Please follow these instructions for mixing and injecting your medication:
1. Clear a work area on your table or countertop and wash your hands.
2. Take out the number of vials of medication you have been instructed to use (i.e., Menopur 1 powder) and 1 vial of the diluent (water). Put aside the remaining vials so there will be no confusion as to how many vials were drawn up.
3. Check carefully for NAME and EXPIRATION DATE of each vial.
4. To open the vial, use your thumb to lift the plastic lid on top of the vial. Wipe the rubber stopper with an alcohol swab or a cotton ball soaked in alcohol. Do not remove the rubber stopper or the metal ring that holds the stopper in place.
5. Open the needle package (3cc syringe with 22G 1 ½-inch needle). Remember to tighten the needle onto the barrel of the syringe by turning clockwise.
6. Insert the needle through the rubber stopper of the vial, turn upside down and draw up 1cc of the diluent making sure the tip of the needle is in the fluid. Flick the syringe with a finger to force the air to the surface of the fluid within the syringe, then push the plunger up to expel the air from the syringe making sure you still have 1cc of fluid to mix with. Mix the diluent with the first vial containing the powder (it dissolves instantly) and draw up all of the medication mixture (1cc). If additional medication is required, add the same medication mixture in the syringe to the second vial of medication and withdraw the entire 1cc. Continue this process until the prescribed number of vials has been mixed. Draw up all of the mixture (1cc) and expel the air, cover the needle and change needle to a 27G ½-inch needle for a subcutaneous injection of Gonal-F, Follistim, or Menopur. At the end of this process, you may have a LITTLE less than 1cc for injection but not more than 1 small line less. If you have only ½ cc of fluid in the syringe, you have not removed all of the medication from the vials and are not getting the correct dose. Go back to the vials and remove the remaining fluid until you have close to 1cc.
7. Locate injection site and cleanse the skin with an alcohol swab or cotton ball soaked in alcohol. (See: Subcutaneous Injection Technique below)
8. Stabilize the skin around injection site with nondominant hand by pinching the skin up with forefinger and thumb. Insert the needle quickly in a dart-like motion (all the way in). Inject the entire contents of the syringe by depressing the plunger fully.
9. Continue holding the surrounding skin while removing the needle quickly. You may notice a small amount of blood or fluid leaking from the injection site when you pull the needle out; this is normal. Wipe with clean tissue or apply Band-Aid if necessary.
10. Dispose of the syringe properly, without recapping the needle, in a sharps container.
11. Alternate injection sites with each injection.
Note: If the uncovered needle touches any surface other than the inside of the medications vial prior to injection, it is contaminated. Twist off the needle and replace with a sterile needle. Use all needles and syringes for one injection only, then promptly discard carefully into a container.