Follistim and Menopur for Intramuscular (IM) Injection

Follistim and Menopur for Intramuscular (IM) Injection

Special Considerations: Rotate injection sites. Inject into the deltoid muscle.

Follistim Storage: Cartridges that have not been punctured must remain refrigerated and may be used until the manufacturer’s expiration date. However, once you start using a cartridge, it must be used within 28 days of the date it was punctured. Once you start using a cartridge, you may refrigerate it or it may be left at room temperature.

Menopur Storage: Store at room temperature. Must be used immediately after reconstituting/mixing.

Supplies: 3 mL syringe, 25 gauge 1½ inch needle for injection, Q-cap, Follistim pen with pen needles, alcohol swabs.

Instructions

1. Prepare Follistim:
   • Wash your hands and work on a clean, dry surface.
   • Remove the blue cap from the Follistim pen, then unscrew the yellow section from the blue section.
   • Clean the rubber stopper on the end of your Follistim cartridge with an alcohol wipe, then insert it with the rubber stopper end first into the yellow section.
   • Completely screw the yellow and blue sections back together – make sure the blue arrow is lined up with the yellow line. If you cannot screw the two pieces back together, check to see if you inserted the cartridge backwards.
   • Remove the seal from one of the needles and screw it completely onto the yellow end of the pen.
   • Pull the outer white cap off the needle. There is another safety shield on the needle that is also white – pull that off also. Please be careful not to let the exposed needle touch anything. If it does, recap the needle with only the larger cap, remove and replace with a new needle.
   • Dial your dose: turn dial until you reach the correct dose. Your dose should be lined up in the center of the clear window, between the two yellow lines.
     • If you accidentally dial too far and go past your dose, do not turn the dial back to your dose. Instead, continue turning the dial toward you all the way to the end, until you reach a “blank” space on the dial, then push the plunger all the way in.
     • You have now reset the pen and can dial your dose again by dialing toward you.
     • You should always be dialing toward you with the Follistim pen. If you dial away from you, the pen will push medication out and then it will be wasted.
   • Check the dosage window:
     • It should be back to zero.
     • If it is not all the way back at zero, you did not get your whole dose because your cartridge likely ran out of medication, and you will notice the plunger probably did not go all the way down.
   • The number in the window is the dose you still need to receive. Please do the following:
     • Place the larger white cap back on the needle and remove the needle by unscrewing it. Discard used needle.
     • Without touching the dose dial, unscrew the pen, take out the old cartridge and discard, clean rubber stopper of a new cartridge with alcohol swab, put in a new cartridge in the pen and put on a new needle. Remove both caps on the needle.
     • When you have received your whole dose (mixed with Menopur), remove and discard the needle. Leave the cartridge in the pen and put the cap on the pen.
2. Prepare Menopur:
   • Determine your dose of Menopur and how many vials of Menopur powder you will need:
     1. 1 vial of powder = 75 units Menopur
     2. 2 vials of powder = 150 units Menopur
     3. 3 vials of powder = 225 units Menopur
   • Wash your hands and work on a clean, dry surface.
   • Place a clear “Q-cap” on a 3 mL syringe.
   • Take one vial of liquid and flip the plastic top off.
   • Using the syringe with the Q-cap, pull back on the plunger so that you have 1 mL of air in the syringe.
   • Now push the Q-cap into the top of the vial of liquid until you feel it “click” into place.
   • Inject the 1 mL of air into the vial of liquid.
   • Turn vial upside down and withdraw the 1 mL of liquid. Regardless of your Menopur dose, you will always use only 1 mL of liquid per injection. Pull the Q-cap and syringe off the vial. Once you have withdrawn 1 mL of liquid, you can discard that vial of liquid. You will not use the opened vial of liquid again.
   • With your Q-cap still on the syringe, push the Q-cap into the top of the vial of Menopur powder until you hear it “click” into place.
   • Inject the liquid into the vial of Menopur powder and swirl gently until all powder is dissolved.
   • If you need to use another vial(s) of Menopur based on your required dose, repeat the steps.
3. Mix Follistim and Menopur:
   • Dial up to the correct dose of Follistim on Follistim pen and attach pen needle.
   • Clean the already mixed vial of Menopur with an alcohol swab.
   • Inject the Follistim dose into the vial of already mixed Menopur. Swirl vial gently to mix.
   • Attach 25 gauge 1 ½ inch needle to a 3 mL syringe.
   • Clean top of vial with both medications in it with an alcohol swab.
   • Puncture vial with Follistim and Menopur and draw up all fluid in the vial for injection.
4. Administration of Follistim and Menopur:
   • Choose an injection site on your deltoid (see image).
   • Clean the area with an alcohol swab and allow to dry.
   • Insert the needle straight into the skin – do not go in at an angle.
   • Push the plunger all the way down, then wait 5 seconds before removing the needle from the skin.
   • Rotation injection sites from day to day.