your hands thoroughly with either:
  • Soap & water
  • Hand sanitizer
• Chose an area to inject – Thigh or Stomach.
  • Chose an area that is intact and clear.
  • It should not have any of the following:
    • Cuts
    • Scrapes
    • Bruises
    • Psoriasis patches
    • If you have extensive psoriasis, inject between patches
    • Moles
    • Scars
  •  
  • Please rotate area each time you inject (shown in picture below).

By British Columbia Institute of Technology (BCIT). Download this book for free at http://open.bccampus.ca [CC BY 4.0 (http://creativecommons.org/licenses/by/4.0)], via Wikimedia Commons

• Cleanse chosen area
  • Cleanse chosen area with either of the following:
    • Alcohol swab
    • Alcohol and a cotton ball
  • Use the chosen alcohol material to “swipe” area
    • Can either use a circular motion or wipe in “strips”
    • Allow the area to dry

The injection

• Take off the white cap, observe the medication in the window to be sure that it is clear (no cloudiness or crystals.)
  • You will see a small air bubble within the window, this is normal and will not cause harm when injecting
• Press down firmly on the clean area of skin, so that the pen is flush with the skin (90-degree angle).
  • The pen needle will not eject unless pressed firmly to skin

For Cimzia® and other medications that come in prefilled syringes

• Pinch the skin around the injection site and insert the needle at a 45-degree angle
• Press in the plunger slowly

You may notice the plunger is hard to press this is due to the size of the medication, be sure to continue to inject slowly to administer all medication

• Press button to inject the medication.
  • You may feel a slight pinch as the needle enters your skin, and tingling as the medication is administered
  • If you have trouble pressing the button try lifting the pen off your skin, and repressing the pen firmly to the area
• Hold for 15 seconds.
  • Window will become colored (yellow) but continue to hold dose for at least 15 seconds to ensure that all medication is administered

What to do after the injection

• Lift the pen up from skin and place the whole pen into the sharps container.
  • If you do not have a sharps container available, contact your pharmacy/doctor’s office about obtaining one
    • In the meantime, you may use an old coffee container with a lid
  • Some hospitals take full Sharps Containers for disposal. Here at the office we do not. Contact your pharmacy for more information about the disposing of your Sharps Container.
• Discard remaining materials in the trash (cap, alcohol swabs, etc.)

If you have any concerns about your medication (e.g., excessive pain, swelling, redness bruising, bleeding, fever, breathing problems), please contact your rheumatologist.

For more information

Humira® – Abbvie

Enbrel® – Amgen

Simponi® – Janssen

Cimzia® – UCB

Jessica Farrell, PharmD.  Clinical Pharmacist, The Center for Rheumatology/Associate Professor, Albany College of Pharmacy and Health Sciences

With the help of Autumn Koniowka. Doctor of Pharmacy Candidate Class of 2018, Albany College of Pharmacy and Health Sciences, and Megan Phillips. Doctor of Pharmacy Candidate Class of 2018, Albany College of Pharmacy and Health Sciences.

A special thanks to Tammy Garren, PhD. Instructional Designer, Center for Innovative Learning, Albany College of Pharmacy and Health Sciences.

Medical Disclaimer

This information is offered to educate the general public. The information posted on this website does not replace professional medical advice, but for general information purposes only. There is no Doctor – Patient relationship established. We strongly advised you to speak with your medical professional if you have questions concerning your symptoms, diagnosis and treatment.