Nutropin AQ

Nutropin AQ—it's already ready

• What is Nutropin AQ?
• Instructions for Use
• Storage and Maintenance

What Is Nutropin AQ?

Nutropin AQ
The amino acid sequence in Nutropin AQ is identical to that of naturally occurring growth hormone produced in the human body. As a liquid growth hormone (hGH or GH) formulation,, Nutropin AQ is ready for immediate injection; no mixing is necessary. Nutropin AQ makes hGH therapy easier by offering these advantages:

• Less time is needed to prepare and administer the medication. Nutropin AQ eliminates about half the steps required to prepare lyophilized (powdered) Nutropin and fewer supplies are needed.
• Less time is required to learn how to give injections compared to powdered Nutropin.
• Once opened, a vial of Nutropin AQ can be used for up to 28 days, if properly refrigerated.

Nutropin AQ is available in the US by prescription only. Healthcare providers should provide patient training prior to use.

Please click here for full prescribing information for Nutropin AQ and Nutropin.

How is Nutropin AQ supplied?
Nutropin AQ is supplied as either 10 mg (approximately 30 IU [international units]) of sterile liquid somatropin per vial or as 10 mg (approximately 30 IU) of sterile liquid somatropin per pen cartridge.

Each vial carton contains a single vial containing 2 mL of Nutropin AQ 10 mg/2 mL (5 mg/mL). NDC 50242-022-20.

Each pen cartridge carton contains a single pen cartridge containing 2 mL of Nutropin AQ 10 mg/2 mL (5 mg/mL). NDC 50242-043-14.

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Instructions for Use

To guard against the spread of infection, follow these safety measures:

• Wash your hands thoroughly with soap and warm water before preparing the medication.
• Clean the rubber stopper on the top of the vial with an alcohol wipe. Be sure not to touch the top of the vials after cleaning.
• If you accidentally touch the rubber seal, clean it with an alcohol wipe.
• Use needles only once.
• Do not share needles.

Measuring the Dose
The medication should be clear before you start. You may notice small, colorless particles in the Nutropin vial after it has been refrigerated. That's okay. These small particles are protein. The medication has not lost its effectiveness. Allow the vial to warm to room temperature, and then swirl it gently.

However, if the medication is cloudy or hazy, do not inject it. Return the cloudy Nutropin vial to your pharmacist or healthcare provider.

Nutropin AQ is supplied in a 10 mg vial. Write the date on the vial when you open it so you will remember when it was first opened and used. Before each use, check the expiration date printed on the vial label and make sure that the Nutropin AQ solution is clear. Do not use the vial of Nutropin AQ 28 days after initial use. It should be discarded.

Measuring a dose of Nutropin AQ
Follow these steps to measure a dose:

Wipe the top of the vial vigorously with an alcohol wipe.
Remove and save the plastic needle guard, and then draw air into the syringe by pulling back on the plunger. The amount of air should be equal to the dose.
Slowly insert the needle straight through the center of the rubber stopper of the vial and gently push the plunger to discharge the air into the vial.
Turn the vial upside down with the needle still in it and hold the vial in one hand. Be sure the tip of the needle is in the solution. Using your other hand, slowly pull back on the plunger in a continuous motion until the correct amount of solution is in the syringe. Try not to inject the medication back into the vial, as this could cause the solution to become cloudy or hazy.
With the syringe and vial still held upside down in one hand, gently tap the syringe to dislodge any large air bubbles. The bubbles will rise to the top of the syringe and can be pushed back into the vial by gently pushing in the plunger. Be sure the correct amount of medication remains in the syringe. If there were many bubbles that had to be pushed out of the syringe, you may need to withdraw more Nutropin solution.
When taking the last dose from a vial, insert the needle tip just past the rubber stopper. Turn the vial upside down and tilt it so that the needle tip is completely covered with solution. You may have to gently tap the vial to withdraw as much of the solution as possible. Do not inject cloudy or hazy medication; return it to your pharmacist or healthcare provider.
Remove the needle from the vial of medication. Be careful not to touch the needle. Your Nutropin solution is now ready to inject. The injection should be given as soon after filling the syringe as possible; do not store the growth hormone in the syringe.
To avoid sticking yourself when recapping the needle, set the needle guard on the table. Without touching or holding the guard, slide the needle into it and "scoop" it up. Then use your free hand to click the guard onto the syringe.

Selecting the injection site
It is very important to rotate the site of your Nutropin injections—that is, you should choose a different injection site each time you use the medication. The injection should not go very deep. It should be given in the subcutaneous space (the fatty layer just beneath the skin's surface).

The following areas are good injection sites because you will be able to grasp the right amount of skin needed for the injection:

Abdomen. The tissue below the skin of the abdomen absorbs medication readily. Injections in this area sometimes hurt less. Avoid giving the injection too close to the navel. Also, be careful to avoid giving the injection where a waistband might chafe and irritate the injection site.
Thighs. The front or outside of the thigh provides a good injection site. To locate this site, think of dividing the leg between the hip bone and the knee into thirds. The injection is given into the skin on the middle third on the front or outside of the thigh (but not into the muscle).
Buttocks. As with the abdomen, injections in the upper, outer area of the buttocks sometimes hurt less. The person receiving the injection should lie face down on a flat surface with toes pointed inward.
Upper arms. The largest part on the back portion of the arm may also serve as an injection site. Occasionally, a problem may develop at an injection site. Contact your healthcare provider if you notice any of the following:

• A lump that doesn't go away
• Bruising that doesn't go away
• Any signs of infection or inflammation at an injection site (such as swelling, pus, persistent redness or pain, or skin that is hot to the touch)

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Things to know before giving an injection
You can learn to give injections skillfully. However, no matter how routine the injections become, it is always important that you pay close attention to what you are doing at all times. Your healthcare team will give you hands-on training on how to give injections. The instructions below will provide you with a review of that training, but do not replace your healthcare provider as a source of information. Call them if you have any questions about giving an injection.

Follow these steps to give the injection:

Expose the injection site completely (never give an injection through clothing). Your healthcare provider will advise you on the skin cleaning technique they recommend. Here is one suggested tip: applying firm pressure, clean the injection site thoroughly with an alcohol wipe. Allow the alcohol to dry from the skin before inserting the needle.
Double-check that the correct amount of Nutropin is in the syringe, then remove the needle guard from the syringe. Hold the syringe the way you would hold a pencil.
Squeeze the skin between your thumb and index finger before and during the injection. Insert the needle into the skin at a 45°–90° angle with a quick, firm motion.
Slowly (taking a few seconds) inject the medication by gently pushing the plunger until the syringe is empty. Count to 5 and then remove the needle.
Withdraw the needle quickly, pulling it straight out, and apply pressure over the injection site with a dry gauze pad or cotton ball. You may gently massage the area for added comfort. A drop of blood may appear. Put a Band-Aid® on the injection site if you'd like.
Do not recap the needle prior to disposal. Safely dispose of plastic needle guards and all used needles and syringes as instructed by your healthcare professional and/or by following the steps outlined below.

Remember, your healthcare team is your primary source of information and care. They are available to help answer any questions you may have about treatment with Nutropin.

Ask your healthcare team about any possible side effects or unusual reactions that might occur because of the injections or the medication itself.

Disposing of used needles and syringes
For safety reasons, it's important to correctly dispose of plastic needle guards and used needles and syringes after you've given an injection. There may be special regulations in your state about what kind of containers can be used for needle disposal. Your healthcare team will instruct you on the proper disposal of items used for the injection. In addition, they may need to review special state and local laws with you.

To prevent injury, safely dispose of plastic needle guards and all used needles and syringes after a single use. To prevent injury:

• Do not recap the injection needle with the plastic needle guard prior to disposal.
• Safely dispose of the plastic needle guard and all used needles and syringes after a single use.
• Always store your disposal container out of the reach of children.

Band-Aid^® is a registered trademark of Johnson & Johnson.

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Storage and Maintenance

How to store Nutropin AQ
Nutropin AQ vial and cartridge contents are stable and may be used for 28 days after initial use when stored at 2–8°C/36–46°F (under refrigeration). Avoid freezing the vials and cartridges of Nutropin AQ. The vials and cartridges of Nutropin AQ should be protected from light. Store the vials and cartridges refrigerated in a dark place when they are not in use.

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